2021 Gauteng Health Annual Report

DEPARTMENT OF HEALTH
2020/21
GAUTENG PROVINCE
HEALTH
REPUBLIC OF SOUTH AFRICA
Human Resources for Health
Total Health
Workforce 81 946
CLINICAL PROFESSIONALS NURSING PROFESSIONALS
PROFESSIONAL
45
Dental Specialist
(Registrar)
NURSES
Dental Specialist 17 169

431 & Practictioner
Medical Specialist
1 267 (Registrar)
PROF NURSE STAFF
(STUDENT) NURSES
1 336 Medical
Specialist
576 7 944
4 245 Medical
Practitioner
Allied Professionals
8 904 & Support Staff
NURSING
ASSISTANT
SUPPORT STAFF 7 352

Lower
level (2-8)
21 612
ADMINISTRATION STAFF
MANAGEMENT PROFESSIONALS
Junior
LOWER management
(2-8) (9-10)
LEVEL (15)
4 LEVEL (16)
8 319
2 5
LEVEL 0
MIDDLE
1 700 (11-12) Level 0
249 129 LEVEL (13)

LEVEL (14)
83
JUNIOR
(9-10)
25
470 Engineering
Professionals
& Support
79
A snapshot of
Health Services
217 717 96 345

Children under Hypertension
1 year immunized visits
1 825 479
women of
reproductive
259 926
Antenatal care
age provided
contraceptives visits
56 643 38 107
New PHC
Assistive
clients
devices
treated for
provided mental health
disorders
87 181 101 300

Diabetic treatment Cervical
visits cancer
screening
43 555 221 1 022 840

HIV tests done. Patients enrolled on the
Centralised Chronic
1 136 662
HIV clients 26 878 Medicine Dispensing and
Distribution programme
remain on Patients treated
treatment (CCMDD)
for TB
Financial Inputs
Actual Expenditure
per Programme
CENTRAL
HOSPITAL
SERVICES
19 254 052
DISTRICT
HEALTH HEALTH
SERVICES CARE
SUPPORT
17 959 247 SERVICES
388 844
PROVINCIAL TOTAL HEALTH

HOSPITAL
SERVICES
EXPENDITURE SCIENCES
AND
9 905 850 57 712 377 TRAINING

787 210
HEALTH FACILITIES ADMINISTRATION

MANAGEMENT
3 695 016
4 041 357 EMERGENCY
MEDICAL
SERVICES
1 680 801
Gauteng Provincial Government | Vote 4: Department of Health | Annual Report 2020 - 2021 1
Gauteng Department of Health

Annual Report
Financial Year
2020/2021
PR215/2021
ISBN: 978-0-621-49615-4
2 Gauteng Provincial Government | Vote 4: Department of Health | Annual Report 2020 - 2021
01 PART A: GENERAL INFORMATION 3

1. General Information 4
2. Abbreviations and Acronyms 5
3. Foreword by the MEC of Health 7
4. Report of the Accounting Officer 8
5. Statement of Responsibility 15
6. Strategic Overview 16
7. Organisational Structure 18
8. Entities reporting to the MEC 18
Contents 9. Legislative and other mandates 18
02 PART B: PERFORMANCE INFORMATION 21

1. Auditor-General’s Report: Predetermined Objectives 22
2. Overview Of Departmental Performance 22
3. Achievements Of Institutional Impact And Outcomes 29
4. Institutional Programme Performance Information 30
4.1 Budget Programme 1: Administration 30
4.2 Budget Programme 2: District Health Services 39
4.3 Budget Programme 3: Emergency Medical Services 75
4.4 Budget Programme 4: Provincial Hospital Services 78
4.5 Budget Programme 5: Central Hospital Services 90
4.6 Programme 6: Health Sciences And Training (HST) 125
4.7 Budget Programme 7: Health Care Support Services (HCSS) 130
4.8 Budget Programme 8: Health Facilities Management (HFM) 134
4.9. Transfer Payments 140
4.10.Conditional Grants 142
4.11. Donor Funds 145
4.12.Capital Investment 151
03 PART C: GOVERNANCE 162

1. Introduction 162
2. Risk Management 162
3. Fraud and Corruption 162
4. Minimising Conflicts of Interest 163
5. Code of Conduct 163
6. Health Safety and Environmental Issues 163
7. Portfolio Committees 166
8. SCOPA Resolutions 167
9. Prior Modifications to Audit Reports 176
10. Internal Control Unit 176
11. Internal Audit and Audit Committees 176
12. Audit Committee Report 177
04 PART D: HUMAN RESOURCES 183

1. Introduction 184
2. Human Resources Oversight Statistics 185
05 PART E: FINANCIAL INFORMATION 207

Financial Information 207
Audit General Report 208
Report of the Auditor General 216
Appropriation Statement 218
Notes to the Appropriation Statement 283
Statement of Financial Performance 285
Statement of Financial Position 286
Statement of Changes In Net Assets 287
Cash Flow Statement 288
Accounting Policies 289
Notes to the Annual Financial Statements 295
Annexures to the Annual Financial Statements 320
06 PART F: GAUTENG MEDICAL SUPPLIES DEPOT 333

General Information 334
Report of the Accounting Officer 335
Report of the Auditor-General 342
Statement of Financial Position 349
Statement of Financial Performance 350
Statement of Changes In Net Assets 351
Statement of Cash Flows 352
Notes to the Annual Financial Statements 362
Report of the Audit Committee – Cluster 03 377
PART A
PART A:
GENERAL
INFORMATION
1. General Information
30 - 38 41 - 124 162 - 379

HOSPITAL AND GOVERNANCE,
ADMINISTRATIVE EMERGENCY HUMAN
OVERVIEW SERVICES FINANCIAL
4 -18 A performance 39 - 74 Performance of the

emergency 125-139
HEALTH CARE
A brief overview on
risk management,
ABOUT THE report outlining DISTRICT HEALTH medical services,
DEPARTMENT quality SUPPORT SERVICES human resources
SERVICES various categories of OVERVIEW statistics overview ,
improvement, hospital effeciency
technology financial
Information about and quality A brief overview on statements.
and transformation Performance of
the mandate, initiatives starting pharmaceutical,
agenda. the priority health
location and with hospitals that blood and supply
programmes
messages from the provide specialised, chain,
accessibility,
MEC and the tertiary care to human resources
treatment and
accounting officer quaternary health capacity
support provided
on performance of care services. development
at primary health
the department. facilities including initiatives and
reengineering of capital
the PHC system. investments.
Gauteng Provincial Government | Health | Annual Report 2020/2021
Physical Address:
45 Commissioner Street
Marshalltown
Johannesburg
2001
Postal Address:
Private Bag X085
Marshalltown
2107
South Africa
Telephone number: 011 355 3477

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
AARTO Administration Adjudication of Road Traffic Offences

AG Auditor-General
AGSA Auditor-General South Africa
AIDS Acquired Immune Deficiency Syndrome
ANC Antenatal Care
APP Annual Performance Plan
ART Antiretroviral Treatment
ARVs Antiretroviral Drugs
AYFS Adolescent and Youth Friendly Services
CCMDD Centralised Chronic Medicine Dispensing and Distribution
CDC Communicable Disease Control
CEO Chief Executive Officer
CFO Chief Financial Officer
CHBAH Chris Hani Baragwanath Academic Hospital
CHC Community Health Centre
CHW Community Health Worker
CMAH Charlotte Maxeke Academic Hospital
DGMAH Dr George Mukhari Academic Hospital
DHIS District Health Information System
DHS District Health System
DID Department of Infrastructure Development
DoH Department of Health (National)
DORA Division of Revenue Act
DPOS Daily Patient Opinion Survey Tool
ECC Emergency Communication Centre
ECD Early Childhood Development Centre
EHWP Employee Health and Wellness Programme
EMC Executive Management Committee
EMS Emergency Medical Services
EPI Expanded Programme on Immunisation
EPWP Expanded Public Works Programme
ESMOE Essential Steps to Manage Obstetric Emergencies
FY Financial Year
GAS Gauteng Audit Services
GDID Gauteng Department of Infrastructure Development
GDoH Gauteng Department of Health
GIAMA Government Immovable Asset Management Act
HAST HIV and AIDS, STIs and TB
HCSS Health Care Support Services
HCT HIV Counselling and Testing
HFM Health Facilities Management
HIV Human Immunodeficiency Virus
HOD Head of Department
HPV Human Papilloma Virus
HR Human Resources
HST Health Sciences and Training
ICT Information and Communication Technology
ILS Intermediate Life Support
IMCI Integrated Management of Childhood Illnesses

IMMR In-Facility Maternal Mortality Ratio
IMR Infant Mortality Rate
ISHP Integrated School Health Programme
IT Information Technology
LTFU Lost to Follow-Up
MCWH&N Maternal, Child, Women’s Health and Nutrition
MDGs Millennium Development Goals
MDR-TB Multi-Drug-Resistant Tuberculosis
MEC Member of Executive Council
MMC Medical Male Circumcision
MMO Managing Medical Officer
NDoH National Department of Health
NHLS National Health Laboratory Services
NIDS National Indicator Data Set
NIMDRTB Nurse Initiated Management of Drug-Resistant TB
NPI Non-Pharmaceutical Intervention
NPO Non-Profit Organisation
OHS Occupational Health and Safety
OPD Outpatient Department
PACS Picture Archiving and Communication System
PCR Polymerase Chain Reaction
PEC Patient Experience of Care
PFMA Public Finance Management Act
PHC Primary Health Care
PHOC Provincial Health Operations Centre
PMTCT Prevention of Mother-To-Child Transmission
PPE Personal Protective Equipment
PSI Patient Safety Incident
PWD People with Disabilities
QA Quality Assurance
RWOPS Remunerative Work Outside Public Service
SAC Severity Assessment Code
SAM Severe Acute Malnutrition
SBAH Steve Biko Academic Hospital
SCM Supply Chain Management
SDIP Service Delivery Improvement Plan
SITA State Information Technology Agency
SOP Standard Operating Procedure
STI Sexually Transmitted Infection
TB Tuberculosis
TR Total Revenue
UPFS Uniform Patient Fees Schedule
USAID United States Agency for International Development
WAN Wide Area Network
WBOT Ward-Based Outreach Teams
WHO World Health Organization
XDR-TB Extensively Drug-Resistant Tuberculosis
The advent of the COVID-19

pandemic has changed the
world and how it operates and
has challenged the ways in
which government conducts its
business.
3. Foreword by the
MEC for Health
The financial year under review is historic in that during this period between business, civil society
it takes place in an unprecedented context where organisations and government in the response to
the world is confronted by one of history’s greatest COVID-19.
medical crises. The advent of the COVID-19
pandemic has changed the world and how it Given the pressure on Human Resources as a
operates and has challenged the ways in which result of COVID-19, the Department has had to
government conducts its business. This period strengthen its workforce by creating additional
has also forced governments across the world to posts to aid in the COVID-19 response. This took
remodel their business strategies, on one hand place in the context of the permanent appointment
opening a world of opportunities, and on the of Community Health Workers as of July 2020,
other hand stifling progress and reversing some when the Department was able to implement the
of the gains that have been made. The Gauteng resolution. A total of 8 532 Community Health
Department of Health has been significantly Workers have been appointed as permanent
stretched and challenged in the previous year employees of the Department level 2 posts. These
to apply innovative strategies to providing health appointments are important as they answer the
services for the people of Gauteng. Areas of call for remuneration above the minimum living
service delivery that have been significantly wage.
affected and set back in this period include our
Primary Heath Care services, having seen a Improvement of governance and leadership in
significant decline in numbers of people accessing the Department has been a special priority for
our health facilities as a result of the hard the year under review alongside the provision of
lockdown that was introduced by President Cyril quality of health care. Efforts have been made to
Ramaphosa in March 2020. Notwithstanding the be responsive to the people served. Team effort
restrictions, innovations also emerged including has been a priority and has resulted in delegations
collaborations across sector departments, being reviewed in order to provide strategies
business and civil society never seen before, to improve Senior Management capacity by
which made the journey more bearable. The year implementing the fast-track approach to filling of
saw an enrolment in the Centralised Chronic vacant positions.
Medicine Dispensing and Distribution programme
of up to 1 022 840 patients with chronic health
conditions, exceeding the annual target with a
more than 26% increase in enrolment in year-
on-year comparison. It is for this reason that we Dr Nomathemba Mokgethi, MPL
continue to appreciate the partnerships forged Gauteng MEC for Health
31 July 2021
Despite COVID-19 pandemic,

the department continued
without fail to deliver essential
health services to the people of
Gauteng.
4. Report of the
Accounting Officer
4.1 Overview of the Operations of the Department
The current annual reporting season coincides service delivery in the financial year in question.
with the completion of the first phase of the This is evidenced by shifts in budgets to aid the
rollout of the COVID-19 vaccination project, response programme as well as amendments of
which saw Gauteng vaccinate a total of 65 881 some of the essential service targets, including
Health Care Workers, in both the public and declining patient volumes at health facilities.
private sector by the end of the financial year. The Department remained unwavering in its
This vaccination project is a culmination of the resolve to ensure that provision of essential
broader COVID-19 response strategy, which health care services in the province continues.
has been shaped by guidelines from leading Many lessons were learnt from the synthesis of
international organisations such as the World the literature review by the research committee
Health Organization and directives from the set up to advise on trends in research on
National Health Minister, Dr Zweli Mkhize and COVID-19 as a novel virus. Emphasis from
the COVID-19 Ministerial Advisory Committee. the literature was on ensuring a balance in the
provision of essential services whilst focussing
The Gauteng Department of Health has since on the COVID-19 response programme, and
the advent of the virus on our shores been some lessons which the Department embraced.
vigilant and conscientious in guiding the
province-wide COVID-19 Response Strategy Provision of essential services was under
through the Provincial Command Centre severe strain for the first two quarters of the
supported by the Office of the Premier and 2020/2021 financial year and only started
other sector departments. Our strategic goal improving with the easing of lockdown to level
to build a health care system that is patient- 1 in the last quarter. Consequently, whilst the
centred, clinician-led and stakeholder driven is overall performance of the essential health
the anchor and guiding force of the work that we services improved, it was however impacted
do as a Department. As a result of this resolve, by these restrictions. To this end, the volume of
the Department benefited from support from a clients seen at Hospital Outpatient Departments
range of stakeholders including business in its (OPDs) was approximately 26 million during
response to COVID-19. the year under review, as compared to 27.3
million in the previous financial year, which
The context of the COVID-19 pandemic has shows a decrease of 4.5% of patient headcount
affected the Department’s broader goals of presenting at hospital OPDs.
In the 2020/2021 financial year, a 20.4% The neonatal death in facility rate was 11.8 per
decrease in the volume of client visits at Primary 1 000 live births in 2019/2020 compared to 12
Health Care (PHC) facilities was observed, from per 1 000 live births in 2020/2021.
21.3 million patient visits accounted for during
the 2019/2020 financial year to 16.9 million In terms of Maternal, Child and Women’s Health,
patient visits in the year under review. a total number of 164 576 (63.3%) pregnant
women visited PHC facilities for first antenatal
Access to care has however been bolstered by care bookings before 20 weeks, compared to
increasing and maintaining the operating hours 180 229 (66.5%) in 2019/2020. The In-Facility
of major PHC facilities to 24-hour services and Maternal Mortality Ratio (iMMR) in 2019/2020
enrolments of clients to receive medicines from was 245 per 100 000 live births compared to
the Centralised Chronic Medicine Dispensing 294 per 100 000 live births in 2020/21.
and Distribution programme, which allows
clients flexibility to collect their medicines from The neonatal death in facility rate was 12.4 per
the nearest shopping malls and health facilities. 1 000 live births in 2019/2020 compared to 13.2
In this regard, all Community Health Centres in 2020/2021. The number of children who died
(CHCs) in the province are providing health of Severe Acute Malnutrition (SAM) in health
services for 24 hours per day, while enrolments facilities was 94 (10.3%) in 2019/2020 compared
in the medicine programmes increased to 75 (9.2%) in 2020/2021. The Expanded
significantly up to 1 022 840 enrolments. Programme on Immunisation saw a decrease
The latter exceeded the annual target of of 2.2% in the financial year under review, with
enrolments by over 26%, based on year-on- the coverage rate of immunisation for children
year performance comparison. Provision of care under one year of age being at 85% (217 717),
through quality-driven PHC facilities remained compared to 87.2% (226 893) in 2019/2020.
critical, thus assessments of the quality of The measles second dose coverage rate is
PHCs continued, with 89% of PHCs assessed recorded as 77.8% (198 630) in the period under
achieving the Ideal Clinic status. review, as compared to 79.8% (205 103) in the
previous financial year, reflecting a decline in
In the previous financial year, the Department performance. Both of these declines are related
was confronted by numerous challenges to the COVID-19 restrictions.
relating to service delivery, in particular a rise
in Patient Safety Incidents (PSIs), with some In the financial year under review, a total of 299
ending up on the media platforms. These out of 43 430 (0.69%) infants tested positive
challenges also led to some setbacks in our for Polymerase Chain Reaction (PCR) around
responsiveness to improving patient experience 10 weeks, compared to 41 294 (0.71%) in
of care as a priority area. Notwithstanding this, 2019/2020. Efforts to intensify infant testing are
the patient experience survey carried out on the being implemented and strengthened across all
aforementioned areas has seen improvement in Health Districts.
a number of areas that patients had previously
complained about, such as cleanliness and In terms of HIV/AIDS, STI and TB, 4 355 221
staff attitudes. More emphasis will however be total tests were done for HIV during 2020/21,
placed on the area of PSIs to ensure that data- as compared to 5 176 849 tests done during
driven interventions are implemented. 2019/2020. The total tests done declined
by 16% during 2020/21 as compared to
A diagnostic evaluation of PSIs and a safety 2019/20. HIV services were also affected by
campaign will be embarked upon in the new the emergence of the COVID-19 pandemic in
financial year to ensure that this important focus March 2020. A total of 1 260 124 HIV tests were
area of improving patient experiences is upheld done during January through to March 2021. As
to guide areas of intervention. at the end of March 2021, the total tests done
for HIV amounted to 4 355 221 and exceeded
The Department has missed some of its targets, the set target of 3.5 million tests. The number
and in the year under review certain gains that of Antiretroviral Treatment (ART) adult clients
have been made over the years have been remaining in care as at the end of March 2021
reversed due to the pandemic’s stalling of health stands at 1 114 157 and remains below the set
services for the people of Gauteng. target of 1 452 199.
Regarding COVID-19, our recovery rate is an Fraud, Security and Risk

impressive 97%, with the case fatality rate
for the same disease being 2.5%, which is In the financial year under review, the Department
certainly below the National average of 3%. has made significant investments in the areas
Most COVID-19 patients and their contacts of fraud, security and risk management. As the
were traced and monitored for the mandatory Accounting Officer, the responsibility to ensure
prescribed period of 10 days. Over 4.2 million that the Department complies with Section 38
citizens of Gauteng were screened for COVID-19 of the Public Finance Management Act (PFMA),
and of these, over 790 000 tested positive for by proactively identifying fraud and risks and
the disease. implementing mitigation strategies to minimise
or curb fraud and corruption, and takes this very
Slow progress was noted on the modernisation important task to ensure ethical governance
of the health system through upgrading of the very seriously. Our strategy considers all fraud
Information and Communications Technology and risks identified, which are then approved by
(ICT) infrastructure, which was largely due to our Executive Management Committee (EMC)
external factors. Urgent acceleration and focus and actioned as prescribed by the leadership of
will be placed on this area due to its importance the EMC.
in improving business process efficiencies, During the 2020/21 performance year, the
effectiveness and governance. following categories of fraud and risks were
identified for mitigation and elimination:
The health sector is resource intensive and at
times the demand exceeds the supply. Provision Fraud:
of additional capacity of Human Resources for • Security vetting for all senior managers
Health during the COVID-19 response was one • Declaration of Remunerative Work Outside
of the hallmarks of the response programme Public Service (RWOPS)
which made the fight possible. Additional HR • Supply Chain Management (SCM)
posts, both clinical and administrative were irregularities
created to improve capacity at the coalface. • Human Resource irregularities
A total of 7 374 posts were created during • Employees doing business with organs of
2020/2021 at a cost of R1 536 226 991. the state
• Theft, irregular, fruitless and wasteful
With regard to Chief Executive Officer (CEO) expenditure
vacancies, the Department started the year with
seven acting CEO positions at the following Risks: The Department identified five categories
hospitals: Thelle Mogoerane, Jubilee, Helen of risks and developed action and mitigation
Joseph, Rahima Moosa Mother and Child, plans to curb and mitigate them in the 2020/21
Heidelberg, Bertha Gxowa and Tshwane District. financial year. These categories are:
Three of the said posts were filled at the end of
March 2021 for the following hospitals: Thelle Strategic and Operational Risks – i.e. risks
Mogoerane, Helen Joseph and Rahima Moosa emanating from potential failure to achieve the
Mother and Child. Recruitment is underway to key priorities, whilst operational defines those
fill the Heidelberg, Bertha Gxowa and Tshwane that relate to the achievement of Departmental
District hospitals. objectives for the current administration.
The COVID-19 pandemic impacted the ability to COVID-19 Risks – i.e. risks which focus on the
fast-track the Department’s capacity to fill critical work that has not been completed, including
posts. The Department has defined a staffing procurement and all other matters related to the
strategy to ensure that all Senior Management state of health facilities and services in dealing
Services vacant positions are filled before the with increasing COVID-19 infections in the
end of the first quarter of the new financial year, province.
in order to contribute towards the stabilisation of
the Department. ICT Risks – i.e. risks which look at the status of
action plans for Information and Communication
Technology across the entire Department.
Compliance Risks – i.e. risks which focus on the number of pieces of legislation that needed to be
complied with, whereby 16 were identified for this financial year.
Emerging Risks – i.e. risks which look at what could negatively impact on the organisation’s ability
to achieve its stated objectives, which the Department must at all times manage. Failure to comply
with the Occupational Health and Safety Act was another area of major concern.
4.2 Overview of the Financial Results of the Department

The impact of COVID-19 was also felt in the collection of revenue during the year under review.
Revenue collected in the 2020/2021 financial year amounted to R513 million, which represents the
lowest amount collected by the Department over the past three years. The collection comprises
patient fees (R359 million: 71% of the total) and other revenue (R154 million: 30% of the total). The
year-to-date total revenue collection for 2020/21 decreased by R214.4 million (42%) when compared
to the 2019/20 collection of R728.2 million.
The major reasons for the decrease in revenue collection during the 2020/21 financial year are
attributed to the lockdown restrictions in the country as a result of the COVID-19 pandemic. This has
negatively affected revenue collection in the following ways:
• Road Accident Fund offices were closed due to the lockdown, resulting in claims not being
processed.
• Later than anticipated implementation of Uniform Patient Fees Schedule (UPFS) Tariffs for the
2020/21 financial period.
• Decreased number of patients seen in the hospitals impacting on revenue collected from other
state departments, medical aids and self-paying patients.

The following is a breakdown of revenue collected per source.
Departmental Receipts
Departmental 2020/2021 2019/2020
Receipts
Estimate Actual (Over)/Under Estimate Actual (Over)/Under
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 463 729 464 512 (783) 502 355 628 775 (126 420)
Transfers received 69 178 (109) 0 0 0
Fines, penalties
and forfeits 1 582 20 1 562 62 53 9
Sales of capital
assets 0 11 147 (11 147) 0 4 301 4 301
Interest, dividends
and rent on land 0 398 (398) 1 502 913 589
Financial
transactions
in assets and
liabilities 34 620 37 532 (2 912) 32 877 94 204 (61 327)
Total 500 000 513 787 (13 787) 536 796 728 246 (191 450)
Tariff Policy
Patient Fee tariff

The Department charges the UPFS tariffs for patients using public hospitals. The UPFS tariffs
are determined by a UPFS Steering Committee consisting of the National Department of Health
and the nine provinces; furthermore, these tariffs are endorsed by the National Health Council.
Tariffs are reviewed and revised annually in • Persons with mental disorders (Mental
accordance with Section 7.3.1 of the Treasury Health Act 18 of 1973)
Regulations issued in terms of the Public • Infectious, formidable and/or notifiable
Finance Management Act No.1 of 1999 and diseases (National Health Act 61 of 2003)
Section 41(1) and (2) of the National Health Act, • Services to formally unemployed
61 of 2003. (Unemployment Insurance Act 63 of 2001)
• Patients receiving HIV and AIDS treatment
Patients accessing public institutions are (Notice 1 of August 2006)
classified into three main groups for the
purposes of service fee determination. Meals and Crèches Fees Tariffs
i. Full Paying The tariffs for meals and crèches are reviewed and
revised annually in accordance with section 7.3.1
This category of patients is liable to pay full of the Treasury Regulations issued in terms of the
UPFS fees for all services provided. Public Finance Management Act No.1 of 1999.
Tariff adjustments are also negotiated and agreed
ii. Subsidised and Exempted Patients upon with employee organisations.
These patients are categorised into six
categories based on statutory requirements: Other Tariffs
PG, HG, H0, H1, H2 and H3. The PG and
HG categories are exempted from paying Other tariffs such as parking and accommodation
fees due to specific circumstances which are determined externally with the involvement of
are statutory based, such as pregnancy and relevant departments.
children less than six years of age. The H0
category receives services free of charge only Patient Fees Debt
when proof of status is provided i.e. social
pensioners. The H1, H2 and H3 categories The debt written off for the 2020/21 financial year
pay discounted fees, which are expressed amounts to R304 764 000. Debts are written off in
as a percentage of the fees payable by full accordance with the Department’s policy and after
paying patients. the Department has taken all reasonable steps to
collect the debt owed. The following are some of
iii. Free Services the debt categories written off:
Free services are provided in line with • Uneconomical debts: where the cost of
the National and Provincial policies. The recovery of the debt is more than the debt;
following free services are provided by the • Undue hardship: wherein the recovery of the
Department: debt will result in undue hardship;
• Free health services for pregnant women and • Prescribed debts: debts that are prescribed
children under the age of six years (Notice as a result of the Department not being able
657 of 1994, 1 July 1994) to make contact with debtors.
• Free primary health care services (Notice
1514 of 1996, 17 October 1996)
• Termination of pregnancy (Act 92 of 1996)
• Social pensioners (Act 81 of 1967 as
amended by Act 100 of 1998)
• Medico-legal service for survivors of rape
and assault and for post-mortem (Criminal
Procedure Act 51 of 1977)
• Donors (Human Tissue Act 63 of 1965)
• Children who are committed to the care of
a children’s home, industrial school or foster
parents (Child Care Act 74 of 1983, Section
15)
Overview of expenditure per budget programme
The Department spent 98% of the overall appropriated budget of R58.8 billion during the 2020/2021 financial year.
The reported percentage spend resulted in underspending of R1.1 billion for the year.
Programme 2020/21 2019/20

Final Actual (Over)/Under Final Actual (Over)/Under
Appropriation Expenditure Expenditure Appropriation Expenditure Expenditure
R’000 R’000 R’000 R’000 R’000 R’000
Administration 3 697 845 3 695 016 2 829 1 482 145 1 481 446 699
District Health
Services 18 366 611 17 959 247 407 364 16 557 681 15 895 452 662 229
Emergency
Medical Services 1 681 370 1 680 801 569 1 541 714 1 539 781 1 933
Provincial Hospital
Services 9 942 279 9 905 850 36 429 9 274 405 9 224 458 49 947
Central Hospital
Services 19 612 633 19 254 052 358 581 19 111 200 19 064 441 46 759
Health Sciences
and Training 901 268 787 210 114 058 1 151 743 1 045 256 106 487
Health Care
Support Services 391 264 388 844 2 420 369 788 368 944 844
Health Facilities
Management 4 242 233 4 041 357 200 876 2 090 143 2 053 885 36 258
Programme
Sub total 58 835 503 57 712 377 1 123 126 51 578 819 50 673 663 905 156
4.3 Virements/Rollovers 4.4 Supply Chain Management

The Department applied for virements of funds to There were no unsolicited bids during the year
alleviate reported excess expenditure within and under review. Due to limited review of policies and
across main divisions of a Vote (i.e. Programmes). interpretation-related challenges of the regulations
Virements of funds were from Programme 2: District within SCM, there were inconsistencies in the
Health Services, Programme 4: Provincial Hospital application of procurement policies.
Services, Programme 5: Central Hospital Services,
Programme 6: Health Sciences and Training and During the year under review, tender irregularities
Programme 8: Health Facilities Management amounting to R3.9 billion were incurred specifically
to Programme 1: Administration, Programme 3: on projects relating to COVID-19 and extension
Emergency Medical Services and Programme 7: of contracts related to security and consignment
Health Care Support Services. stock, amongst others. The Department
anticipates having its projects on tender process
The Department also applied for a rollover of completed during the third quarter of the financial
conditional grant funds that were committed but year to address the irregularities and is also in the
could not be processed for payment before the process of obtaining approval from Treasury for the
closure of the 2020/21 financial year. This rollover condonation of irregular expenditure.
was applied for machinery and equipment from
Programme 2: District Health Services, Programme Out of the R3.9 billion irregular expenditure,
4: Provincial Hospital Services and Programme 5: R2.3 billion constitutes the COVID-19 Personal
Central Hospital Services. Furthermore, a rollover Protective Equipment (PPE) procurement which
application on equitable share was made towards is being investigated by the Special Investigating
the non-negotiable items such as medicine, Unit. A further R1.3 billion is a result of the month-
laboratory services and consumable supplies. to-month extension of security contracts and
consignment stock contracts that have not gone 4.7 Events after the reporting date
through the tender process. Infrastructure-related
projects amounting to R762 million will be reported
as per directive or guidelines from Treasury. The Department suffered fire damages at the
The Gauteng Department of Infrastructure Charlotte Maxeke Academic Hospital. This will
Development (GDID) as the implementing be disclosed as a non-adjusting event in the
agent will report on expenditure incurred in this Annual Financial Statements. The financial loss
regard, in line with the preliminary audit report and damages suffered cannot be estimated
issued for the Department of Infrastructure at this stage. A newly renovated, refurbished
Development (DID) for the financial year ending Anglo Ashanti Hospital was completed with the
31 March 2021. completion certificate issued before 31 March
2021. There were however a few cosmetics or
Fruitless and Wasteful Expenditure some snagging that were done after year end.
This event will be disclosed as an adjusting
The Department incurred an overall amount of event on the Annual Financial Statements.
R224 million in fruitless and wasteful expenditure
for the year under review. The amount constitutes 4.8 Acknowledgements and
payments made on over-priced PPE-related
inventory. Included in the R224 million balance
Appreciation
is interest paid on late settlement amounting to
The Department remains committed to its
R1.5 million for medico-legal claims.
constitutional mandate and remains resolute
in not wasting any crisis by pursuing its priority
4.5 Gifts and Donations received in of being a health care system that is patient-
kind from non-related parties centred, clinician-led and stakeholder driven,
amongst other priorities. The work done by foot
soldiers, our clinicians and support services
Donor Funds Received
workers at the coalface will never go unnoticed.
These are the true heroes of our nation and they
Donor assistance includes both cash and in-kind
will forever be appreciated. The administration
contributions. Reporting on donor assistance
will do all in its power to ensure that the coalface
requires substantial improvement considering the
is supported. Partnerships from business and
lack of sufficient funding information received in
sector departments including development
prior financial years from institutions.
partners have gone a long way in ensuring a
successful COVID-19 response, the outcome of
The Department received donations of R80 million
which would have been different without these
worth of assets for the year under review from
helping hands.
various donors. The donors that made contributions
towards better health services for patients include
but are not limited to: SAME Foundation, Defy
Appliances, United States Agency for International 4.9 Approval and sign off
Development (USAID), Abela Africa, Phoenix
Neomed, Class Three Medical Solutions (Pty) Ltd,
Johannesburg Expo Centre, BMW South Africa,
3G Relocations, WECO (Pty) Ltd, Makro, Isibani
Development Partners and 2Care4Cares.
Dr S. Zungu
Acting Accounting Officer
4.6 Exemptions and deviations Gauteng Department of Health
received from the National 31 July 2021
Treasury
During the year under review, an instruction Note
5 of 20/21 was released by National Treasury
for instruction on procurement of emergency
resources in response to the National State of
Disaster. This assisted in regularising pricing.
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 the 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
2021.
Yours faithfully
Dr S. Zungu
Acting Accounting Officer
31 July 2021
6. Strategic Overview
Vision
A responsive, value based and
people centred health care
system in Gauteng.
Mission
Transforming the health care system, improving the quality,
safety and coverage of health services provided, focusing on
primary health care, strengthening public health education
and health promotion, and ensuring a responsive, innovative
and digitally enabled health system.
Values
H Humane Value system of Ubuntu/Batho Pele as whole, health
restores human dignity
E Effeciency Value for money, efficiency in delivery, etc. in line with
Batho Pele
A Accountability Good governance, being responsible for our actions,
respecting public resources
L Legality Respect for the Rule of Law, policies and regulations
T Transparency Openness to scrutiny, keeping communities engaged in
their own health accessibility informative & empowering
the public with especially about how we govern
H Honest Basic principles and commitment to honesty
I Integrity Ethics, quality, reliability etc.
GAUTENG PROVINCE
HEALTH
7. 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.
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

Medical Supplies Depot (MSD) Registered as ‘The The depot charges a levy The MSD is responsible
Central Medical Trading of 5% on stock supplied for the supply of essential
Account’ since 1 to the Provincial Health medicines and disposable
April 1992 under the Care facilities. sundry items to the Gauteng
Exchequer Act, Act 1 of Provincial Health Care
1976. facilities.
9. Organisational Structure
MEC FOR HEALTH

Dr N. Mokgethi
HEAD OF
DEPARTMENT
Dr. S. Zungu
DDG HUMAN
CHIEF DIRECTOR: DDG CLINICAL CHIEF OF CHIEF DIRECTOR: CHIEF FINANCIAL RESOURCES &
ICT SERVICES OPERATIONS STRATEGIC OFFICER ORGANISATIONAL
Mr L.A. Malotana PLANNING DESIGN
Mr S. Cave Dr F. Kgongwana Ms T. Adelekan Ms L.Madyo Mr S. Cave
(Acting) (Acting) (Acting) (Acting)
1 022 840 clients were put on the

Centralised Chronic Medicine Dispensing
and Distribution programme, which allows
clients flexibility to collect their medicines
from the nearest shopping malls and
health facilities. Over 4 million HIV tests
were conducted and up to 80% of the
health care users were happy with our
health services.
PART B
PART A:
PERFORMANCE
INFORMATION
Part B: Performance Information

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 of the report dealing with the
legal and regulatory requirements section of the Auditor-General’s report.
Refer to page 208 of the Report of the Auditor-General, published as Part E: Financial Information.
2. OVERVIEW OF DEPARTMENTAL PERFORMANCE
2.1. SERVICE DELIVERY ENVIRONMENT
The Gauteng Department of Health has been confronted with numerous challenges linked to
the emergence and persistence of the COVID-19 pandemic in the 2020/2021 financial year. The
first confirmed case of COVID-19 in South Africa was reported on 5 March 2020 in Gauteng and
subsequently to this, the World Health Organization then declared COVID-19 a pandemic on 12 March
2020. The Department has been in the forefront of the Provincial COVID-19 Response Strategy,
which has seen the Gauteng Provincial Government fairly wade the COVID-19 storm. The context of
the pandemic has presented significant challenges for service delivery in the Department, especially
under the circumstances presented by the lockdown regulations. There has been a regression in
the rendering of Primary Health Care services and the overall performance of the Department in
Gauteng since the advent of the pandemic.
However, the Department continues to ensure that essential services are provided to the people of
Gauteng. The Department has ensured that services that needed to be provided in the period under
review remained a priority, and that attention was not shifted to COVID-19 only. For example, the
Department has invested in HIV Testing Services (HTS) by ensuring that a total of 4 355 221 clients
are tested for HIV, and that clients who are tested positive for HIV are immediately put on treatment,
therefore applying the Universal Test and Treat (UTT) Policy. As such, a total of 1 1155 74 clients
across the province of Gauteng are currently on ART.
The provision of integrated school health services declined drastically from 79 885 during the 2019/20
financial year to 49 365 in 2020/21. This decline is attributed to the COVID-19 pandemic, which
resulted in a complete lockdown and school closure across the province, meaning the provision of
these school health services could no longer be rendered. This is evident between April and August
2020, where there were little or no services taking place with regard to school health.
During this reporting period, the Department has provided integrated school health services to a total
of 49 365 school learners across the province. The health services provided include deworming,
immunisations, eye care, hearing problems, oral health, speech problems and Td dose. The number
of learners screened for various health conditions decreased from 128 579 in 2019/20 to 22 866 in
this current reporting period. From the 22 866 learners screened, 3 890 learners were referred for
eye care, speech problems, oral health and hearing problems. Only two learners were referred for
suspected TB. The Department continues with its school health interventions to ensure that children
are fully immunised, and their weight is observed. This includes immunisation of 291 children, and
weight assessments conducted, with 867 learners measured to be overweight and 209 learners
diagnosed as underweight.
Table 2.1.1: Integrated school health services

Type of service 2020/21 2019/20
School learner is given a deworming dose 36 549 16 496
School learner immunised 291 1 626
School learner overweight 867 4 542
School learner referred for eye care 982 10 098
School learner referred for hearing problems 137 1 202
School learner referred for oral health 2 748 22 037
School learner referred for speech problems 23 265
School learner referred for suspected TB 2 157
School learner underweight 209 1 242
Td dose at 12 years 3 681 9 616
Td dose at 6 years 3 876 12 604
TOTAL 49 365 79 885
With the easing of lockdown regulations and opening of the schools, improvements are observed
in the rehabilitative service provision of various assistive devices aimed at enhancing the quality of
life of clients. The issuing of hearing aids has dropped from 80.7% in the previous financial year to
79.8% in this reporting period. The issuing of wheelchairs has increased from 87.7% to 88.9%, whilst
issuing of prostheses also increased from 52.2% to 56.3% in the 2020/21 financial year.
The overall provision of rehabilitative services increased from 79.1% in the previous financial year to
84.2% in the 2020/21 financial year. The table below shows the devices issued and requested, and
the issue rate for the reporting period.
Table 2.1.2: Assistive devices requested and issued in 2019/20 and 2020/21
Number issued Requested Issue rate
Devices 2019/20 2020/21 2019/20 2020/21 2019/20 2020/21
Hearing aids 6 436 2 744 7 980 3 440 80.7% 79.8%
Orthosis 26 575 18 569 27 767 19 192 95.7% 96.8%
Podiatry 1 819 1 550 2 303 1 560 79% 99.4%
Prostheses 1 025 888 1 965 1 576 52.2% 56.3%
Walking aids 38 226 29 783 n/a n/a n/a n/a
Wheelchairs 4 639 3 109 5 288 3 499 87.7% 88.9%
Total 78 720 56 643 45 303 29 267 79.1% 84.2%
During this reporting period, the province has recorded 414 261 COVID-19 cases with 401 457
recoveries. The new cases reported at the end of March 2021 amounted to 390. The total number of
reported COVID-19 related deaths in the province amounted to 10 318. By the end of March 2021,
the total number of active cases across the province was 2 486.
Table 2.1.3: Breakdown of COVID-19 cases

District Cumulative New cases Deaths Recoveries Active cases
cases
City of Johannesburg 163 665 146 3 249 159 527 889
City of Tshwane 109 278 105 2 982 105 613 683
Ekurhuleni 88 909 72 2 404 86 053 452
Sedibeng 24 605 43 812 23 515 278
West Rand 24 274 24 795 23 319 160
Unallocated 173 0 76 97 0
Address outside Gauteng 3 357 0 0 3 333 24
TOTAL CASES 414 261 390 10 318 401 457 2 486
Source: NICD report as at 31st March 2021
COVID-19 Screening and Testing
The total number of people tested for COVID-19 in Gauteng Province from April 2020 to March 2021
is 3 234 197, which contributes a 33% testing rate at national level. From the 3 234 197 tested, those
who tested positive for the virus amounted to 413 593. The COVID-19 testing rate in the province at
the end of March 2021 was 13.9%.
All contacts of primary cases are identified, monitored and undergo a mandatory COVID-19 testing.
Contacts of clients who are tested positive for the virus are duly requested/encouraged to quarantine
themselves to prevent them from spreading the disease. The South African National Defence Force
was deployed in the province and played a critical role in the tracing of COVID-19 contacts through
telephonic calls.
COVID-19 Vaccination Rollout
The Provincial vaccination rollout plan was developed. The first phase was the vaccination of Health
Care Workers (HCWs) who work in both public and private health care facilities. The vaccination
took place across a selected number of vaccination sites. As of the 31st of March 2021, GDoH
had vaccinated a total of 65 881 HCWs across the province. The second phase of the vaccination
programme will focus on the elderly (50 years and above) people across the province and those with
chronic illnesses.
Risk Communication and Community Engagement
Risk communication and community engagement is one of the most important interventions that
has been internally instituted by the Department. Amongst other activities, this entails continual
communication to the public about the need and the importance of Non-Pharmaceutical Interventions
(NPIs) against the COVID-19 disease, which included washing of hands, sanitising with 70% or more
of alcohol solution, wearing of masks especially when people are within the public domain, social
distancing by 1.5 metres and, lastly, avoidance of closed and crowded confines. The messages are
shared through pamphlets, posters, radio stations, television and different social media platforms.
2.2. 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 2.2.1 Main services and standards: Mental health services

Main services / Beneficiaries Current/actual Desired standard Actual achievement
Activities standard of service of service
Seamless • Mental health care Secondary level refers Seamless integration of All the five districts
integration of users patients with mental secondary level mental have integrated
mental health • Families of mental health conditions to health care services intomental health services
services into PHC health care users psychiatric clinics PHC. as district mental
• Mental health care within the CHC without health teams (District
practitioners initiating treatment. Specialist Mental
Health Teams, Clinical
25 district mental health Establishment of district Community Psychiatric
teams to be established mental health teams Teams, and NGO
in 2020/21 Governance and
Compliance Teams)
have been appointed.
Other districts are
still in the process
of completing the
appointments of other
team members.
25 teams have been

established in all the
districts
Early detection • Mental health care 100% of PHC visits to 100% of PHC visits to 100% of PHC visits are
of mental illness users be screened for mental be screened for mental screened for mental
and initiation of • Families of mental illness illness illness
treatment at PHC health care users
level • Mental health care
practitioners
Increased number • Mental health care Severe shortage Provision of 72-hour Renovations completed
of acute beds for users of acute beds in assessments in general at the following
admission of mental • Families of mental general hospitals hospitals. hospitals: Helen
health users in health care users because of lack of Joseph, Jubilee,
general hospitals • Mental health care suitable infrastructure. Provision of care, Charlotte Maxeke,
Refurbishment of treatment and Sebokeng (Male ward),
practitioners
psychiatric wards in rehabilitation for acutely Tambo Memorial and
general hospitals ill mental health care Dr George Mukhari
users. Academic Hospital
Refurbishment of
psychiatric wards in
general hospitals.
Table 2.2.2: Batho Pele arrangements with beneficiaries

Current/actual Desired arrangements Actual achievements
arrangements
Mental health care Professional standards
services Services provided by professionals registered Services provided at the hospitals and at PHC
with a professional body in accordance with facilities are all provided by professionals
their scope of practice registered with a professional body and in
accordance with their scope of practice
Legal standards
Mental health services are governed mainly Guidelines developed at Provincial level are
by the Mental Health Care Act, No. 17 of 2002 aligned with legal standards.
(amended in 2007).
The National Mental Health Policy Framework The Province has begun to implement the
and Strategic Plan 2013–2021 (NMHPF & SP strategy: Mental health teams have been
2013–2020) is the model used in South Africa appointed in the districts. Some of the
to deliver mental health care services. hospitals (acute mental health units) have
A costed and ratified Gauteng Province been refurbished. Hospital posts have been
Mental Health Strategy and Action Plan created and hospitals are in the process
(2019–2023) is in line with the National Mental of appointing staff. Registered counsellors
Health Policy Framework and Strategic Plan have been appointed in Johannesburg
2013–2020 as well as the Provincial Mental District to strengthen mental health services.
Health Directorate as stipulated Strategic Plan A Medical Specialist post has been created
for the strengthening of the Mental Health
Directorate. HR: Organisational Development
is working on obtaining approval from DPSA
of a Chief Director post for mental health
services.
Consultation
Regular meetings are held with non- Yearly and quarterly meetings were held
governmental organisations providing with various stakeholders, although some
mental health services, civil society, meetings were disturbed by the COVID-19
advocacy groups, contracted care and other pandemic.
stakeholders.
Intersectoral collaboration through quarterly
meetings with other relevant Departments.
Access
Mental health services are available at clinics, Mental health care users are able to access
CHCs and at District, Regional, Tertiary and care, treatment and rehabilitation at all levels
Central hospitals in accordance with the of care as prescribed by the Act.
Mental Health Care Act NO 17 of 2002.
Courtesy
SAPS assists with uncontrollable and Provision of services by SAPS and EMS as
violent mental health care users in need of and when required.
admission. EMS assists with users in need of
sedation and transportation to hospitals.
Service standards
Services are delivered in accordance with the Provision of services within existing legal
legal frameworks that govern mental health frameworks.
including the Gauteng Mental Health Strategy
and Action Plan.
Value for money
Services are offered free to patients It is a free service to the mental health care
users, which is vital to assist them to achieve
their full potential.
Table 2.2.3: Service Delivery Information Tool

Current/actual Desired information tool Actual achievements
information tool
Mental Health Care Information Promotional material such as posters and
Services Information is provided to patients in a pamphlets are available in English, Afrikaans,
number of official languages. isiZulu and Setswana.
Table 2.2.4: Complaints Mechanism

Current/actual Desired complaints mechanism Actual achievements
complaints mechanism
Provincial Complaints sub- Provincial Complaints sub-directorate in the Mental health practitioners provide support
directorate in the Quality Quality Assurance Directorate deals with and assistance during investigations of
Assurance Directorate mental health complaints reported cases.
deals with mental health
related complaints
NDoH refers some None All complaints referred by NDoH are
complaints to the province successfully addressed.
Office of Health Standards None All complaints referred by OHSC are
Compliance (OHSC) refers successfully addressed.
complaints to the province
Table 2.2.5: Complaints Mechanism: Communications

Current/actual
complaints Desired complaints Actual achievements
Daily monitoring of social To resolve complaints timeously Complaints are rerouted to Directorates/
media networks Hospitals/District Offices for resolution.
Complaints through media To reduce the number of complaints through Timeous response to media enquiries in
enquiries media. manner that addresses issues.
2.3 ORGANISATIONAL ENVIRONMENT
During the financial year under review, although the Department continued to render services in line
with its core mandate, the Department experienced an overall decline in the coverage of various
services and volumes of patients who accessed health facilities. The impact of COVID-19 related
restrictions also ultimately affected the outputs of various strategic priority programmes.
Various Executive management positions were vacated, namely the MEC, Head of Department and
Chief Financial Officer following allegations of impropriety with regard to the public finances use of
COVID-19 personal protection equipment (PPE). Suspensions were also meted against the Chief
Director of Supply Chain Management and Human Resources Deputy Director General. This has
resulted in the Department being run largely by an executive in acting capacity.
Key COVID-19 response plans were incorporated into the Department’s 2020/21 Annual Performance
Plan (APP) and tracked as part of the routine health services of the Department. The following Pillars
guided the response to the pandemic. These included the following:
• Establishment of a Command Centre through a multisectoral coordination of support from all
sectors led by the Office of the Premier.
• Enhancement of existing tracking and tracing teams for rapid case investigations with the support
of development partners and business sectors.
• Upscaling screening and testing to further support case investigations.
• Collaboration with both private and public sector laboratories and facilities.
• Ensuing that there is continuous provision and supplies of protective clothing for frontline HCWs.
• Ongoing research and evaluations to help provide evidence-based insights related to the
improvement of the current plans and future preparedness plans.
Following the declaration of the coronavirus as a pandemic in March 2020, the province was
recognised as one of the epicentres of the coronavirus in the country. The GDoH was faced with
the responsibility of proper management of the virus, and its response underlined the reality of a
province that was already challenged by high population density, migration, poverty and inequality,
among other social ills, including inequities in the distribution and shortages of health personnel.
The appointment of staff to support the COVID-19 response was rolled out in three phases to address
inadequate capacity where needed. The rollout of these personnel is outlined in the table below:
Phases Part Posts Cost of Posts

Phase 1 404 R165 836 560
Phase 2 Part I 1 701 R415 695 378
Phase 2 Part II 369 R84 694 753
Phase 3 4 900 R870 000 000
Grand Total 7 374 R1 536 226 691

The following table reflects the number of posts filled by the end of March 2021. The contracts of the
incumbents for those posts were extended for another year after the Department had been allocated
with funds for the 2021/22 financial year.
Group Category Number Total Cost

Administration Staff 506 R122 268 950
Allied Professionals 409 R171 472 965
Allied Support Staff 117 R26 991 163
Clinical Professionals 281 R241 832 372
Engineering Professionals 2 R1 031 873
Nursing Professionals 2 826 R750 585 881
Support Staff 1 297 R185 943 309
Grand Total 5 438 R1 500 126 513
Moreover, COVID-19 had an impact on testing the capacity of the Department to deliver health
services to the people of Gauteng. The prime example of the capacity issues was the lack of
comprehensive integrated health information systems, which made it difficult for the Department
to have a standardised and accurate data management system. This also resulted in a lack of a
standardised and structured reporting system by hospitals and other health care facilities. As a
result, reporting of COVID-19 data became a major challenge, which raised concerns on the media
platforms, in the National Coronavirus Command Council (NCCC) and National Department of Health
(NDoH). In responding to these challenges, the Department has prioritised key strategic drivers,
namely: implementation of an Integrated Health Information system, Research and Evaluations,
Health Observatories/Management information systems, and improved governance and management
committee systems that will enable improvement in leadership and governance. These prevailing
COVID-19 challenges provided an opportunity to introduce and refine these information systems and
governance strategies to enable a more efficient system of governance within the GDoH. One of the
strategies implemented was to incorporate a set of COVID-19 indicators into the revised APP of the
Department to monitor and track the performance and response to the pandemic.
To respond to the expected increase in the volume of COVID-19 patients who required hospital care,
the Department put in place a number of interventions. The Department had to scale up the capacity
of public health care institutions to treat COVID-19 patients including procurement of PPE, oxygen
machines for patients and equipping the intensive care units. This also included establishment of
field hospitals, procuring equipment, recruiting staff and purchasing medicines. The Department
was forced to reprioritise its budget for the COVID-19 response and ensure that public health care
facilities are equipped in fighting the pandemic. One of the other responses to the pandemic was the
implementation of Phase 1 of the vaccination rollout plan targeting HCWs in both public and private
health care facilities.
Governance Systems
In order to strengthen strategic governance and leadership, the Department establishment a

management committee system focused on supporting health systems effectiveness. This also ensured
improved accountability through an approved Governance Framework of the Committee system. In
the advent of COVID-19, the Department’s COVID-19 operations have been enhanced through the
establishment of a COVID-19 response governance structure led by the Chief of Operations (COO).
These governance structures account on a weekly/daily basis to the Provincial Command Centre
and EMC. These governance structures are governed by Standard Operating Procedures (SOPs)
that have been developed to guide the operations of the structures. These governance structures
comprise Members of the Senior Management Services (SMS) in the Department.
2.4 KEY POLICY DEVELOPMENTS AND LEGISLATIVE CHANGES
There were no key policy development and legislative changes during the reporting period.
3. ACHIEVEMENTS OF INSTITUTIONAL IMPACT AND OUTCOMES
GDoH 2025 Impact Outcome Gauteng progress during 2020/21

towards achievements of the impacts
and outcome
Universal Health Quality of health services in public The positive experience of care continually
Coverage for all South health facilities improved improved across all health facilities. This
Africans achieved, and was seen in positive responses from
all citizens protected from patient experience of care, which is above
the catastrophic financial 84% in all levels of care. The management
impact of seeking health of patient safety is well monitored in health
care by 2030 facilities and close to 73% of the patient
safety incidents were closed within 60
days. The improved management of
patient safety allowed the Department to
reduce the medico-legal claims by 12%
during the 2020/21 financial year. 54% of
employees indicated that they are satisfied
and happy at their place of work in the
Department.
Package of services available to 95.8% of the priority calls were responded
the population is expanded, with to within 30 minutes in urban areas.
priority given to equity and most cost-
effective services Increased platforms for provision of service
delivery to 34 CHCs, thereby ensuring that
communities can access care at these
CHCs which operate for 24 hours.
Leadership and governance in the Up to 80% of the health facilities had
health sector enhanced to improve functional Clinic Committees even in
quality of care the midst of the COVID-19 pandemic.
Governance structures were heavily
impacted by the emergence of the
COVID-19 pandemic and no hospitals had
100% functionality of their boards.
Infrastructure maintained and backlog Delay in accessing work areas that were
reduced meant to be decanted. The contractor
awaits the hospital to decant services
on building in the next phase of repairs.
Construction progress is at 55%. Sections
handed over of completed mothers’ lodge
and nurses’ residences.
GDoH 2025 Impact Outcome Gauteng progress during 2020/21

towards achievements of the impacts
and outcome
Life expectancy of South Maternal, neonatal, infant and child While much has been done to attend and
Africans increased to 70 mortality reduced respond to safety incidents, the maternal
years by 2030 deaths are still recorded as high at 294,
bringing the overall MMR to 118.7 per
100 000 live births, with hypertension
reported as a leading cause of death.
Morbidity and Premature mortality There were 2 312 clients who died during
due to Communicable diseases (HIV, the course of the TB treatment with the
TB and Malaria) reduced death rate remaining at 7.4%, which is still
above the planned target.
During 2020/21 FY, the Malaria case
fatality rate was at 1.2% and remains
above the threshold of below 1%.
4. INSTITUTIONAL PROGRAMME PERFORMANCE INFORMATION

4.1 BUDGET PROGRAMME 1: ADMINISTRATION
Programme Purpose
The purpose of this programme is to conduct strategic management and overall administration of the
Department through the following sub-programmes:
I. Office of the MEC: rendering of advisory, secretarial and office support services (including
administrative, public relations / communication and parliamentary support).
II. Management: Policy formulation, overall management and administration support of the Department
and the respective regions and institutions within the Department.
Programme Outcomes
• Quality of health services in public health facilities improved.

• Improved financial management.
• Robust and effective health information systems to automate business and improve evidence-
based decision-making.
PERFORMANCE OVERVIEW OF BUDGET PROGRAMMES
INFORMATION COMMUNICATION TECHNOLOGY

Significant achievements
The commencement of the health information systems project, after protracted procurement
processes, has seen the implementation of the system across four Community Health Centres
(CHCs). This was achieved against steep constraints brought about by the COVID-19 pandemic. In
addition, the conclusion of the Picture Archiving Communications System (PACS) was a significant
milestone in preparation to digitise radiology services within the 24-hour CHC environment. The
said solution will also be utilised to augment radiology services across hospitals not having a digital
radiology solution.
Summary of how achievements against planned targets contributed towards achieving the
Department’s outcomes.
The performance delivery of the unit did not meet the planned targets primarily due to the impact of
the COVID-19 pandemic. Progress has however been made towards the latter part of the financial
year as far as the Health Information System is concerned. Moreover, outstanding acquisition, which
will contribute towards improved performance, has been concluded in the concluding parts of the
20/21 financial year. The latter will contribute significantly towards improvement in the 21/22 financial
year.
Prioritisation of women, youth and persons with disabilities in its service delivery environment and
challenges encountered.
Progress was made, in the preceding financial year, as far as the recruitment of women at a Senior
Management level. Progress earmarked for the current financial year will be focused on concluding
the appointments of two female SMS members. In addition, focus will also be placed on ensuring
that persons with disabilities are prioritised for employment in the current financial year.
Challenges
A primary constraint remains the ability to procure products and services speedily through the
mandated SITA procurement channel. The aforesaid constraint has to a large extent hamstrung
performance against agreed targets.
LEGAL SERVICES
During the year under review, the National Department of Health appointed CAJV (Pty) Ltd to provide
expert and strategic support to the Department in the management of medico-legal claims against
the Department. As a result of this intervention, the Department is reducing its contingent liability.
In implementing corrective measures, the Department is applying a strategy to not only mitigate
litigation but to also analyse and eradicate the actual root cause of medico-legal court cases. The
three key areas of intervention that are being implemented focus on addressing the causes of
medical negligence at root cause level, namely at the clinical facilities of the Department; facilitating
and maintaining a good working relationship with the State Attorney Johannesburg and the State
Attorney Pretoria, being the two State Attorney offices that are dealing with the Department’s medico-
legal claims; and filling vacant posts that arise in the Directorate: Litigation as soon as possible.
Extraordinary measures must be taken to avoid a possible collapse of the health care system by
strengthening the ability of Provincial Health Departments to comply with their obligation to render
health care services in terms of section 27 of the Constitution.
If this is not done immediately, South Africa may face a constitutional crisis in that the financial
resources of the Provincial Health Departments may become so depleted due to the payment of
judgments for medical negligence claims that it will not have resources left to provide health care
services – with dire consequences for patients in need of health care. It will also lead to failure to
realise the National Development Goals 2030, and the inability of Provincial Health Departments to
fulfil their constitutional mandate due to insufficient resources to provide care to the masses who
depend on these public health care services.
Significant Achievements
Mediation remains one of the most successful methods to reduce cases of medical negligence and
consequentially also reduces the Contingent Liability of the Department. Thus far, Mediation has
proved to be a cost-effective tool and can be implemented before or during the litigation process.
To this end, the Department has been able to mediate a total of 27 matters, of which 26 have
been finalised and paid whilst five new matters were referred to Mediation during February 2021.
Mediation has so far saved the Department an estimated amount of R106 million. This could not
have been possible without the involvement of Integrated Forensic Auditors and CAJV (Pty) Ltd,
engagements with the Office of the Premier to draft the Gauteng Medical Litigation and Mediation
Bill, Employee Value Proposition (EVP) aimed at improving staff morale at clinical facilities and other
clinical governance related interventions to improve safety and care.
Challenges
High contingent liability as a result of medico-legal litigation remains a national challenge affecting
all the provinces. This is also exacerbated by theft of medical records from the clinical institutions or
failure by institutions to keep proper records or clinical institutions having inadequate or incomplete
records, which results in the Department losing court cases. Lack of consequence management
in the form of disciplinary and/or civil recovery steps taken against those responsible for medical
negligence in our institutions (hospitals and clinics) and unsupervised medical interns are among the
other challenges experienced.
Table 4.1.1: Programme 1: Administration (ORIGINAL APP)
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation from Reasons for Reasons for
(as per SP Indicators Target Achievement planned target deviations revisions to the
2020/21- 2020/2021 2020/2021 to Actual Outputs/Output
2024/25) 2017/18 2018/19 2019/20 Until date of Achievement indicators/
re-tabling 2020/2021 Annual Targets
(April-June)
Robust and Quality % of public # # # 18.9% 0% (18.9%) Indicator reported The targets are
effective health of patient health (7/37) only on an incorporated
information information facilities annual basis into the Health
systems to in health electronically and discontinued Information
automate facilities recording when App was System delivery
business improved clinical codes re-tabled end of and as such will be
and improve for patients June. better tracked in
evidence- visits the delivery of the
based decision The said Health Information
making implementation System progress.
is a multi-year
process that
will deliver the
functionality of
coding across
33 CHCs and
10 hospitals
in the 21/22
financial year
and complete the
balance in the
subsequent year.
Quality of Health Percentage # # # 10% 85% 75% Target exceeded Indicator was
health services facilities are of hospitals (4/37) because made more
in public compliant compliant nominations of specific by defining
health facilities with with Occupational, the targeted area
improved Occupational Health and Safety of intervention
health and Representatives during re-tabling.
safety were successfully
done and
compulsory OHS
assessment were
conducted.
Gauteng Provincial Government | Vote 4: Department of Health | Annual Report 2020 - 2021
33
Table 4.1.2: Programme 1: Administration (RE-TABLED APP)
Outcome Outputs Output Indicators Audited/ Actual performance Planned Actual Deviation Reasons for deviations
34
(as per SP Target Achievement from planned

2020/21- 2020/2021 2020/2021 target to
2024/25) 2017/18 2018/19 2019/20 Actual
Achievement
2020/2021
Quality of health Health facilities Percentage of # # # 10% 85% 75% Target exceeded because
services in public are compliant hospitals compliant (4/37) nominations of Occupational, Health
health facilities with Occupational with Occupational and Safety Representatives were
improved Health and Safety health and safety successfully done and compulsory
OHS assessment were conducted.
Quality of health Lean Number of hospitals 4 12/37 10/37 8 5 (3) Target not achieved. Five hospitals
services in public Management implementing (CMJAH, Sebokeng, Leratong,
health facilities System Lean Management DMGAH and Bheki Mlangeni) are
improved implemented System implementing a Lean Management
in public health System. Limited Human Resources
facilities available for the rollout of the
programme and COVID-19 pandemic
restrictions resulted in the inability
of the team to effectively conduct
training with facilities, as some
were challenged with connectivity
for virtual training and others were
inundated with sick patients.
Quality of health Contingent liability Rand value of # # # R19.8 billion R16,7 billion R3.1 billion Target achieved. Reduction of
services in public of medico-legal medico-legal claims R1.4 billion from Q2 2020/21 to Q4
health facilities cases reduced by 2020/21 was observed, resulting in a
improved 80% 12% reduction of rand value medico-
legal claims.
Improved Unqualified audit Audit opinion of Unqualified N/A N/A N/A
financial opinion Provincial DoH
management
Robust and Quality of patient Percentage of # # # 30% 0% (30%) Target not achieved. The delays
effective health information in CHCs implementing (10/33) (0/33) associated with the procurement of
information health facilities PACS the new PACS contract impacted
systems to improved the delivery against the target. SITA
automate provided the Department with an

business award recommendation in March
and improve 2021.
evidence-based Percentage # # # 45% 12% (33%) The impact of the COVID-19
decision making of CHCs with (15/33) (4/33) pandemic constrained the
Integrated Health deployment of the Health Information
Information systems System which constrained delivery
against the set targets.
(as per SP Target Achievement from planned
2020/21- 2020/2021 2020/2021 target to
2024/25) 2017/18 2018/19 2019/20 Actual
Achievement
2020/2021
Quality of patient Percentage of # 62% 0% 62% 10% (52%) The impact of the COVID-19
information in hospitals with (23/37) (23/37) (4/37) pandemic constrained the
health facilities Integrated Health deployment of the Health Information
improved Information systems System which constrained delivery
against the set targets.
Robust and Quality of patient Percentage # # # 25% 0% (25%) The procurement proposal for the set
effective health information in of indicators output was received from SITA in April
information health facilities tracked through 2021. Delivery against the set target
systems to improved the functional could not be achieved as a result of
automate Population Health the aforesaid.
business Observatory
and improve
evidence-based
decision making
Leadership and Township Percentage of 16.7% 29.5% 23% 29.2% 13.2% (16%) Target not achieved due to
governance in economy in local budget spent (R86.4/ unwillingness of major suppliers to
the health sector communities on Township R292.8) sub-contract to designated groups
enhanced to promoted enterprises -Pricing structure
improve quality of against identified -Incomplete tender documentation
care commodities -Unresolved web-cycles and
Expired tax clearance certificate.
Leadership and Short-term Number of # # # 5706 5438 (268) Target not achieved. Inability to
governance in COVID-19 clinical people appointed attract staffing due to the uncertainty
the health sector capacity provided for COVID-19 on whether the Covid-19 post would
enhanced to temporary positions be extended.
improve quality of
care
Robust and Quality of patient Percentage of # # # 45% 0% (45%) The system has been developed by
effective health information in Forensic Pathology (5/11) Gauteng e-Government; however key
information health facilities Management amendments were requested by the
systems to improved Information Forensic Pathology unit before the
automate Systems solution can be piloted. The aforesaid
business implemented delayed the achievement of the
and improve target.
evidence-based
decision making
35
Strategies to overcome areas of underperformance

ICT
• The enabling contracts required to deliver against the majority targets have now been concluded. The primary
focus in the current (21/22) financial year will be on the implementation of the information systems associated
with the said targets.
• Performance has not been as planned, however greater emphasis will be placed on implementation and
delivery to ensure that performance is aligned with planned targets.
LEGAL SERVICES
• Removal of LODs from Contingent Liability Register.

• Verification of all settled claims for removal from Contingent Liability Register.
• Removal of dormant matters from Contingent Liability Register.
• Strengthening and capacitating the Legal Services Unit.
• Addressing the challenges of medical negligence arising at clinical level.
• Improving accountability by implementing consequence management.
• Strengthening and improving the relationship between the State Attorney and GDoH.
LEAN MANAGEMENT
Resource capacitation
• A Governance Chief Directorate has been established within the Department to, amongst others, oversee the
rollout of lean management in health facilities. The establishment of the Chief Directorate is expected to aid
in giving the lean management unit a presence and priority with regard to availing Human Resources to aid
in facilitating and overseeing the rollout.
• Two new recruits have been added to the team and are being exposed to the work of the team.
• Because lean management principles require process owner management, the unit has identified champions
in facilities who are being trained to also train others to ensure that capacity is established at facility level.
COVID-19
• Lean training has been conducted virtually via the Microsoft Teams platform since September 2020.
• In January 2021 during the COVID-19 alert Level 1, the team started to give support and training physically
at the respective institutions.
SUPPLY CHAIN MANAGEMENT (SCM)
• The Department has identified categories to award to township enterprises i.e. Bread, Meat, Processed
vegetables and room alterations for medical equipment.
• Procurement of identified commodities <R500 000 from township enterprises.
• Utilisation of the Central Supplier Database (CSD) to obtain a list of prospective township enterprises in
various corridors.
• Utilisation of service providers on a rotational basis in procuring goods and services to promote ongoing
competition amongst township enterprises contracted for identified commodities.
• Workshops were held for designated groups to explain various opportunities for the 2021/2022 financial year.
• Utilisation of P Card for purchases <R10 000 for the 2021/2022 financial year.
• Department to ensure the uplifting of historically disadvantaged individual enterprises by encouraging
subcontracting for bids above R500 000.
Budget Programme Intervention Geographic No. of beneficiaries Total budget Budget spent per Contribution to the Immediate
location (Province/ (where possible) allocation per intervention Outputs in the APP outcomes
District/local intervention (R’000) (where applicable)
(R’000)
municipality)
(where possible)
1. ADMINISTRATION -Compensation of Whole Province Eight staff employed 4 099 11 871 Patient experience of Quality of health
Employees (Staff for COVID-19 care in public health services in public
Appointments facilities improved health facilities
towards COVID-19 improved
pandemic)
Nursing personnel
sourced through the
Nursing Agencies and
distributed
- Goods & Services PPE and Rental 1 860 519 1 935 142 Quality of health
(Consumable and hiring services services in public
supplies and Medical such as tents for health facilities
supplies) treatment of patients improved
were also paid
through centralised
procurement
Machinery and Medical equipment 351 000 354 012 Quality of health
Equipment (Assistive services in public
Device) health facilities
improved
37
PROGRAMME 1 EXPENDITURE TABLES
Table 4.1.3: Departmental Budget and Expenditure

2020/21 2019/20
Programme
R’000 R’000 R’000 R’000 R’000 R’000
Administration 3 697 845 3 695 016 2 829 1 482 145 1 481 446 699
District Health
Services 18 366 611 17 959 247 407 364 16 557 681 15 895 452 662 229
Emergency
Medical Services 1 681 370 1 680 801 569 1 541 714 1 539 781 1 933
Provincial
Hospital Services 9 942 279 9 905 850 36 429 9 274 405 9 224 458 49 947
Central Hospital
Services 19 612 633 19 254 052 358 581 19 111 200 19 064 441 46 759
Health Sciences
and Training 901 268 787 210 114 058 1 151 743 1 045 256 106 487
Health Care
Support Services 391 264 388 844 2 420 369 788 368 944 844
Health Facilities
Management 4 242 233 4 041 357 200 876 2 090 143 2 053 885 36 258
Programme
sub total 58 835 503 57 712 377 1 123 126 51 578 819 50 673 663 905 156
Table 4.1.4: Budget Programme 1: Administration: Sub-Programmes

PROGRAMME 1: ADMINISTRATION
Sub-programme 2020/21 2019/20
R’000 R’000 R’000 R’000 R’000 R’000
Off. of the MEC 24 043 16 067 7 976 19 789 17 051 2 738
Management 3 673 802 3 678 947 (5 145) 1 462 356 1 464 395 (2 039)
3 697 845 3 695 014 2 831 1 482 145 1 481 446 699
4.2 BUDGET PROGRAMME 2: DISTRICT HEALTH SERVICES
Programme Purpose
The purpose of the programme is to render Primary Health Care (PHC), District and Regional Hospital
services.
i. District Management planning and administration of services, managing personnel, financial

administration and the coordination and management of PHC facilities, including those provided by
Local Authorities and NGOs.
ii. Coordination and management of services in District and Regional hospitals.
iii. Community Health Centres (CHCs) rendering a primary health service with full-time medical officers
in respect of mother and child, health promotion, geriatrics, occupational therapy, physiotherapy,
psychiatry, speech therapy, communicable diseases, mental health, etc.
iv. Community-based services rendering a community-based health service at non-health facilities

in respect of home-based care, services for survivors of abuse, mental health care, chronic care,
school health, etc.
v. Other community services rendering environmental, port health and part-time district surgeon
services, etc.
vi. HIV and AIDS, rendering a PHC service in respect of HIV and AIDS campaigns and Special Projects.
vii. Nutrition, rendering a nutrition service aimed at specific target groups and which combines direct
and indirect nutrition interventions to address malnutrition.
viii. Coroner Services rendering forensic and medico-legal services in order to establish the
circumstances and causes surrounding unnatural death.
ix. District hospitals rendering a hospital service at district level.
Sub-programmes
• District health management and PHC services

• District hospitals
• Maternal, child and women’s health and nutrition
• HIV and AIDS, STIs and TB care
• Disease prevention and control
• Forensic pathology services.
Programme Outcomes
• Package of services available to the population with priority given to equity and most cost-effective
services.
• Maternal, neonatal, infant and child mortality reduced.
PROGRAMME PERFORMANCE OVERVIEW
DISTRICT HEALTH MANAGEMENT AND PHC SERVICES
Summary of how achievements against planned targets contributed towards achieving the Department’s
outcomes.
Provision of services at all levels of the service delivery platform enabled easy access to services as
required in an equitable and cost-effective manner. There was an increase in the number of CHCs
providing 24-hour services, which created easy access to services after hours in those communities.
Continual quality improvement enabled the Department to improve the Ideal Clinic status to increase
from 84% to 89%, which also contributes in providing quality services.
In terms of package of services available to the population, priority was given to equity and most
cost-effective services through an increased number of CHCs providing health services for 24 hours,
including the CHCs that have achieved the Ideal Clinic status.
As regards Clinic Committees, due to high turnover of committee members, the Department
continuously engages community leaders/stakeholders and ward councillors so as to ensure that
there is continuous community representation in the clinics.
Prioritisation of women, youth and persons with disabilities in its service delivery environment and
Of the 9 648 EPWP work opportunities reported, 8 122 were women who benefited from the job
creation projects. In addition, 4 060 of the 9 648 work opportunities reported were to the benefit of
youth. The appointment of CHWs as permanent employees of the Department also contributed in
increasing the number of youth and women appointed.
The Clinic Committees are dynamic and do have more or less equal representation of gender;
however, there is a challenge to retain youth, because as soon as they find jobs they abscond.
The Department is engaging community leaders and organisations to encourage dedicated youth
to represent them in our facilities. The functionality of Clinic Committees is based on the committee
members being appointed, and the committee reporting monthly and quarterly.
Significant achievements
All CHCs in the province are providing health services for 24 hours while 89% of PHC facilities have
achieved the Ideal Clinic status. This has contributed towards improved quality of health services in
public health facilities.
Permanent appointment of Community Health Workers
The Gauteng Department of Health took a resolution to appoint CHWs as permanent employees
of the Department. Effective from July 2020, the Department was able to implement the resolution.
A total of 8 532 CHWs have been appointed as permanent employees of the Department level 2
posts. These appointments will ensure that CHWs are remunerated above minimum living wage. The
majority of these CHWs have served their communities selflessly for years providing services such
as home-based care, condom distribution and linkage to care whilst earning a stipend. These CHWs
were also at the forefront of the Department’s COVID-19 response, doing community screening and
assisting with tracing and education on the virus in communities. The CHWs were amongst the first
groups of health workers to be trained as the COVID-19 pandemic started spreading in the country.
Created work opportunities contributing towards quality of life
A total of 9 648 EPWP work opportunities were reported on the EPWP Reporting System from
EPWP-specific funding and from projects that are EPWP aligned. This is an achievement of 240%
when measured against a target of 4 015 work opportunities constricted by available funding. Of
the 9 648 EPWP work opportunities reported, 8 122 were women and 4 060 were youth. This will
contribute towards improvement in the quality of life of the women and youth and their families.
Strengthening of the implementation of Quality Improvement plans.
The improvement of Ideal Clinic score of 89% against the set target of 84.7% in the 2020/2021
financial year attributed to the strengthening of the implementation of Quality Improvement plans
by operational managers and constant monitoring and support from the District Permanent Perfect
Team for Ideal Clinic Realisation and Maintenance (PPTICRM) and Provincial Ideal Clinic champion.
Immediately after each assessment, a joint meeting is held with the district Quality Assurance
managers, including the support structures, e.g., Supply chain, Pharmacy and Infrastructure, to
address the challenges that contributed towards the failure of compliance by some elements in the
Ideal Clinic framework. The operational managers will then gradually correct the non-complying
elements with the support from the supporting structures as mentioned.
The benchmarking with other clinics is also a contributor to the improvement of the clinic scores.
Challenges
COVID-19 Interruption of Community Outreach Services
Due to lockdown restrictions, some community outreach services suffered setbacks as efforts were
concentrated towards the COVID-19 response. Community Health Workers could not visit households
for normal services due to lockdown restrictions. Patients who benefited from treatment adherence
services temporarily lost the support they previously had. Data indicates that for services such as
TB and HIV, the defaulter tracing fell drastically in the first quarter during the epitome of lockdown
restrictions. Performance increased substantially from the second quarter and for the rest of the
financial year.
In the District and Regional hospitals, planned surgical procedures were also delayed as focus was
given to COVID-19-related demands on the institutions.
Clinic Committees
There was a lack of sustainability and commitment resulting in high turnover through abscondment
and resignations, largely due to unavailability of stipends.
DISTRICT HOSPITALS
During the year under review, the number of women who died in health facilities reduced from a ratio
of 55.3 per 100 000 live births in 2019/20 to 50 per 100 000 live births in 2020/21, therefore saving
lives and contributing to the care of the new-born babies who have their own mothers to care for
them, improving neonatal and infant health outcomes as a result.
In terms of integration of mental health into mainstream services from PHC level to hospital level,
the Department was able to allocate 5.6% (165/2 901) of District hospital beds to provide services
for acutely ill mental health care users.
HIV and AIDS, STIs and TB (HAST)
Summary of how the achievements against planned targets have contributed towards achieving the
Department’s outcomes, which will impact on the strategic priorities of government.
The achievements in terms of HAST performance are still lagging behind with regard to the reduction
of mortality and morbidity due to communicable diseases. More work will be done in the second year
of implementation of the Strategic Plan so as to achieve the outcomes set.
During the reporting year, implementation of HIV prevention strategies to reduce HIV infection was
supported by implementation of Pre-exposure Prophylaxis (PrEP) in July 2020 for all HIV-negative
people at a substantial risk of HIV infection as part of a combined HIV prevention strategy. In this
regard, 15 228 patients were initiated on PrEP, which targeted populations considered to be at
substantial risk of HIV infection, namely: Adolescent girls and young women, Men who have sex
with men, People with more than one sexual partner, People who inject drugs, People with a recent
history of STI(s), People who recognise their own risk and request PrEP, Serodiscordant couples if
the HIV-positive partner is not virally suppressed, and Sex workers.
• Supply and distribution of condoms to females and males to reduce sexually transmitted disease
and HIV infections (a total of 234 286 648 male condoms and 10 007 495 female condoms).
• Implementation of Voluntary Medical Male Circumcision (VMMC) programme and expansion of
services by contracting 11 General Practitioners in three districts.
• Effective treatment for HIV and TB prioritised adherence (viral load suppression) by increasing psycho-
social support for people living with HIV and TB (PLHIV and TB) through more support groups, a campaign
against stigma and discrimination led by PLHIV and TB, and efficient health services with access to
professional mental health care and legal services.
• Expanding focus on programmes for key/high-risk populations who have been found to have high
HIV prevalence
• Expansion of high transmission areas and harm reduction services for; people who inject drugs,
Lesbians, Gay, Bisexual, Transgender and Intersex (LGBTIs) individuals, Sex Workers, etc.
• Increase as well as sustain prevention towards elimination of mother-to-child HIV transmission;
ART initiation rate for pregnant women at over 97% with less than 0.8% transmission rate from
mother-to-child at about 10 weeks.
• Introduction of New ART guidelines (2019) with the new drug Dolutegravir. These guidelines will
increase access to ART services, advance South Africa’s ability to control the epidemic and help to
achieve the 2030 SDG goals through the following:
• Results in minimal side effects
• Improved rapid viral suppression
• Improved adherence to treatment
• Strong focus on Youth in general, and Adolescent Girls and Young Women in particular: including
Adolescent and Youth Friendly Services (AYFS) and Child Friendly Spaces.
• Strengthen and sustain the implementation of the HIV Universal Test and Treat (UTT) strategy.
• Implementation of deployment strategy to expand decongestion of patients at facilities in response
to the COVID-19 pandemic, with emphasis on External Pick-Up Points (ExtPUP) – inclusive of
Central Chronic Medical Dispensing and Distribution (CCMDD); Adherence Clubs and Chronic
Dispensing Units.
• Strengthen the comprehensive management of patients with TB and HIV co-infection and all
comorbidities with HIV through improved service integration.
• Reduce burden of HIV/AIDS and TB (intensify the fight against HIV/AIDS) by implementation of the
UNAIDS 90-90-90 strategy for HIV, TB and Non-Communicable Diseases.
• Improvement of HTS performance by contracting 101 NPOs to conduct HIV testing on behalf
of the Department, resulting in increased HIV community testing.
• Implement strategies towards improving viral loads suppression as an indicator of ART treatment
effectiveness and outcomes through adherence strategy implementation and improved data
quality management at source. Desired outcomes include:
• 90% of all people living with HIV will know their HIV status, and to diagnose 90% of people
with TB;90% of all people with diagnosed HIV infection will receive sustained ART,
• while 90% of people with TB should be initiated on treatment; and90% of all people receiving
ART will have viral suppression,
• with 90% treatment success for drug-susceptible TB and 60% treatment success for drug-
resistant TB.
Tuberculosis prevention and management
• Improve case detection by integrating TB screening and COVID-19 screening in health facilities;
• Implementing the finding the missing TB cases strategy aiming at targeted missed opportunities,
optimised TB screening and efficient tracing of contacts of index patients;
• Improve TB success rate and reduce Lost to Follow-Up (LTFU) rate through visiting all diagnosed
TB patients as a way of tracking and to verify the addresses;
• Integrate prevention, diagnosis and treatment of TB and HIV; and
• Provide training of TB staff on Nurse Initiated Management of Drug-Resistant TB (NIMDRTB)
coaching and mentoring to increase uptake of drug-resistant TB.
Challenges
The COVID-19 lockdown affected cohorts of both HIV and TB patients returning to health facilities,
leading to an increase of missed appointments, LTFU and poor treatment compliance for both TB
and HIV.
MATERNAL, CHILD AND WOMEN’S HEALTH AND NUTRITION (MCWH&N)
Maternal and New-born Health
The Department continues to implement the 1st Thousand Days Programme, which aims at improving
the health status of children within the first two years (from confirmation of pregnancy to two years
of life) through the Integrated Maternal Child Health Side-by-Side campaign to encourage early
booking for antenatal care before 20 weeks, and provision of daily antenatal care services including
promotion of exclusive breastfeeding for six months and up to two years.
During the reporting period (2020/21), a total number of 95 350 pregnant women visited PHC facilities
for first antenatal care (ANC) bookings compared to 180 229 in 2019/20, a decline of 84 879 as a
result of COVID-19 and subsequent lockdowns that impacted on the volume of patients accessing
PHC facilities.
The institutional Maternal Mortality Ratio (iMMR) was 118.7 per 100 000 live births in 2020/21 when
compared to 102.9 per 100 000 live births in 2019/20. A total of 117 advanced midwives and 25
doctors were trained on Essential Steps to Manage Obstetric Emergencies (ESMOE) as an important
intervention in reducing the iMMR. A further 143 professional nurses were trained on Basic Antenatal
Care (BANC) Plus to address conditions leading to maternal complications. Thirty-eight professional
nurses and doctors were trained on Helping Baby Breath (HBB) and Management of Sick and Small
New-borns (MSSN) as interventions to reduce neonatal deaths.
Child Health Programme
A total of 217 664 (85%) children under five years were fully immunised and 198 562 (77.8%) were
vaccinated with the measles second dose during the reporting period. The Department has noted a
significant improvement in the management of sick children aged below five years, as the number of
children who died from diarrhoea has reduced to 70 (2.7%) when compared to 88 (1.7%) in 2019/20.
Pneumonia deaths have reduced to 98 (2.3%) in 2020/21 when compared with 116 (1.8%) deaths in
2019/20. During the period under review, the Severe Acute Malnutrition (SAM) deaths decreased from
86 (5.9%) in 2019/20 to 75 (7.7%) in 2020/21.
A total of 179 professional nurses were updated on the new Integrated Management of Childhood
Illnesses (IMCI) Guidelines and 54 professional nurses were trained on the IMCI Strategy with an aim
of improving child care standards, Nurse Initiated Management of ART (NIMART) in children and to
reduce infant and child morbidity and mortality rates in children.
Health education campaign sessions were provided to mothers and caregivers in collaboration with
Dettol New Mom / Triple eight NGO on washing of hands and prevention of diarrhoea and COVID-19,
including awareness on general danger signs to be noted in sick children and when to seek early
medical interventions.
Integrated School Health Programme (ISHP)
In the reporting period, a total of 22 866 learners were screened to identify health barriers compared to
198 526 learners in 2019/20. The Grade 1 learners screened in 2020/2021 to identify health barriers to
learning amounted to 17 922, while 4 944 were learners screened from Grade 8. The numbers in the
present reporting period were lower compared to the previous reporting periods due to the emergence
of COVID-19 which came with lockdown regulations.
The number of learners identified with health problems amounted to 4 973 and were referred
appropriately for further management at PHC facilities and/or hospitals. A total of 36 603 learners were
dewormed during routine school health screening during the reporting period.
Prioritisation of women, youth, and persons with disabilities in its service delivery environment and
Implementation of Youth Zones in Health Facilities
A total of 104 health facilities were identified to implement the Youth Zones with the aim of improving
access by Youth to health facilities. A total of 25 sub-district managers from all Health Districts and 81
facility managers were trained on AYFS concentrating on the following Pillars, namely: Youth Teenage
Pregnancy, HIV and AIDS, Teenage Suicide, Gender-Based Violence, Sexual Reproductive Health
and Nutrition. Implementer’s trainings were conducted in four Health Districts: Tshwane, Ekurhuleni,
Sedibeng and West Rand. A total of 25 Health Facilities are conducting Termination of Pregnancy
(TOP) services in the province to prevent and reduce maternal deaths from unsafe abortions.
The Human Papillomavirus Vaccination (HPV) Campaign and Td Vaccination Campaign
The HPV first dose Vaccination Campaign was conducted in March 2021 at 1 008 Primary and Special
schools, where 43 423 Grade 5 and 6 girls aged above 9 years were vaccinated with the HPV vaccine
to protect them from cervical cancer in future. A total of 4 454 Grade 6 girls outstanding from the 2020
learner cohorts were also vaccinated with the HPV second dose.
During the HPV vaccination campaign in March 2021, a total of 99 360 eligible Grade 5 boy and girl
learners in Gauteng Primary Schools were vaccinated with the Tetanus diphtheria (Td) booster dose
to prevent diphtheria outbreaks among learners in communities and to increase the Td immunisation
coverage among eligible school-going adolescents.
Challenges
The COVID-19 pandemic and the lockdown restrictions have negatively impacted on the number of
women and children who accessed health facilities and the number of learners screened in schools.
Sick children were presented late at health care facilities to seek medical intervention. There is a
shortage of Integrated School Health Nurses especially in Johannesburg, West Rand and Sedibeng
Health Districts.
Data management at health facility level poses a huge challenge as the number of infants documented
on the cohort register always differs to that on the monthly summary and captured on the DHIS.
All five Health Districts are affected by cross-boundary issues whereby infants will be delivered in
health facilities in the province or a particular district, but the mothers then attend Child Health Services
including the Expanded Programme of Immunisations and HIV tests in neighbouring provinces or
districts, thereby affecting infant testing uptake, immunisation coverage and mothers’ postnatal visits
within six days after delivery.
DISEASE PREVENTION AND CONTROL
One of the six strategic pillars that anchor the Gauteng Health Strategic Plans as contained in the
Gauteng Department of Health Annual Performance Plan (APP) of 2021/2022 is Health Education
and Health Promotion.
Furthermore, as documented in this APP, the Department of Health is determined to position itself
towards becoming a highly reliable organisation through endorsed and outlined outcomes that will
include the reduction of morbidity and premature mortality due to communicable diseases, particularly
the priority notifiable communicable diseases.
These to a large degree have been achieved in the Malaria and the COVID-19 Prevention and
Control programmes.
Screening of cases and the tracing of close contacts, particularly for COVID-19; health promotions
and risk communication activities that talk to Non-Pharmaceutical Interventions (NPIs) against
COVID-19; and impact trainings of relevant staff and members of the community on the management
and prevention of COVID-19 and Malaria have assisted in reducing the morbidity and premature
mortality associated with these two global priority conditions in the province.
Significant achievements on outputs and output indicators
The Malaria case fatality rate improved significantly in the year being reviewed. There were few
Malaria patients who were diagnosed or died during the reporting year due to the reduction in
movement by travellers from Malaria-endemic areas during a greater part of the year, which further
proves that most Gauteng Malaria cases are imported. Another factor behind this achievement was
the Directorate and the CDC sub-directorate making sure that all health care facilities are stocked
with sufficient essential Malaria diagnostic and treatment sundries.
Our recovery rate for the COVID-19 disease is at an impressive 95%, with the case fatality rate for
the same disease at 2.5%, which is significantly below the National rate of 3%. Health Promotion
and Risk Communication and Community Engagement around COVID-19, especially on the NPI
measures continued throughout the year.
Several case management seminars and lectures on COVID-19 took place in the province, with
almost all relevant practitioners trained on the recognition and management of the disease, most
especially in the area of infection control and prevention. Most COVID-19 patients and their contacts
were traced and monitored for the mandatory prescribed period of 10 days.
Enforcement of COVID-19 compliance prevention principles were instituted in all relevant premises
including restaurants, factories, schools and early development centres. Prohibitive Notices were
issued to Non-Complaint premises.
During April 2020 – end of March 2021, 3 234 197 COVID-19 tests were conducted and 413 593 of
these were positive for COVID-19 disease.
Challenges
The reporting year was a very difficult one due to the COVID-19 pandemic. Most resources were
diverted from other programmes to the COVID-19 programmes.
The programmes that suffered most were the Non-Communicable Disease Control and Eye Care
Programmes. Meetings and activities that pertain to these programmes had to be placed on complete
hold. The Eye Care Programme, and especially the establishments of Low Vision Care centres had
to be stalled completely. Cataract surgery operations and the associated cataract surgery rate in the
hospitals therefore plummeted in number.
For the CDC and Malaria programme, Surveillance of the priority Notifiable Medical Conditions also
became a major challenge, with the possibility of the province having missed a number of these priority
conditions during the year. The hard lockdowns of level 1 and 2 also added to the problem, with support
visits to the districts and the facilities coming to an abrupt halt. This compromised active surveillance
in the districts and facilities in the direction of assessment and evaluation of epidemic preparedness in
these entities.
The Viral Hepatitis Prevention and Control Programme, the One Health Programme and the Soil-
Transmitted Helminths Reduction Programme were also stalled completely.
Health Promotion and Social Mobilisation activities in the province were also compromised. Most
Health Promotion resources and activities had to be repurposed to the COVID-19 Prevention and
Control programme in the communities.
Table 4.2.1: Performance Indicators: Sub-Programme 2.1: District Health Services (ORIGINAL APP)
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation Reasons for deviations Reasons for revisions
(as per SP Indicators Target Achievement from to the Outputs/Output
2020/21- 2020/2021 Until planned Indicators/Annual
2024/25) date of re-tabling target to Targets
Actual
2017/18 2018/19 2019/20
Quality Patient Percentage # 58% 50% 75% 56% (19%) Shortage of staff due to Targets reduced due
of health experience of PHC (215/372) (186/372) (279/372) (210/372) self-isolation owing to the to the emergence of
services in of care in facilities with increase in COVID-19 COVID-19, which affected
public health public health average cases. patient waiting times and
facilities facilities treatment In Tshwane there were reprioritisation of HR
improved improved waiting times power failures which personnel shifts to focus
below agreed impeded the smooth on COVID-19-related
benchmark running of the health care matters.
of 100 system.
minutes Fragmented filing
systems and shortages
of IT tools such as
computers to capture the
waiting times.
The other four Health
Districts also had most
of the staff on quarantine
due to the COVID-19
pandemic
Package Seamless Number # # 0 3 0 3 Target exceeded due to Indicator changed after
of services integration of districts remodelled intervention the programme was
available of mental clinical remodelled to ensure
to the health into community that each district has a
population Primary psychiatric comprehensive team of
with priority Health Care teams specialist mental health
given to practitioners.
equity and
most cost-
effective
services
Number of # # 350 350 N/A (335) N/A The indicator was
psychiatric The target was to be changed following
qualified reported by Q4 as it is an the remodelling of the
health care annual indicator, hence intervention.

professional no report of deviation
(Nurses) in by the time of re-tabling
47
PHC facilities period.

48
Table 4.2.2: Performance Indicators: Sub-Programme 2.1: District Health Services (RE-TABLED APP)
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation Reasons for deviations
(as per SP Indicators Target Achievement from planned
2020/21- 2017/18 2018/19 2019/20 2020/2021 target to Actual
2024/25) Achievement
2020/2021
Quality of Positive Patients 85% 82% 84% 80% 92.5% 12.5% Target exceeded due to a higher
health services experience of care experience of number of positive responses
in public of health care care satisfaction obtained from the implemented
health facilities users improved rate survey tool, namely the DPOS.
improved In addition, the tool used during
the COVID season to assess
the level of satisfaction with
core service matters such as
cleanliness, staff attitudes, etc.
was less cumbersome and easy
to understand.
Management of Severity # # # 60% 94.7% 34.7% Target exceeded due to
patient safety assessment code (161/170) additional capacity for capturing
incidents improved (SAC) 1 incident and support availed for
to reduce new reported within 24 processing of SAC 1. Provincial
medico-legal hours rate office conducted training for 21
cases interns involved in capturing
of SAC incidents and provided
supervisory visits during the
period under review.
Severity # # # 60% 91.8% 31.8% Target exceeded. Capacity was
assessment code (235/256) strengthened for management
(SAC) 1 incident of closure of PSIs through
case closure rate monitoring of institutional PSI
committees. Training was
conducted for quality assurance
office staff including on the spot
training of all staff involved in
PSIs during management of all
prioritised PSIs.
2020/21- 2017/18 2018/19 2019/20 2020/2021 target to Actual
2020/2021
Package PHC facilities Ideal Clinic status 78% 89.2% 93.0% 84.7% 89% 4.3% Target exceeded following the
of services provide integrated obtained rate (306/369) (330/370) (334/359) (315/372) inclusion of the Alexander 4th
available to the quality healthcare Avenue and Claremont clinics,
population with service which added to the list of
priority given to facilities obtaining the required
equity and most Ideal Clinics status. These
cost-effective facilities had not been included
services in the 2019/2020 assessments
as they were still under
construction; with their inclusion,
target was achieved.
Leadership and Functional Percentage of 76% 80% 80% 100% 80% (20%) Target not achieved. This is due
governance governance PHC facilities with (239/369) (372/372) (298/372) to the lack of sustainability and
in the health structures in PHC functional Clinic commitment resulting in high
sector facilities committees turnover through abscondment
enhanced to and resignations, largely due to
improve quality unavailability of stipends. The
of care Department is exploring data-
driven strategies to improve
retention and will be conducting
a province-wide evaluation of
Governance committees to
inform the most appropriate
interventions from the
perspective of these structures.
Package All CHCs Number of CHCs 30 30 32/32 34 34 0 Target achieved.
of services provide 24-hour providing 24-hour
available to the full service. services
population with
priority given to
equity and most
cost-effective
services
49
50
2020/21- 2017/18 2018/19 2019/20 2020/2021 target to Actual

2020/2021
Quality of All submitted Complaints 95.9% 96.1% 98% 95% 95% 0% Target achieved.
health services complaints resolution within
2060/2165 (707/744)
in public resolved within 25 25 working days
health facilities working days rate
improved
Package S e a m l e s s Number of trained # # 350 350 15 (335) Target not achieved due to the
of services integration of psychiatric impact of COVID. The initial target
available to the mental health into qualified health of 350 was an overestimate that
population with Primary care professional had not considered the immense
priority given to Health Care (Nurses) in PHC risk imposed by COVID-19 and
equity and most facilities its associated restrictions and
cost-effective impact on training.
services
Number of # # 0 3 2 (1) Target not achieved. There
multidisciplinary are various reasons for
districts clinical underperformance provided
community by districts, which range from
psychiatric teams districts not receiving enough
applications and, in some
instances, applicants not
following appropriate application
processes, thus districts had to
re-advertise.
Package PHC facilities Field worker # # # 60% N/A N/A Not collected as part of the
of services provide integrated COVID-19 current APP in its current form
available to the quality healthcare screening due to lack of information
population with service coverage systems for its collection.
priority given to Removal reported at the portfolio
equity and most committee since Q2.
cost-effective Field worker # # # 80% N/A N/A Not collected as part of the
services reporting rate current APP in its current form
due to lack of information
systems for its collection.
Removal reported at the portfolio

committee since Q2.
Field worker # # # 8% N/A N/A Not collected as part of the
referral rate for current APP in its current form
COVID-19 due to limitations in systems.
Removal reported at the portfolio
committee since Q2.
Strategies to address areas of underperformance
District Health Services (DHS)
The District family physicians who are part of the District Specialist Support Team are engaged
in increasing capacity to support implementation of clinical governance and provide technical
support and capacity development for the implementation of clinical governance tools, systems and
processes in the District health system and community-based services, PHC facility services and
District hospital services. An additional two clinics will be activated to operate 24-hours in improving
access to after-hours services. This will be implemented in the new financial year.
Functional Clinic Committees
An Evaluation project will be implemented during the first six months of the financial year to help
provide data-driven insights to improve functionality and other models considered to strengthen
functionality of governance structures. Continuous engagement with community leadership and
community organisations will be carried out by conducting roadshows.
Table 4.2.3: Performance Indicators: Sub-Programme 2.2: District Hospitals (ORIGINAL APP)
52
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation from Reasons for deviations Reasons for
(as per SP Indicators Target Achievement planned target revisions to the
2020/21- 2020/2021 to Actual Outputs/Output
2024/25) 2017/18 2018/19 2019/20 Until date of Achievement Indicators/Annual
re-tabling 2020/2021 Targets
Quality Management Patient Safety # # 50% 60% 52% (8%) Some facilities did not Target reduced to
of health of patient’s Incident (PSI) (47/90) capture PSIs on the accommodate the
services in safety case closure ideal web tool, citing shift in focus of
public health incidents rate non-availability of login Quality personnel to
facilities improved to credentials. COVID-19 response.
improved reduce new
medical/legal
cases
Hospitals Ideal hospital # # # 16.6% 8.3% (8.3%) Target not achieved. By Target reduced to
ready to status (2/12) (1/12) end of Q1 performance accommodate the
deliver quality obtained was on track, however if shift in focus of
health care compared to annual target Quality personnel to
there is a deviation of COVID-19 response,
8.3%.
Quality Hospitals Percentage # # # 50% N/A N/A N/A Indicator

of health ready to of hospitals discontinued
services in deliver quality implementing because NDoH
public health health care quality introduced Quality
facilities improvement learning centres to
improved initiative prepare facilities for
quality improvement
initiatives.
Integration Percentage # # # 5.6% N/A N/A Target was not
of mental of beds (165/2901) defined in the
health into in District Original APP and
mental health hospitals had to be estimated
services offered to when re-tabling.
acutely ill
mental health
care users
(72hrs)
Table 4.2.4: Performance Indicators: Sub-Programme 2.2: District Hospitals (RE-TABLED APP)
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from
2020/21- 2020/2021 2020/2021 planned
2024/25) target to
Actual
Achievement
2020/2021
Maternal, Number of women Maternal mortality # # # 55.3 69.8 (14.5) Target not achieved due to
neonatal, infant who die in health in facility ratio (29/52 441) (32/45 814) increased hypertension during
and child mortality facilities reduced pregnancy. In addition, there
reduced were clients who demised due to
COVID-19 complications.
Maternal, Less children Child under 5 # # # <1% 2% (1%) Targeted threshold not achieved
neonatal, infant under 5 years years’ diarrhoea (6/600) (10/503) due to late presentation of children;
and child mortality dying from case fatality rate these children presented with
reduced diarrhoea dehydration, retroviral disease and
acute severe gastroenteritis.
Maternal, Less children Child under 5 # # # 1.6% 1.8% (0.2%) Targeted threshold not achieved
neonatal, infant under 5 years years pneumonia (17/1 063) (9/511) due to children presenting with
and child mortality dying from case fatality rate complications relating to retroviral
reduced pneumonia disease exposure, aspiration
pneumonia following epileptic fits
and lower respiratory tract infection.
Maternal, Stunting among Severe acute # # # 7% 22% (15%) Targeted threshold not achieved
neonatal, infant children reduced malnutrition death (16/229) (13/59) due to children presenting with
and child mortality under 5 years rate severe acute malnutrition with
reduced retroviral disease and pneumonia.
Maternal, Number of children Death in facility # # # 3.5% 0.74% 2.76% Target achieved. There
neonatal, infant who die in health under 5 years (330/44 522) were regular once a week
and child mortality facilities reduced against live birth paediatrics meetings held to
reduced rate discuss children under 5 deaths
and recommendations were
implemented. In other facilities, the
discussions were held whenever
there were under 5 deaths.
53
2020/21- 2020/2021 2020/2021 planned
54
2024/25) target to
Actual
Achievement
2020/2021
Quality of health Patients Patients’ # # 80% 80% 90.2% 10.2% Target exceeded due to a higher
services in public report positive experience of care (65341/73 151) number of positive responses
health facilities experience of care satisfaction survey obtained from the implemented
improved rate survey tool, namely the DPOS.
90.2% of the responses reflected
positive experience of care on
various aspects.
Virtual training was conducted
by the Provincial Team prior to
conducting the PEC Surveys in
August to September 2020.
Facility Support visits were
conducted by the Provincial Team
from 10 August – 30 September
2020.
Quality of health Hospitals ready Ideal hospital # # # 0% 16.7% 16.7% Target achieved. Kopanong
services in public to deliver quality status obtained (0/12) (2/12) Hospital achieved Silver status. In
health facilities health care addition, Heidelberg was assessed
improved during Q1 and obtained gold status.
Training was conducted prior to
self-assessment in preparation to
ensure that the hospital attained
the set standard.
Quality of health Management of Severity # # # 60% 72.7% 12.7% Target exceeded due to additional
services in public patient safety assessment code (290/399) capacity for capturing and
health facilities incidents improved (SAC) 1 incident processing of PSIs of SAC.
improved to reduce new reported within 24 Provincial office conducted training
medico-legal hours rate for 21 interns involved in capturing
cases of SAC 1 incidents and provided
supervisory visits during the period
under review.
Quality of health Management of Patient Safety # # # 40% 74.4% 34.4% Target exceeded. Capacity was
services in public patient safety Incident (PSI) (468/629) strengthened for management of
health facilities incidents improved case closure rate closure of PSIs through monitoring
improved to reduce new of institutional PSI committees.
medico-legal Training was conducted for QA
cases office staff including on the spot
training of all staff involved in PSIs
during management of all prioritised
PSIs.
2020/21- 2020/2021 2020/2021 planned
2024/25) target to
Actual
Achievement
2020/2021
Quality of health All submitted Complaints 99.4% 99.1% 97.8% 95% 92.2% (2.8%) Target not achieved, as
services in public complaints resolution within (529/ (500/ (508/ (320/ Bheki Mlangeni and South
health facilities resolved within 25 25 working days 534) 511) 534) 347) Rand Hospitals experienced
improved working days rate instability within the HR Quality
Assurance units following the
resignations of both QA managers.
Reappointments were made at end
of third quarter.
Leadership and Functional Percentage of # # # 100% 66.7% (33.3%) Target not achieved. Board
governance in governance hospitals with (12/12) (8/12) members not forming a quorum
the health sector structures in functional hospital due to absconding, death and
enhanced to hospitals boards resignations. Board activities
improve quality of affected by the outbreak of
care COVID-19 and its restrictions.
Quality of health Integration of Percentage of # # # 5.6% 5.6% 0% Target achieved.

services in public mental health into beds in District (165/2 901) (165/2 901)
health facilities primary health hospitals offered
improved services to acutely ill
mental health care
users (72hrs)
• Strengthen maternal and child death audits, and implement improvement to decrease deaths.
• Implement health education and community outreach to decrease the number of children
presenting late.
• Operationalise additional two clinics to operate 24 hours.
• Mortality review meetings implemented in all districts.
• Training on management of Obstetric Emergencies.
• To expedite timeous referrals from Obstetrics and Gynaecology (O and G) to medical care.
55
Table 4.2.5: Performance Indicators: Sub-Programme 2.3: HIV/AIDS, STI & TB (ORIGINAL APP)
56
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation Reasons for Reasons for revisions
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from deviations to the Outputs/
2020/21- 2020/2021 planned Output Indicators/
2024/25) until date of target to Annual Targets
re-tabling Actual
Morbidity and People living HIV positive # # # 5.3% 5.2% 0.1% Target achieved. Indicator was revised
premature with HIV are 15-24 years’ (571/10 904) in the revised July APP
mortality tested, initiated (excl. ANC) as it was speaking to
due to on treatment, and rate coverage rate instead
retained on care of HIV positivity rate.
Adult viral load 89% 88% # 90% 88.1% (1.9%) Viral load Target reduced to
suppressed (667 396/ (44 430/ suppression was make it more realistic
rate 762 817)1 50 408) affected by low viral and in alignment with
load results capturing the UNAIDS 90-90-90
due to high LTFU and strategy.
by implementation
of New pharmacy
SOP, which changed
prescription from 6
months to 12 months
to align to COVID-19
restrictions.
Morbidity and People living ART child 66% 67% # 90% 65.4% (24.6%) Viral load suppression Target reduced to
premature with HIV are viral load (28 449/ (574/878) is affected by low viral make it more realistic
mortality tested, initiated suppressed 34 814) load results capturing and in alignment with
due to on treatment, and rate due to high LTFU and the UNAIDS 90-90-90
retained on care clients were given strategy.
multiple prescriptions
due to COVID-19
lockdown restrictions.
Morbidity and TB cases are All DS-TB 6.3% 6.3% 9.4% 90% 8.8% (81.2%) Target not achieved Target was revised from
premature detected and client LTF rate (2 318/ (2 146/ (3 216/ (726/ due to highly mobile 90% to 5.5% in the
mortality successfully 36 800) 34 190) 34 101) 8 287) community WBOT revised APP. This was
due to treated and Tracer nurses to a typo as the indicator
trace all LTFU using persistently performed
the TB LTFU tool. at 5.5%.
1 Numerator and Denominator correction required and to be amended in the final submission
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from deviations to the Outputs/
2020/21- 2020/2021 planned Output Indicators/
2024/25) until date of target to Annual Targets
re-tabling Actual
Morbidity and DS-TB and DR- TB Rifampicin 51.7% 54.2% 57.4% 52.1% 58.2% 6.1% Target achieved. The Target was increased
premature TB cases are Resistant/ (702/ (723/ NDoH policy change from 52.1% to 60% in
mortality detected and MDR/pre-XDR 1 275) 1 388) introduced new the revised APP. The
due to successfully treatment drugs and related indicator was increased
treated success rate treatment protocols due to policy change
that resulted in better which introduced new
treatment outcomes. drugs and related
treatment protocols.
DS-TB and DR- TB XDR 97.6% 100% 98% 100% 100% 0% Target achieved. Target was reduced
TB cases are treatment start (53/53) The policy dictates from 100% to 98% in
detected and rate that all XDR patients the revised APP. This
successfully are admitted, thus indicator was reduced
treated resulting in treatment as some patients die
completion. before they are started
on treatment, while
others are traced and
not found.
TB mortality Deaths from TB All DS-TB 6.2% 6.3% 7.1% 6.3% 7.1% (0.8%) Target not achieved. Target was reduced
reduced reduced death rate (2 159/ (2 400/ (592/ Late presentation from 6.3% to 5.5%.
by 75%. 34 190) 34 101) 8 287) of patients at health The 6.3% was a typo
Morbidity and facilities. error and overestimate
premature as death rates have
mortality consistently been
due to around the 5.5%
threshold.
57
Table 4.2.6: Performance Indicators: Sub-Programme 2.3: HIV/AIDS, STI & TB (RETABLED APP)
58
2020/21- 2020/2021 2020/2021 planned
2024/25) target to
Actual
Achievement
2020/2021
Morbidity and People living HIV positive 15- # # # 4.8% 2.9% 1.9% Target achieved. The prevalence rate
premature with HIV 24 years’ rate2 (108 361/ (22 715/ amongst the adolescent and young
mortality are tested, 2 217 170) 795 984) people was maintained below the 4.8%
due to initiated on positivity rate. The achievement is due to
communicable treatment, implementation of the Prep guidelines as
diseases and retained at 1st July 2020 to prevent HIV infection.
reduced on care Implementation of new SOPs focusing on
adolescents and young adults.
Programmatic impacts of the following
programmes targeting children,
adolescents and young adults: DREAMS,
She Conquers and First Things First.
Higher Health contributed as well.
Number of 3 082 921 3 253 783 5 174 748 3.5m 4 355 221 855 221 Target exceeded due to introduction of
people tested for new testing modalities, namely HIV index
HIV testing, increase in community testing
and HIV self-screening . This included
Integrated screening for COVID-19, TB,
and HIV testing as well as extension of
101 contracts for NPOs to conduct HIV
testing on behalf of the Department.
ART Adults 898 561 1 011 503 1 111 128 1 452 199 1 115 574 (336 625) Target not achieved due to high number
remaining on of untraceable clients who relocated
ART at end of from original locations without prior
period notification. A total of 107 402 clients
consisting of adults and children
remained untraceable even after follow-
up by WBOTs.
The Department contracted 22
professional and enrolled nurses to work
as linkage and tracking officers across

sub-districts focusing mainly on sub-
districts with high unconfirmed LTFU
numbers.
2 Indicator had typo which mistakenly included phrasing that has since been corrected such as HIV-positive 15-24 years’ month coverage rate.
2020/21- 2020/2021 2020/2021 planned
2024/25) target to
Actual
Achievement
2020/2021
ART children 29 264 25 709 23 591 33 000 21 088 (11 912) Target not achieved due to high number of
under 15 years untraceable children even after follow-up
remaining in care by the WBOT.
at end of period Health education for caregivers on the
importance of bringing children under
their care for treatment.
One-Stop (Integrated) Maternal and Child
Health care (ANC, HAST, etc.).
Adult viral load 90.2% 88.7% # 95% 88.1% (6.9%) Target was not achieved due to treatment
suppressed rate (113 897/ (156 945/ interruption by patients who missed
119 681) 178 222) their appointments to collect treatment.
Emphasis will be put on ensuring
that SMS reminders and viral load
anniversaries are shared with clients
including use of E-labs.
ART child viral 67.8% 67.4% #3 95% 66.7% (28.4%) Target was not achieved due to treatment
load suppressed (5 265/ (1 955/ interruption by patients who missed
rate 5 542) 2 934) their appointments to collect treatment.
Emphasis will be put on ensuring
that SMS reminders and viral load
anniversaries are shared with clients
including use of E-labs.
Morbidity and TB cases All DS-TB client 6.3% 6.3% 9.4% 5.5% 8.7% (3.2%) Target was not achieved due to
premature are detected LTF rate (2 318/ (2 149/ (3 216/ (1 930/ (2 736/ relocating patients, untraceable and
mortality and 36 800) 34 190) 34 101) 34 800) 31 366) giving of wrong addresses. TB Technical
due to successfully Working Group has been formed bringing
communicable treated together programme and clinical experts
diseases from government and the development
reduced partners to investigate best practice
treatment regimens and outcomes
All DS-TB Client 84.2% 84% 81.6% 90% 83.5% (6.5%) Success rate affected by the two
Treatment (30 998/ (28 705/ (27 955/ (31 320/ (26 184/ unfavourable outcomes, namely high
Success Rate 36 800) 34 190) 34 101) 34 800) 31 366) LTFU of 2 736 clients and 2 312 TB
59
deaths.
3 Not measured in 2019/2020

(as per SP Indicators Target Achievement from
60
2017/18 2018/19 2019/20

2020/21- 2020/2021 2020/2021 planned
2024/25) target to
Actual
Achievement
2020/2021
Morbidity and DS-TB and TB Rifampicin 52.3% 58% 55.1% 60% 60.7% 0.2% Target achieved due to usage of the new
premature DR-TB Resistant/ (199/343) (702/ (603/ (734/ drugs and related treatment protocols.
mortality cases are MDR/pre-XDR 1 275) 1 003) 1 210) 675 clients were able to complete their
due to detected treatment treatment successfully due to improved
communicable and success rate compliance to drug regimen.
diseases successfully
reduced treated TB XDR 100% 97.7% 95% 98% 100% (2%) Target achieved due to improved
treatment start (50/51) (19/19) surveillance on XDR treatment, which
rate enables 24-hour turnaround time
diagnosis and admission of patients due
to the XDR policy.
Facilities are required to follow strict
implementation of national policy
and guidelines on the treatment and
management of XDR-TB.
Deaths from All DS-TB death 6.2% 6.3% 7.1% 5.5% 7.4% (1.9%) TB clients presented late at health
TB reduced rate (2 159/ (2 400/ (1 930/ (2 312/ facilities and this includes patients
34 190) 34 101) 34 800) 31 366) who died during the TB initial phase
of treatment. Facilities to conduct
TB mortality audits to support TB
management and clinical outcomes.
Communities will be provided with
health education on the importance of
seeking treatment early. A province-
wide evaluation programme focussing
on areas of underperformance such
as TB LTFU will be implemented in the
new financial year as part of the Quality
Improvement Plans (QIP).

• Contracted 52 professional and 52 enrolled nurses to work as linkage and tracking officers across
sub-districts focusing mainly on sub-districts with high LTFU numbers
• Implement the National Adherence strategy
• Absorption of peer educators and CHWs onto PERSAL and target setting as a KPI for them
• Ensure the Welcome Back Campaign across all districts
• Support and guide districts on Daplab med strategy to improve adherence
• Use of mobiles to reach hard-to-reach areas and populations
• Increase ExtPUP in all districts and number of patients decanted
• Conduct mortality audits across all districts
• Establish TB and HIV mortality TWG
• Educate caregivers on the importance of bringing children under their care for treatment
• Implement the support groups per district PLHIV
• Support all districts to provide (Integrated) Maternal and Child Health care (ANC, HAST, etc.)
• Implement the system of Viral load anniversaries
• Implement SMS reminder system
• Rollout of E-labs
• Caregiver education on importance of compliance
• TB Technical Working Group has been formed bringing together programme and clinical experts
from government and the development partners to investigate:
• Best practices
• TB treatment regimens and outcomes
• Missing TB cases
• TB mortality audits
• TB treatment adherence
• TB/HIV/COVID-19 integration
• Launch of TB hotline
• The interventions of LTFU and death rate will impact positively on the TB success rate and
reduction in mortality
• TB mortality audits
• Improvement of TB management and clinical outcomes
• Health education around early presentation for treatment
• Continuous integration of clinical management of TB/HIV patients
• Marketing and community usage of TB hotline for better patient outcomes
• Early case detection and linkage to treatment
Table 4.2.7: Performance Indicators: Sub-Programme 2.4: Maternal, Child and Women’s Health and Nutrition (ORIGINAL APP)
62
Outcome Outputs Output Audited/ Actual performance

Planned Actual Deviation Reasons for Reasons for revisions
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from deviations to the Outputs/Output
2020/21- 2020/2021 planned Indicators/Annual
2024/25) until date of target to Targets
re-tabling Actual
Achievement
2020/2021
Maternal, Coverage of Couple year 54.1% 55% 44% 65% 30.3% (34.7%) Target not achieved The target was revised
neonatal, infant family planning protection (175 (273 255/ due to shortage due to unavailability of
and child mortality services rate 352/ 420 393) of contraceptives injectable contraceptives
reduced increased 397 and low health care in health facilities, as
208) facility utilisation as there was no signed
a result of COVID-19 National contract for
and National injectable contraceptives
Lockdown. Oral in April through to June
contraceptives and 2020.
long-acting reversible
contraceptives were
promoted.
Institutional Maternal 108.5/ 122.8/ 102.9/ <80 103.6 (23.6%) Target not reached Target was changed,
maternal mortality in 100 100 100 (177/ (66/ as a result of factoring in deaths that
mortality ratio facility ratio 000 000 000 221 020) 63 683) hypertension in could increase due to
reduced live births live births live births pregnancy as one of COVID-19.
the leading causes of
maternal deaths.
Continuation of M&M
meetings to review
maternal deaths in
order to prevent future
similar deaths is
necessary.
Morbidity and Mother-to-Child Infant 0.99% 0.73% 0.71% <1.3% 0.65% 0.52% Target achieved There was reduction in
premature Transmission positive PCR (294/ (292/ (70/ because of the number of infants
mortality due to of HIV AIDS test around 40 251) 41 294) 10 768) implementation of testing positive for PCR
communicable eliminated 10 weeks Side-by-Side Strategy. around 10 weeks.
diseases reduced rate
The implementation
of Side-by-Side
Strategy by engaging
communities on health
education through
community radio
stations improved
identification and
testing of infants at
health facility visits.
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from deviations to the Outputs/Output
re-tabling Actual
Achievement
2020/2021
Morbidity and Epidemics / Immunisation 77% 84.3% 87.3% 98% 77.7% (20.3%) Target not achieved. Target changed due
premature occurrences of under 1 year 200 139/ (221 437/ (227 222/ (197 525/ (49 715/ All districts did not to reduced PHC head
mortality due to communicable coverage 259 772 262 623) 256 733) 201 556) 63 985) meet the target due to count due to COVID-19
communicable diseases low PHC utilisation as lockdown.
diseases reduced reduced a result of COVID-19
lockdown.
Action Plan
The implementation
of Side-by-Side
education through
community radio
stations to improve
access to health
facilities.
Morbidity and Epidemics / Measles 74.5% 77.2% 79.9% 98% 69.6% (28.4%) Target not achieved. Target changed due
premature occurrences of second dose (189 446/ (202 725/ (205 414/ (199 884/ (44 302/ All districts did not to reduced PHC head
mortality due to communicable coverage 254 306) 262 623) 256 733) 203 963) 63 652) meet the target due to count due to COVID-19
communicable diseases low health care facility lockdown.
diseases reduced reduced utilisation as a result of
COVID-19 lockdown.
Action Plan
The implementation
of Side-by-Side
education through
community radio
stations to improve
access to health
facilities.
63
(as per SP Indicators Target Achievement from deviations to the Outputs/Output
64
2017/18 2018/19 2019/20

re-tabling Actual
Achievement
2020/2021
Maternal, Under 5 deaths Death under # # # 1.8% 1.5% 0.3% Action Plan There was a downward
neonatal, infant reduced 5 years (4 000/ (928/61 449) Improved trend in mortality
and child mortality against live 221 020) implementation of observed.
reduced birth rate protocols.
Continue
implementation
of Side-by-Side
education through
community radio
stations to improve
access to health
facilities.
Maternal, Nutritional Vitamin A 50.5% 55.1% 52.6% 80% 34.7% (45.3%) Target not met due to The target was corrected
neonatal, infant needs of dose 12- (1 (175 343/ (176 003/ low health care facility back to the initial
and child mortality children under 59 months’ 067 632/ 219 179) (1 010 832/2)) utilisation as a result of recommended target of
reduced 5 taken care of coverage 2 026 COVID-19 lockdown. 57%.
062) Districts could not
reach out to ECD
centres due to closure
of ECDs.
Action Plan
The implementation
of Side-by-Side
education through
community radio
stations to improve
access to health
facilities.
TABLE 4.2.8: Performance Indicators: Sub-Programme 2.4: Maternal, Child and Women’s Health and Nutrition (RE-TABLED APP)
Outcome Outputs Output Audited/ Actual performance Planned Target Actual Deviation Reasons for deviations
(as per SP Indicators 2020/2021 Achievement from
2020/21- 2020/2021 planned
2017/18 2018/19 2019/20
2024/25) target to
Actual
Maternal, Coverage Couple year 54.1% 55% 44% 55% 45.3% (9.7%) Target not achieved due to shortage
neonatal, of family protection rate (175 352/ (231 216/ (1 825 479/ of contraceptives. In January 2021 a
infant and planning 397 208) 420 393) 4 028 597) new contract was signed to increase
child mortality services availability of injectable contraceptives.
reduced increased
Teenage Delivery 10-19 8.1% 6.7% 7.5% 10% 8.9% (1.1%) Target not achieved. Teenagers who
pregnancy years in facility (14 920/222 (15 882/ (23 490/ (20 250/226 delivered in our health facilities have
managed rate 115) 210 544) 234 826) 633) increased by 4,368 when compared
to the previous financial year period.
Continuation of health education on
reproductive health services at health
facilities and schools to promote access
to health facilities will be embarked on
including promotion of Adolescent and
Youth Friendly Services to promote
access to health services.
Antenatal Antenatal first 61.4% 64.7% 66.5% 70% 63.3% (6.7%) Target not achieved due to COVID-19
care visits visit before 20 (173 316/ (180 229/ (208 351/ (164 576 / lockdown-related restrictions resulting in
before weeks rate 268 008) 271 224) 297 644) 259 926) low PHC utilisation and ANC attendance.
20 weeks A comparison of the two financial years
increased on ANC attendance reveals a decline in
ANC attendance when compared to the
same period in the previous year.
Emphasis will be placed on the provision

of health education in health facilities
focussing on early ANC attendance and
the importance of early bookings. This
will include routine testing according
to circular 1 of 2020 on compulsory
pregnancy testing of women of
childbearing age, pregnancy screening
at community levels by WBOTs and

subsequent referrals of pregnant women
to facilities.
65
66
2020/21- 2020/2021 planned

2017/18 2018/19 2019/20
2024/25) target to
Actual
Institutional Maternal 122.8/ 102.9/ <95 118.7 (23.7) Target not achieved. Hypertension in
maternal mortality in 100 000 100 000 (220/230 (294/247 755) pregnancy is one of the leading causes
mortality facility ratio live births live births 417) of maternal deaths. A comparison of
ratio the two financial years on in-facility
reduced maternal mortality ratio (iMMR)
during the two reporting periods
revealed an increase. Focus will be on
improving implementation of maternal
care standards for management of
hypertension in pregnancy at PHC level
and strengthening of BANC Plus and
ESMOE training, including monitoring of
midwives for early detection of risks and
referral to next level of care.
Maternal, Improved Live birth # # #4 13.5% 13% 0.5% Target achieved. To continue
neonatal, under (31 000/230 (31 005/238 strengthening of the Basic Antenatal
infant and 2 500g in 417) 749) Care (BANC) Plus Trainings to address
child mortality facility rate maternal conditions known to contribute
reduced to preterm birth such as hypertension in
pregnancy.
Postnatal Mother 70.8% 75.1% 85.5% 80% 75% (5%) Target not achieved due to cross-
care postnatal visit (166 728/ (180 000/ (184 333/ (169 959/ boundary issues as some women who
coverage within 6 days 222 115) 210 544) 230 417) 226 633) delivered in hospitals do not return to
increased rate health care facilities, as some are still
admitted in hospitals on day 6 or have
left the district and/or Province where
they delivered.
Neonatal Neonatal (<28 13.6 13 12.4 12 13.2 (1.2) Target not achieved. The most common
death days) death in 1 000 live (2 840/ (3 161/ causes of neonatal deaths were
reduced facility rate births 230 417) 238 749) nosocomial sepsis, birth asphyxia and
prematurity.
To continue implementing the monthly
PPIP Programme and M&M meetings
where neonatal deaths are discussed

and reviewed with recommendations
implemented promptly.
4 New measurement
2020/21- 2020/2021 planned
2017/18 2018/19 2019/20
2024/25) target to
Actual
Morbidity and Mother- Infant positive 0.99% 0.73% 0.71% <1.2% 0.69 % 0.5% Target achieved due to the
premature to-Child PCR test (294/40 251) (292/41 294) (418/34 800) (299/43 430) implementation of Side-by-Side health
mortality around 10 education strategy delivered through
due to weeks rate community and national radio stations.
To continue with Side-by-Side campaign
strategy to strengthen ongoing radio
dialogues with caregivers through
community and national radio stations.
Morbidity and Epidemics / Immunisation 77% 84.3% 88.5% 90% 85% (5%) Target not achieved because Tshwane,
premature occurrences under 1 year 200 139/ (221 437/ (227 222/ (235 179/ (217 717/ Sedibeng and West Rand Health
mortality of coverage 259 772 262 623) 256 733) 261 310) 255 530) Districts did not use the opportunity to
due to implement the Integrated Child Health
catch-up drive on time, which started at
the end of quarter 3. The catch-up drive
was meant to ensure that children with
missed immunisations were inoculated.
Strengthen the Integrated Child Health
catch-up drive and Side-by-Side Strategy
until June 2021. WBOTs to refer and
encourage caregivers to bring their
children to clinic for immunisations.
Measles 74.5% 77.2% 79.9% 90% 77.8% (12.2%) Target not achieved because Tshwane,
second dose (189 446/ (202 725/ (205 414/ (235 179/ (198 630/ Sedibeng and West Rand Health
coverage 254 306) 262 623) 256 733) 261 310) 254 832) Districts did not use the opportunity of
implementing the Integrated Child Health
catch-up drive on time to give missed
immunisations which started at the
end of quarter 3. Emphasis will be on
strengthening the integrated Child Health
catch-up drive and Side-by-Side Strategy
that will continue until June 2021 to
encourage parents and caregivers to
bring their children for immunisations.
67
68
2020/21- 2020/2021 planned

2017/18 2018/19 2019/20
2024/25) target to
Actual
Maternal, Child under Child under 2.3% 2.1% 1.7% <2.0% 2.7% (0.7%) Target not achieved. Late presentation
neonatal, 5 years 5 years’ (88/4 205) (88/5 191) (87/4 360) (70 /2 603) at health care facilities and use of herbal
infant and mortality diarrhoea case medicine which contributes to diarrhoea.
child mortality reduced fatality rate Focus will be on strengthening the IMCI
reduced community component and continuation
of the Side-by-Side Strategy on
educating parents to be well capacitated
with prevention methods and timely
presentation to seek health care.
Child under 2.6% 2.8% 1.8% <2.4% 2.3% 0.1% Target achieved. The implementation
5 years (132/ (116/ (90/ (98/ of Side-by-Side Strategy in which the
pneumonia 4 678) 6 532) 3 681) 4 269) Department engaged the community
case fatality through radio stations on health
rate education, IMCI Training and update of
health professionals.
Severely Severe acute 6.2% 6.8% 6.4% 7.2% 9.2% (2%) Target not achieved due to late
malnutrition (105/1 544) (94/1 472) (92/1 276) (75/818) presentation at health care facilities. To
death under 5 continue to support SAM deaths reviews
years rate and strengthening triaging system in
facilities so that priority can be given to
cases with life-threatening conditions
including IMCI training of health
professionals. In addition, will continue
with community MUAC project in order
to train community members for early
identification of malnutrition amongst
children.
Maternal, Under 5 Death under 5 # # #5 1.6% 1.7% (0.1%) Target not achieved due to delay in
neonatal, deaths years against (3 766/ (3 979/ seeking medical assistance by care
infant and reduced live birth rate 230 417) 238 749) givers. Causes of deaths also include
child mortality SAM, pneumonia and acute gastro
reduced enteritis with dehydration. Emphasis
need to still `be laid on timely health
seeking behaviour by care givers
and continuation of IMCI trainings,

Paediatrics M&M death review meetings
using PIP and CHIP reporting forms to
monitor causes of deaths and modifiable
factors for each death.
5 New measurement
2020/21- 2020/2021 planned
2017/18 2018/19 2019/20
2024/25) target to
Actual
Maternal, Nutritional Vitamin A dose 50.5% 55.1% 52.6% 57% 47.5% (9.5%) Target not achieved due to inability to
neonatal, needs of 12-59 months’ (1067 632/ (1 151 696/ (961 292/ visit ECDs in all five Health Districts to
infant and children coverage 2026 062) 2 020 520) 1010832*2) conduct outreaches due to COVID-19
child mortality under 5 restrictions.
reduced taken care
of
• To continue with the Integrated Maternal and Child Health catch-up drive that started at the end of
quarter 3 to June 2021 and support Side-by-Side campaigns.
• Continue supportive supervision and monitor of correct implementation of Maternal Child Health
ISHP and Nutrition protocols in all health facilities.
• Support Regional Training Centre on capacity building to improve skills of staff and services
provision.
69
Table 4.2.9: Performance Indicators: Sub-Programme 2.5: Disease Prevention and Control (ORIGINAL APP)
Outcome Outputs Output Indicators Audited/ Actual performance Planned Actual Deviation Reasons for Reasons for revisions
70
(as per SP Target Achievement from deviations to the Outputs/Output

2020/21- 2020/2021 2020/2021 planned Indicators/Annual Targets
2017/18 2018/19 2019/20
2024/25) until date of target to
re-tabling Actual
Morbidity and Aspects Number of people # # # 3M 95 631 (2 904 369) Health promotion As the COVID-19 pandemic
premature of healthy reached on aspects teams in all spread and lockdown
mortality lifestyles of healthy lifestyle Health Districts restrictions were imposed,
due to non- conducted in were assigned implementation of COVID-19
communities to the provision activities became a priority
of prioritised in all Health Districts, putting
COVID-19 on hold implementation of
activities and thus healthy lifestyles activities
neglecting and that were planned for the
interrupting most reporting period such as
non-COVID-19 campaigns, events, blitzes
activities, including and radio talks.
implementation of The pandemic also led to the
aspects of healthy halting of planned meetings
lifestyles that between health promoters
include educational and support group members
messages on at venues such as health
physical activity, facilities, halls, etc. for
healthy eating healthy lifestyles/physical
and dangers of activity programmes to avoid
smoking, alcohol transmission.
and substance This interruption led to
abuse. underperformance of healthy
lifestyles indicator and thus
leading to the revision of the
annual target from 3 million to
1 million.
Morbidity and Diabetes Normal # # # 30% 35% 5% Most controlled The target was changed from
premature prevalence Haemoglobin A1c (17 508/ patients were 30% to 50% based on the
mortality managed (HbA1c) test with 49 578) managed according data that was initially shared
due to non- result <7% rate to diabetes by NHLS which showed
management over performance. However,
guidelines. HbA1c NHLS later confirmed that

was strictly there was over reporting of
monitored. cases as the data shared
was not cleaned which led to
discrepancies
Table 4.2.10: Performance Indicators: Sub-Programme 2.5: Disease Prevention and Control (RE-TABLED APP)
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation from planned Reasons for deviations
(as per SP Indicators Target Achievement target to Actual
2020/21- 2017/18 2018/19 2019/20 2020/2021 2020/2021 Achievement 2020/2021
2024/25)
Morbidity and Eliminate Malaria 1.5% 1.4% 1.3% <1% 1.2% (0.2%) Target not achieved due to
premature Malaria by inpatient case (18/1 280) (22/1 757) (16/1 600) (5/425) late health-seeking behaviour
mortality 2023 fatality rate of Malaria clients at the
due to non- facilities. The five patients
communicable who died due to Malaria came
and on average after 5 days to the
communicable facilities instead of presenting
diseases earlier for treatment.
reduced by
10% Action plan: Health promotion
to educate community
members on how to identify
symptoms relating to Malaria
and be encouraged to seek
medical attention quicker so
that diagnosis can commence
earlier
Reduced Percentage # # # 85% 97% 12% Target exceeded due to
transmission of contacts (2 390/ (280 780/ early identification of index
and COVID- traced 2 811) 288 831) cases and their contacts
19-related shared daily with districts to
mortality commence with tracing of
contacts.
COVID-19 # # # 30% 100% 70% Target achieved due
testing (91/303) (36 631/ to Outbreak Response
coverage 36 631) meeting held, where data
among management and reporting
symptomatic of NIDS indicators was
contacts of discussed and instructions
confirmed pertaining to the correct
case testing and reporting strategy
were given to districts to
implement.
All Health Districts were

instructed to test and report

COVID-19 symptomatic
contacts of the confirmed
71
cases.
72
2020/21- 2017/18 2018/19 2019/20 2020/2021 2020/2021 Achievement 2020/2021
2024/25)
Morbidity and Number # # # 565 287 28 822 055 28 256 768 Target achieved, as more
premature of people media platforms were used
mortality reached on for awareness campaigns
due to non- COVID-19 and the listenership of some
communicable prevention media platforms overlap to
diseases measures other provinces. Letters from
reduced by (this includes radio stations confirming
10% people listenership, dates when
reached messages were broadcasted,
through media briefings linked to
campaigns, those particular periods and
radio and registers on the numbers
other media linking to the 28 million.
platforms)
Morbidity and Diabetes Normal # # # 50% 33% (17%) Target not achieved due to
premature prevalence Haemoglobin (3 132 759/ (122 296/ poor lifestyle modification.
mortality managed A1c (HbA1c) 6 265 519) 371 869)
due to non- test with result Obesity is one of the biggest
communicable <7% rate challenges in management of
diseases diabetes.
reduced by Poor implementation of
10% treatment guidelines in
managing diabetes.
Morbidity and School School Grade 83 402 88 200 74 222 82 000 17 922 (64 078) HPV and Td Vaccination
premature Grade 1 and 1 learners Campaigns were conducted
mortality 8 learners screened in March 2021.
due to non- screened (Quintile 1-5 ISHP Teams participated
communicable public primary in follow-up of COVID-19
diseases schools) contacts and cases in
reduced by schools.
10% Due to lockdown regulations,
school attendance was
affected as schools were

following rotational schedules.
2020/21- 2017/18 2018/19 2019/20 2020/2021 2020/2021 Achievement 2020/2021
2024/25)
School School Grade 46 612 48 818 54 357 42 000 4 944 (37 056) ISHP Teams participated
Grade 1 and 8 learners in follow-up and risk
8 learners screened assessments of COVID-19
screened (Quintile 1-5 contacts and cases.
public primary Lockdown regulations and
schools) school attendance was
affected as schools were
following rotational schedules.
Aspects Number # # # 1M 3 733 348 2 733 348 Target exceeded due to
of healthy of people Health Promoters in all the
lifestyles reached Health Districts trained on
conducted in on aspects Integrated Healthy Lifestyles
communities of healthy messages with COVID-19
lifestyles messages between
September and December
2020.

• Adjust HbA1c targets from 7% to ≤8% according to the current Primary Health Care guidelines as from 1 April 2021.
• Strengthen healthy lifestyle educations and campaigns.
• HBA1c – Continue with M&E support visits to the facilities in the districts.
• Public Health Directorate will also conduct support visits to districts targeting the worse performing facilities and conduct diabetes patient file
audit to monitor if patients are managed according to the guidelines.
• Facilities are encouraged to develop Quality Improvement plans to improve the management of diabetes.
• Districts continue with patients’ files audits to monitor management of diabetes patients. If there are gaps identified, an onsite in-service
training will be conducted to address the gaps or strengthen the diabetes management.
73
Table 4.2.11: Progress on Institutional Response to the COVID-19 Pandemic Institutional response to COVID-19
Budget Intervention Geographic Total budget Budget spent per Contribution to the Immediate outcomes
74
No. of beneficiaries
Programme location (Province/ (where possible) allocation per intervention Outputs in the APP
District/local intervention (where applicable)
(R’000)
municipality) (R’000)
(where possible)
DISTRICT - Compensation of PHC clinics, District 1 790 staff employed 165 909 336 340 Quality of health services
HEALTH Employees (Staff hospitals and five for COVID in public health facilities
Reduced
SERVICES Appointments District offices improved.
transmission and
towards COVID-19
COVID-19-related
pandemic) Morbidity and premature mortality
mortality
due to non-communicable and
communicable diseases reduced
by 10%.
- Goods & Services PPE and COVID-19 750 360 726 442 Morbidity and premature mortality
(Medical Lab, testing of Personnel due to non-communicable and
Consumable communicable diseases reduced
supplies and by 10%.
Medical supplies)
- Machinery and Medical equipment 0 7 311 Quality of health services

Equipment procured for clinical in public health facilities
(Assistive Device) care improved.
Table 4.2.12: District Health Services Expenditure Table

PROGRAMME 2: DISTRICT HEALTH SERVICES
R’000 R’000 R’000 R’000 R’000 R’000

District Management 741 510 826 873 (84 863) 3 630 667 3 525 137 105 530
Community Health
Clinics 2 619 815 2 475 289 44 526 690 759 676 273 14 486
Community Health
Centres 2 189 501 2 064 122 125 379 2 502 946 2 365 449 137 497
Community-Based
Services 2 379 878 2 445 328 (65 450) 2 118 456 1 970 765 147 691
HIV/AIDS 6 167 521 5 986 853 180 938 2 310 909 2 191 503 119 406
Nutrition 4 591 4 591 - 4 984 690 4 862 623 122 067
Coroner Services 265 549 263 857 1 692 58 627 58 586 41
District Hospitals 3 998 246 3 893 104 105 142 260 627 245 116 15 511
18 366 611 17 959 247 407 364 16 557 681 15 895 452 662 229
4.3 BUDGET PROGRAMME 3: EMERGENCY MEDICAL SERVICES
Purpose of the programme
• To render pre-hospital Emergency Medical Services (EMS), including inter-hospital transfers and
planned patient transport services
• Emergency transport
• Rendering EMS including special operations, communications and air ambulance services
• Rendering planned patient transport including local outpatient transport (within the boundaries of
a given town or local area) and inter-city/town outpatient transport (into referral centres)
Strategic Objectives
• Improved patient experience of care

• Improved clinical services
List of Sub-Programmes
• Emergency Transport
• Planned Patient Transport
Programme Outcome
• Quality of health services in public health facilities improved: -

• EMS has invested in diagnostic equipment per category of ambulance, as well as skills training
that has contributed to correct prioritising of patients in order to be transported to the correct
and appropriate health facility.
Provincialisation
• Gauteng Department of Health EMS has successfully provincialised the City of Ekurhuleni
Emergency Management Services on 1 July 2020 to render seamless emergency medical services
in line with economies of scale.
EMS footprint
• We increased the EMS footprint to 57 EMS bases in Gauteng Province.
Fleet
• We have completed our recapitalisation plan with a total fleet now standing at 1 328 vehicles.
• We have all vehicles fitted with vehicle tracking, so the closest and most available resource can
be dispatched in emergencies.
Human Resources
• We have invested in Human Capital to improve operational capacity with an additional 2 685
employees, attracting scarce skills. The breakdown is as follows: 520 Intermediate Life Support
(ILS), 6 Emergency Care Technicians, 13 Advanced Life Support Paramedics, 22 Shift Leaders
and 15 Station Managers.
Emergency Communication Centre (ECC)
• The ECC has been expanded in line with call demands post Provincialisation with an additional
20 call-taking seats and 25 call-dispatching seats.
• The Provincial Health Operations Centre (PHOC) has been rearranged with a Complaints desk,
Fleet desk, COVID-19 desk, Aeromedical & CU desk and Managing Medical Officer (MMO) desk.
Equipment
• Invested in diagnostic equipment to improve patient outcomes, e.g., Ultrasound technology.
Training and Development
• We have completed the first class of Emergency Care Assistants (Higher Certificate qualification),
a first of its kind in the Republic of South Africa.
• In line with Clinical Practice Guidelines (CPGs), we have completed all updates on Basic
Ambulance Assistants and ILS.
Challenges
• Paramedic attacks and associated robberies of personal items.

• Retention of scarce skills in the long term.
• Proposed amendments to AARTO Act affecting drivers’ licences of EMS employees.
• EMS bases not meeting requirements of Ideal EMS framework.
1. Conduct trend analysis and resource reallocation.

2. Look at Infrastructure needs as per caller locations.
3. Ongoing skills attraction in Human Resources (scarce skills).
Table 4.3.1: Performance Indicators: Programme 3: Emergency Medical Services
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation from Reasons for deviations
(as per SP Indicators Target Achievement planned target
2020/21- 2020/2021 2020/2021 to Actual
2024/25) 2017/18 2018/19 2019/20 Achievement
2020/2021
Quality of health EMS EMS P1 urban 81.2% 82.3% 82.8 82% 95.8% 13.8% Target achieved. Continuous monitoring.
services in public response time response under (5 481/ (7 570/
health facilities improved 30 minutes rate 6 660) 7 903)
improved
EMS P1 rural 100% 100% 100% 100% 94.4 (5.6%) Target not achieved.
response under (170/170) (118/125) Specialised Ambulances responded
60 minutes rate [Intensive Care Unit (ICU)] to calls [Priority
(1) inter-facility transfers] in Urban areas,
which affected response time.
Table 4.3.2:Emergency Medical Services Expenditure Table

PROGRAMME 3: EMERGENCY
MEDICAL SERVICES
Final Appropriation Actual Expenditure (Over)/Under Final Appropriation Actual Expenditure (Over)/Under
Expenditure Expenditure
R’000 R’000 R’000 R’000 R’000 R’000
EMERGENCY TRANSPORT 1 517 413 1 531 680 (14 267) 1 341 503 1 424 067 (82 564)
PLANNED PATIENT TRANSPORT 163 957 149 121 14 836 200 211 115 714 84 497
1 681 370 1 680 801 569 1 541 714 1 539 781 1 933
77
4.4 BUDGET PROGRAMME 4: PROVINCIAL HOSPITAL SERVICES
Programme Purpose
Delivery of hospital services, which are accessible, appropriate, effective and provide general
specialist services, including a specialised rehabilitation service, as well as a platform for training
health professionals and research.
• General (Regional) Hospitals
Rendering of hospital services at a general specialist level and a platform for training of health workers
and research.
• Tuberculosis Hospitals
Convert present Tuberculosis hospitals into strategically placed decentralised sites in which a small
percentage of patients may undergo hospitalisation under conditions, which allow for isolation during
the intensive level of treatment, as well as the application of the standardised multi-drug-resistant
(MDR) protocols.
• Psychiatric / Mental Hospitals
Rendering a specialist psychiatric hospital service for people with mental illness and intellectual
disability and providing a platform for the training of health workers and research.
• Sub-acute, Step-down and Chronic Medical Hospitals
These hospitals provide medium- to long-term care to patients who require rehabilitation and/or a
minimum degree of active medical care but cannot be sent home. These patients are often unable to
access ambulatory care at our services, or their socio-economic or family circumstances do not allow
for them to be cared for at home.
• Dental Training Hospitals
Rendering an affordable and comprehensive oral health service and training, based on the primary
health care approach.
Department’s outcomes which will impact on the strategic priorities of government
The strategic objective of reducing maternal mortality was achieved, as the target of 129 deaths/100
000 live births was exceeded with 128/100 000 deaths (105/81 895 live births).
The Regional hospitals also allocated 1.8% of beds (82/4 547) for acutely ill mental health patients.
This contributed to the integration of Mental Health Care from Primary Health Care services to hospital
services.
Comments by the programme on its response to prioritising women, youth and persons with disabilities
in its service delivery environment and challenges encountered (if applicable)
Of the 9 648 EPWP work opportunities reported, 8 122 were women who benefited from the job
creation projects. This will contribute towards improvement in the quality of life of the women and their
families. In addition, 4 060 of the 9 648 work opportunities reported were to the benefit of youth. The
appointment of Community Health Workers (CHWs) as permanent employees of the Department also
contributed in increasing the number of youth appointed and women.

A number of the EPWP participants were also placed in the Regional hospitals.
Challenges
In the Regional hospitals, planned surgical procedures were delayed as focus was given to COVID-19-
related demands on the institutions.
• Mortality Audit meetings to be strengthened in all facilities, and Improvement plans to be developed.
• Compliance to clinical treatment protocols to be monitored.
Table 4.4.1: Performance Indicators: Sub-Programme 4.1: Regional Hospitals (ORIGINAL APP)
80

2020/21- 2020/2021 2020/2021 planned Indicators/Annual
2024/25) 2017/18 2018/19 2019/20 until date of target to Targets
re-tabling Actual
Maternal, Number of Maternal # # # 139.0 107.7 31.3 Target achieved due Targets were reduced
neonatal, women who mortality in (101/72 500) (23/21 352) to the implementation to align them with
infant die in health facility ratio of M&M Committee retrospective patterns.
and child facilities is meetings in which
mortality reduced all maternal deaths
reduced are discussed and
recommendations
for improvement are
made.
Death of Child under # # # 2.7% 3% (0.3%) Target not achieved. Targets were reduced
children 5 years’ (42/1 550) (4/134) Deaths due to to align them with
under 5 diarrhoea diarrhoea were due retrospective patterns.
years from case fatality to severe acute
diarrheal rate gastroenteritis,
diseases is severe dehydration and
reduced late presentation of
clients.
Death of Child under # # # 3.4% 2.2% (0.6%) Target achieved, as Targets were reduced
children 5 years’ (69/2 022) (7/314) Paediatric ward rounds to align them with
under 5 pneumonia were implemented after retrospective patterns.
years from case fatality hours.
pneumonia rate Gaps identified through
is reduced the Child Healthcare
Problem Identification
form, which identifies
modifiable factors such
as late presentation
which are attended
to quicker during
paediatrics discussion
meetings.
re-tabling Actual
Maternal, Death of Severe # # # 5.0% 12.5% (7.5%) Target not achieved Targets were reduced
neonatal, children acute (30/590) (6/48) due to general increase to align them with
infant under 5 malnutrition in SAM, Retroviral retrospective patterns.
and child years from death under disease exposure and
mortality malnutrition 5 years’ dehydration.
reduced is reduced rate SAM deaths are
compounded by other
factors such as severe
infection, sepsis and
RVD.
Quality Patients Patients’ 81.7% 80% 76% 90% 85.7% (4.3%) Target not achieved. Targets changed due
of health report experience (53 029/ Due to COVID-19 to shifts in Quality
services in positive of care 61 880) Pandemic restrictions, Assurance managers
public health experience satisfaction the National PEC who were shifted to
facilities of care rate Survey Tool was not support the COVID-19
improved used. Instead, the Daily response.
Patient Opinion Survey
Tool (DPOS) was used
which is simple, short,
with straightforward
questions.
Target exceeded due
to a higher number
of positive responses
obtained from the
implemented survey
tool, namely the DPOS.
81
82

re-tabling Actual
Quality Incidence % of # # # 4 beds/ N/A N/A Not measured quarterly Target discontinued
of health of harm and Regional 1 000 live but only annually. due to lack of
services in hospitals births standardised norms.
public health with
facilities adequate
improved neonatal
beds
capacity
Quality Hospitals are Percentage # # # 44.4% N/A N/A N/A Indicator discontinued
of health of hospitals because NDoH
services in (4/9) introduced Quality
public health learning centres to
facilities prepare facilities for
improved. Quality Improvement
initiatives.
Adverse Severity # # # 60% 74% 14% Provision of additional Target revised in
events and assessment personnel in health anticipation of the
(62/84)
incidents code (SAC) facilities to support COVID-19 pandemic
reported incident capturing and disruptions.
within 24 reported processing of PSIs.
hours within Supervisory support
24 hours’ visits to all facilities that
rate were non-compliant
was conducted.
Training was conducted
to QA office staff and
on the spot teaching to
all staff involved in PSI
was done.
Table 4.4.2: Performance Indicators: Sub-Programme 4.1: Regional Hospitals (RE-TABLED APP)
2020/21- 2020/2021 2020/2021 target to Actual
2024/25) 2017/18 2018/19 2019/20 Achievement
2020/2021
Maternal, Number of Maternal # # # 129.0 128.2 0.8 Target achieved.
neonatal, women who die mortality in (98/74 700) (105/81 895) Mortality review meetings
infant and in health facilities facility ratio implemented in all districts.
child mortality is reduced Training on management
reduced of Obstetric emergencies
continuing.
Death of children Child under 5 # # # 2.2% 2.7% (0.5%) Target not achieved.
under 5 years years’ diarrhoea (40/1 750) (23/851) Children who died due
from diarrheal case fatality rate to diarrhoea had other
diseases is conditions such as severe
reduced acute gastroenteritis and
severe dehydration
complicated by late
presentation of clients.
Death of children Child under # # # 3.0% 2% 1% Target achieved, as
under 5 years 5 years’ (65/2 100) (34/1 667) Paediatric ward rounds
from pneumonia pneumonia case were implemented after
is reduced fatality rate hours.
Gaps identified through the
Child Healthcare Problem
Identification form, which
identifies modifiable factors
such as late presentation
which are attended to
quicker during paediatrics
discussion meetings.
Maternal, Death of children Severe acute # # # <5% 8.5% (3.5%) Target not achieved due
neonatal, under 5 years malnutrition (30/600) (24/281) to general increase in
infant and from malnutrition death under 5 SAM children presenting
child mortality is reduced years’ rate with Retroviral disease
reduced exposure and dehydration.
SAM deaths are
compounded by other
factors such as severe
infection and sepsis.

83
84
2020/21- 2020/2021 2020/2021 target to Actual

2024/25) 2017/18 2018/19 2019/20 Achievement
2020/2021
Maternal, Death of children Death in facility # # # # 1.8% N/A Children presenting at
neonatal, under 5 years in under 5 years (1 451/79 677) health facilities do present
infant and health facilities is against live birth late at facilities and
child mortality reduced rate also present with other
reduced underlying conditions such
as RVD, Sepsis, SAM and
pneumonia.
Quality of health Patients Patients’ 81.7% 80% 76% 50% 85.69% 35.69 Target exceeded due to a
services in report positive experience of (53 029/61 880) higher number of positive
public health experience of care satisfaction responses obtained from
facilities care rate the implemented survey
improved tool, namely the DPOS.
85.7% of the responses
reflected positive
experience of care on
various aspects.
Virtual training was
conducted by the
Provincial Team prior
to conducting the PEC
Surveys.
conducted by Provincial
Team.
Quality of health Hospitals are Ideal Hospitals # # 0 22.2% 22.2% 0% Thelle Mogoerane Hospital
services in ready to deliver status obtained (2/9) (2/9) and Sebokeng Hospital
public health quality health achieved Silver status.
facilities care and obtain Training by was conducted
improved ideal status prior to self-assessment.
Adverse events Severity # # # 40% 74.1% 34.1% Target exceeded due to
and incidents assessment (519/700) additional capacity for
reported within code (SAC) capturing and to support
24 hours incident reported processing of PSIs of
within SAC 1. Provincial office
24 hours’ rate conducted training to

21 interns involved in
capturing SAC incidents
and provided supervisory
visits during the period
under review.
2020/21- 2020/2021 2020/2021 target to Actual
2024/25) 2017/18 2018/19 2019/20 Achievement
2020/2021
Patient safety Patient Safety # # 50% 60% 74% 14% Capacity was strengthened
incidents Incident (PSI) (917/1 242) for management of
reported and case closure closure of PSIs through
managed rate monitoring of institutional
timeously PSI committees. We
have conducted training
for QA office staff and
furthermore provided
on the spot teaching for
all staff involved in PSIs
during management of all
prioritised PSIs.
Leadership and Functional Percentage # # # 100% 0% (100%) There was no activity due
governance in governance of hospitals 9/9 (0/7) to outbreak of COVID-19
the health sector structures in with functional and its restrictions.
enhanced to hospitals hospital boards
improve quality Hospital board members
of care are volunteers and they do
not perform an essential
function. They were not
given permits to work
during the period (first
surge of the outbreak of
the pandemic).
Board membership number
not forming a quorum due
to absconding, death and
resignations.
Quality of health Integration of Percentage of # # # 1.8% 1.8% 0% Target achieved.
services in mental health beds in Regional (82/4 547) (82/4 547)
public health into primary hospitals offered
facilities health services to acutely ill
improved mental health
care users
(72hrs)
85
Table 4.4.3: Performance Indicators: Sub-Programme 4.2: Specialised Hospitals (ORIGINAL APP)
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation Reasons for deviations Reasons for
86
(as per SP Indicators Target Achievement from revisions to the

2020/21- 2020/2021 2020/2021 planned Outputs/Output
2024/25) until date of target to Indicators/Annual
re-tabling Actual Targets
2017/18 2018/19 2019/20 Achievement
2020/2021
Percentage # # # 44.4% N/A N/A N/A Indicator
of hospitals discontinued
implementing because NDoH
Quality introduced
Improvement Quality learning
programme centres to prepare
facilities for Quality
Improvement
initiatives.
Table 4.4.4: Performance Indicators: Sub-Programme 4.2: Specialised Hospitals (RE-TABLED APP)
2020/21- 2020/2021 2020/2021 to Actual
2020/2021
2017/18 2018/19 2019/20
Quality of health Patients Patients’ 85.2% 85.4% 77% 6 80% 94.6% 14.6% Target exceeded by 14.6%.
services in public report positive experience (6 326/ 6 683) Target exceeded due to a
health facilities experience of of care higher number of positive
improved care satisfaction responses obtained from the
rate implemented survey tool,
namely the DPOS. In addition,
the tool used during the
COVID-19 season to assess
level of satisfaction was less
cumbersome and easy to
understand.
by Provincial Team prior to the
conduction of PEC Surveys
in Q2.
Quality of health Hospitals ready Ideal # # # 22.2% 22.2% 0% Target achieved. Weskoppies
services in public to deliver quality Hospitals (2/9) (2/9) and Tshwane Rehab Hospitals
health facilities health care status obtained Silver status.
improved obtained
Quality of health Prompt response Severity # # # 60% 66.7% 6.7% Target exceeded due to
services in public to adverse events assessment (12/18) additional capacity for
health facilities code (SAC) capturing and to support
improved 1 incident processing of PSIs of SAC 1.
reported Provincial office conducted
within 24 training for 21 interns involved
hours’ rate in capturing SAC incidents
visits during the period under
review.
87
6 Indicators never audited.

88
2020/21- 2020/2021 2020/2021 to Actual

2020/2021
2017/18 2018/19 2019/20
Quality of health Incidence of harm Patient Safety # # # 60% 92.5% 32.5% Target achieved. Capacity was
services in public managed and Incident (422/456) strengthened for management
health facilities reduced (PSI) case of closure of PSIs through
improved closure rate monitoring of institutional
PSI committees. We have
conducted training for QA
office staff and furthermore
provided on the spot teaching
for all staff involved in PSIs
during management of all
prioritised PSIs.
Leadership and Functional Percentage # # # 100% 0% 100% There was no activity due to
governance in governance of hospitals (9/9) (0/6) outbreak of COVID-19 and its
public health structures in with functional restrictions.
facilities hospitals hospital Hospital board are volunteers
enhanced to boards and they do not perform an
improve quality of essential function and had no
care permits to work.

Continuation of implementation of Saving Mothers Report recommendations and improvement of
child outcomes through improvement in clinical governance.
Institutional response to COVID-19

Budget Programme Intervention Geographic No. of Total budget Budget spent per Contribution to the Immediate outcomes
location (Province/ beneficiaries allocation per intervention Outputs in the APP
District/local (where possible) intervention (where applicable)
(R’000)
(where possible)
4. PROVINCIAL - Compensation of Regional hospitals 2 050 staff 44 216 105 100 Reduced Quality of health services
HOSPITAL Employees (Staff and Specialised employed for transmission and in public health facilities
SERVICES Appointments towards hospitals in all the five COVID COVID-19-related improved.
COVID-19 pandemic) districts mortality.
Morbidity and premature

- Goods & Services Largely provision of Reduced mortality due to non-
(Consumable supplies PPE transmission and communicable and
0 11 780
and Medical supplies COVID-19 related communicable diseases
mortality. reduced by 10%.
- Machinery and Provision of 0 15 131
Equipment (Assistive Ventilators and other
Device) medical equipment
Machinery and Provision of 0 27 734 Quality of health services
Equipment (Assistive Ventilators and other in public health facilities
Device) medical equipment improved.
-Building and other Refurbishment and 1 777 461 1 760 937 Reduced
fixed structures expansion and transmission and
COVID-19 beds COVID-19-related
mortality.
Table 4.4.5: Provincial Hospital Services Expenditure

Programme 4: PROVINCIAL HOSPITAL SERVICES
R’000 R’000 R’000 R’000 R’000 R’000
GENERAL HOSPITALS 7 279 341 7 414 991 (135 360) 6 768 628 6 735 022 33 606
TUBERCULOSIS HOSPITALS 333 806 305 465 28 341 325 754 310 335 15 419
PSYCHIATRIC/MENTAL HOSPITALS 1 585 024 1 523 443 61 581 1 461 226 1 531 428 (70 202)
DENTAL TRAINING HOSPITALS 633 467 563 679 69 788 622 249 551 622 70 627
OTHER SPECIALISED HOSPITALS 110 641 98 272 12 369 96 548 96 051 497
9 942 279 9 905 850 36 429 9 274 405 9 224 458 49 947
89
4.5 BUDGET PROGRAMME 5: CENTRAL HOSPITAL SERVICES
CENTRAL HOSPITALS
Programme Purpose
To provide tertiary health services and create a platform for the training of health workers through sub-
programmes: Tertiary and Central hospitals.
• The Provincial Tertiary Hospital Services sub-programme renders general specialist and tertiary
health services on a national basis and maintains a platform for the training of health workers and
research.
• The Central hospitals sub-programme renders highly specialised medical health and quaternary
services on a national basis and maintains a platform for the training of health workers and
research.
Programme Outcomes
• Maternal, neonatal, infant and child mortality reduced.
• Leadership and governance in public health facilities enhanced to improve quality of care.
Department’s outcomes which will impact on the strategic priorities of government.
The establishment of the 32-bed lodger Mothers Ward at the CHBAH is a testimony to the improvement
of quality health services for the Mother and Child Health Programme as well as the improvement
in access to health care services for mothers and children. The reduction in the fatality of children
below five years due to Severe Acute Malnutrition (SAM) and pneumonia indicates that the Central
and Tertiary hospitals are doing their best with limited resources and the challenges of the COVID-19
pandemic to provide health services geared for better outcomes for the Mother and Child Priority
Health Programme.
Challenges
The establishment of the 32-bed lodger Mothers Ward at CHBAH, and the existence of lodger Mothers
Wards at Kalafong PTH, Tembisa PTH and Dr George Mukhari Academic Hospital are currently aimed
towards the prioritisation of women’s health. The 24/7 Maternity/Gynaecological Services at all the six
(4+2 excluding HJPTH) hospitals is indicative of the firm investment in women’s health by the GDoH.
Access to internship and learnership opportunities in Administrative activities at the 4 Central and 3
Tertiary hospitals is a contribution towards skills transfer and enhancement for the youth. In addition, it
creates opportunities for employment in the GDoH and other entities, both public and private.
Persons living with disabilities are employed in the facilities, however infrastructure challenges are still
encountered which require redress and consolidation for the access of persons living with disabilities
to the 4 Central and 3 Tertiary hospitals. This has been complicated by the COVID-19 pandemic and
all its effects.
Dr George Mukhari Academic Hospital
At DGMAH we still lack Obstetrics and Gynaecology subspecialist posts in many areas except
Oncology. These posts are required to deliver the needed sub-specialty services that are part of a
Central Hospital’s mandate. It is recommend to create these posts at GDoH and advertise them to
attract interested individuals.
Required Posts
• Head of Clinical Unit: Feto-Maternal

• Head of Clinical Unit: Infertility
• Head of Clinical Unit: Uro-gynae
These posts are needed over and above the currently existing posts in the Department at DGMAH.
Decrease in mortality of children under 5 years who were admitted for SAM, pneumonia and diarrhoea.
Chris Hani Baragwanath Academic Hospital
Target for death of children under 5 years in facility against the planned target was achieved. The
annual performance is 3.8% against the planned target of 4.7%. This reflects a positive deviation of
0.9% for the period under review. This has enabled early intervention and prevention of complications
that could have resulted in poor outcomes.
The hospital is a 24-hour operation providing Gynaecology clinics to prioritise women who require
emergency gynaecology services. Refurbishment of the Mother and Child division is in progress, and
refurbishments for the Neonatal unit have been expedited to be finished in July 2021. The 32-bed
mother lodger facility was handed over during August 2020.
There were two unavoidable maternal mortalities in the month of July 2020 out of 641 live births. There
were no under-5 mortalities from pneumonia in April 2020 at DGMAH, and only one admission with
SAM and no mortality in July 2020 at DGMAH.
Challenges
Infrastructure, appropriate HR (e.g. advanced midwives and specialists), late referrals of maternity
patients which often lead to fatalities, the need to sustain low maternal mortality rates, budget challenges
and cost containment, as well as the COVID-19 pandemic and all its complications.
Chris Hani Baragwanath Academic Hospital
Accessibility to persons living with disabilities is a challenge in certain areas of the facility. In addition,
there are infrastructural challenges that pose a risk to OHS compliance. DID need to expedite the
appointment of a service provider to remedy the situation.
Overcrowding of patients and limited infrastructure leading to unavailability of beds, which in turn results
in mothers not being properly monitored according to standards.
The hospital has few theatres, with only one emergency obstetrics theatre, one theatre dedicated
to gynaecology and one elective obstetrics theatre. These cannot cater for the population that has
increased significantly.
Other challenges include unreasonable nurse–patient ratios and gross shortage of staff, dilapidated
infrastructure which makes it difficult to sustain infection control protocols, and late referral of mothers
by cluster or patients reporting late to health facility.
Table 4.5.1: Performance Indicators: Programme 5: Central Hospitals
Outcome Outputs Output Audited/ Actual Planned Actual Deviation Reasons for Reasons for
92
(as per SP Indicators performance Target Achievement from planned deviations revisions to the
2020/21- 2017/18 2018/19 2019/20 2020/2021 2020/2021 until target to Outputs/Output
2024/25) date of re- Actual Indicators/Annual
tabling Achievement Targets
2020/2021
Maternal, neonatal, Women who Maternal # # # 181 215.6 (34.6) Target not achieved. During the 2nd
infant and child die in health mortality in (80/44 000) Mother transferred quarter of 2020/21,
(23/10 670)
mortality reduced facilities facility ratio to seek care in a facilities were told
reduced critical state: RVD to revise targets in
stage 4. line with previous
performance.
Less children Child under # # # 1.9% 2.6% (0.7%) Target not achieved During the 2nd
under 5 years 5 years’ (30/1 620) due to late quarter of 2020/21,
(4/151)
dying from diarrhoea presentation by facilities were told
diarrhoea case fatality clients. to revise targets in
rate line with previous
performance.
Less children Child under # # # 2.1% 3.7% (1.6%) Target not achieved During the 2nd
under 5 years 5 years’ (36/1 700) due to COVID-19 quarter of 2020/21,
(8/219)
dying from pneumonia complications. facilities were told
pneumonia case fatality to revise targets in
rate line with previous
performance.
Less children Severe acute # # # 5% 4.5% 0.5% Target achieved. During the 2nd
dying from malnutrition (28/560) quarter of 2020/21,
(4/88)
malnutrition death under 5 facilities were told
years’ rate to revise targets in
line with previous
performance.
Maternal, neonatal, Number of Death in # # # 5.8% 3.8% 2% Target achieved. During the 2nd
infant and child children who facility under 5 (1 500/ quarter of 2020/21,
(401/10 498)
mortality reduced die in health years against 26 000) facilities were told
facilities live birth rate to revise targets in
reduced line with previous
performance.
Outcome Outputs Output Audited/ Actual Planned Actual Deviation Reasons for Reasons for
(as per SP Indicators performance Target Achievement from planned deviations revisions to the
2020/21- 2017/18 2018/19 2019/20 2020/2021 2020/2021 until target to Outputs/Output
2020/2021
Quality of health Incidence of Patient Safety # # # 60% 67.6% 7.6% Target achieved. Target amended
services in public harm managed Incident (PSI) (1 197/1 770 Capacity was in anticipation of
health facilities and reduced case closure strengthened for the COVID-19
improved rate management of pandemic
closure of PSIs disruptions.
through monitoring
of institutional PSI
committees. We
have conducted
training for QA office
staff and have also
provided on the spot
teaching to all staff
involved in PSIs
during management
of all prioritised
PSIs.
Quality of health Percentage # # # 2 N/A N/A N/A Indicator
services in public of hospitals discontinued
health facilities implementing because NDoH
improved Quality introduced
Improvement Quality learning
initiative centres to prepare
facilities for Quality
Improvement
initiatives.
Quality of health Incidence % of Central # # # 4 beds/1 000 N/A N/A N/A Not measured
services in public of harm and Hospitals with live births due to lack of
health facilities overcrowding in adequate standardised norms.
improved neonatal health neonatal beds
wards capacity
93
Table 4.5.2: Performance Indicators: Programme 5: Central Hospitals
Outcome Outputs Output Indicators Audited/ Actual performance Planned Target Actual Deviation Reasons for deviations
94
(as per SP 2017/18 2018/19 2019/20 2020/2021 Achievement from planned

2020/21- 2020/2021 target to
2024/25) Actual
Achievement
2020/2021
Maternal, Women who die Maternal mortality in # # # 194 266.6 (72.6) Target not achieved due to
neonatal, in health facilities facility ratio (86/44 274) late referrals of cases and
(109/40 883)
infant and child reduced unpreventable mortalities.
mortality reduced Maternal cases come with
intracranial bleed and others
with placenta praevia and
massive PV bleeding.
Less children Child under 5 years’ # # # 2.5% 3.1% (0.6%) Target not achieved due to
under 5 years diarrhoea case (40/1 556) late presentation of clients in
(26/838)
dying from fatality rate seeking care.
diarrhoea
Less children Child under 5 years’ # # # 2.7% 2.7% 0% On target.
under 5 years pneumonia case (52/1 960) (40/1 480)
dying from fatality rate
pneumonia
Less children Severe acute # # # 2.7% 7.2% (4.5%) Target not achieved due to
dying from malnutrition death (24/880) late referrals of SAM cases.
(27/375)
malnutrition under 5 years’ rate
Number of Death in facility under # # # 4.7% 4.1% 0.6% Target achieved.

children who die 5 years against live (1 680/35 914) (1 646/40 348)
in health facilities birth rate
reduced
2020/21- 2020/2021 target to
2024/25) Actual
Achievement
2020/2021
Quality of health Patients Patients’ experience 81.5% 77% 75%7 80% 84% 4% Target achieved by 4%.
services in public report positive of care satisfaction Target exceeded due to a
(81 424/
health facilities experience of rate higher number of positive
improved care 96 892) responses obtained from
the implemented survey
tool, namely the DPOS. In
addition, the tool used during
the COVID-19 season to
assess level of satisfaction
was less cumbersome
and easy to understand.
In addition, Virtual training
was conducted by Provincial
Team prior to the conduction
of PEC Surveys in Q2
(August – September 2020).
conducted in August 2020.
Quality of health Hospitals ready Ideal Hospitals status # # # 25% 25% 0% Target achieved. Steve
services in public to deliver quality obtained (1/4) (1/4) Biko and Charlotte Maxeke
health facilities health care conducted self-assessments
improved as planned and both hospitals
obtained silver status.
Quality of health Prompt response Severity assessment # # # 60% 95% 35% Target exceeded due to
services in public to adverse events code (SAC) 1 (819/862) additional capacity for
health facilities incident reported capturing and to support
improved within 24 hours’ rate processing of PSIs of
SAC 1. Provincial office
conducted training for 21
interns involved in capturing
SAC incidents and provided
95
7 Previously not audited.

96
2020/21- 2020/2021 target to

2024/25) Actual
Achievement
2020/2021
Quality of health Incidence of harm Patient Safety # # # 40% 67.2% 27.2% Capacity was strengthened
services in public managed and Incident (PSI) case (1 190/1 770) for management of closure
health facilities reduced closure rate of PSIs through monitoring of
improved institutional PSI committees.
We have conducted training
for QA office staff and have
also provided on the spot
teaching to all staff involved
in PSIs during management
of all prioritised PSIs.
Leadership and Functional Percentage of # # # 100% 75% 15% Board members not forming
governance in governance hospitals with (4/4) (3/4) (3/4) a quorum due to absconding,
public health structure functional hospital death and resignations.
facilities boards Board activities affected by
enhanced to the outbreak of COVID-19
improve quality and its restrictions.
of care
Table 4.5.3: Chris Hani Baragwanath Academic Hospital (ORIGINAL APP)
Outcome Outputs Output Audited/ Planned Actual Deviation Reasons for Reasons for
(as per SP Indicators Actual Target Achievement from planned deviations revisions to the
2020/21- performance 2020/2021 2020/2021 until target to Outputs/Output
2017/18 2018/19 2019/20 2020/2021
Quality of health Percentage # # # - N/A N/A N/A Indicator
services in public of hospitals discontinued
health facilities implementing because NDoH
improved. Quality introduced Quality
Improvement learning centres to
programme prepare facilities for
Quality Improvement
initiatives.
Quality of health Prompt Severity # # # 100% 100% 0% Provision of Target amended in
services in public response to assessment additional personnel anticipation of the
health facilities adverse events code (SAC) (6/6) in health facilities to COVID-19 pandemic
improved 1 incident support capturing disruptions.
reported and processing of
within 24 PSIs.
hours’ rate Supervisory support
visits to all facilities
that were non-
compliant were
conducted.
Training was
conducted to QA
office staff and on the
spot teaching to all
staff involved in PSI
was done.
Quality of health Incidence of Patient Safety # # # 60% 100% 40% The capacity for Target amended in
services in public harm managed Incident (PSI) management of anticipation of the
health facilities and reduced case closure (42/42) closure of PSIs COVID-19 pandemic
improved rate was strengthened disruptions.
through monitoring
of institutional PSI
committees.
Training was
conducted to QA
office staff and on the

spot teaching to all
staff involved in PSI
was done.
97
Table 4.5.4: Chris Hani Baragwanath Academic Hospital (RE-TABLED APP)
98
(as per SP 2020/21- Indicators 2017/18 2018/19 2019/20 Target Achievement from planned
2024/25) 2020/2021 2020/2021 target to Actual
Achievement
2020/2021
Maternal, neonatal, Number of Maternal mortality # # # 154 178.4 (24.4) Target not achieved due to
infant and child women who die in facility ratio (32/20 700) (34/19 054) late referral of maternal cases
mortality reduced in health facilities which contributed towards
reduced non-achievement of target.
The causes of death were
haemorrhage, hypertension,
puerperal sepsis, respiratory
with / without COVID-19,
organophosphate (suicide),
cancers and deaths on arrival.
All the reported deaths were
not avoidable.
Less children Child under 5 # # # 2.5% 8.4% (5.9%) Target not achieved as a
under 5 years years’ diarrhoea (20/800) (16/191) result of social circumstances.
dying from case fatality rate Patients present at a very late
diarrhoea stage and all the reported
deaths were not avoidable.
Less children Child under 5 # # # 1.5% 4.4% (2.9%) Target not achieved due to
under 5 years years’ pneumonia (4/260) (11/252) slight increase of deaths
dying from case fatality rate coincident with COVID-19
pneumonia pandemic. All the reported
deaths were not avoidable.
Maternal, neonatal, Less children Severe acute # # # 6% 10.9% (4.9%) Target not achieved because
infant and child dying from malnutrition death (12/200) (12/110) of late referral of maternal
mortality reduced malnutrition under 5 years’ cases which contributed
rate towards non-achievement of
target. All the reported deaths
were not avoidable.
2024/25) 2020/2021 2020/2021 target to Actual
Achievement
2020/2021
Maternal, neonatal, Number of Death in facility # # # 4.3 3.6% 0.7% Target achieved because
infant and child children who die under 5 years (600/ (676/18 784) of early referral of maternal
mortality reduced in health facilities against live birth 14 000) cases which contributed
reduced rate towards achievement of
target.
Quality of health Patients Patients’ 84.7% 68.6% 67% 80% 83.7% 3.7% Target achieved due to
services in public report positive experience of (29 344/35 043) increased positive responses.
health facilities experience of care satisfaction
improved care rate
Quality of health Hospitals ready Ideal Hospitals # # # 0% 0% 0% Not planned in this financial
services in public to deliver quality status obtained year.
health facilities health care
improved
Quality of health Prompt response Severity # # # 60% 100% 40% Target exceeded due to
services in public to adverse events assessment code (48/48) additional capacity for
health facilities (SAC) 1 incident capturing and to support
improved reported within 24 processing of PSIs of SAC 1.
hours’ rate Provincial office conducted
training to 21 interns involved
in capturing SAC incidents
visits during the period under
review.
Quality of health Incidence of harm Patient Safety # # # 40% 99% 59% Capacity was strengthened
services in public managed and Incident (PSI) (410/414) for management of closure
health facilities reduced case closure rate of PSIs through monitoring of
teaching to all staff involved in
PSIs during management of
all prioritised PSIs.
Leadership and Functional Percentage of # # # 100% 100% 0% Target achieved.
governance in public governance hospitals with
(1/1) (1/1)
health facilities structure functional hospital
enhanced to improve boards
quality of care
99
Table 4.5.5: Charlotte Maxeke Academic Hospital (ORIGINAL APP)
100

re-tabling Actual
Maternal, Number of Maternal # # # 190.5 309.2 (118.7) The cause of deaths Targets were revised
neonatal, infant women who mortality in (20/ (7/2 264) ranged from pre- to accommodate the
and child mortality die in health facility ratio 10 500) eclampsia to septic projected trends, as
reduced facilities shock following maternal mortality stats
reduced retained products post- were consistently above
delivery. Additional target.
causes of death
included COVID-19-
related pneumonias
complicating the
clinical progress of
admitted patients.
Underlying avoidable
factors include late-
booking patients and
unbooked patients
presenting late to the
health system and late
referral to CMJAH.
Other systematic
contributors to death
were lack of access
to ICU beds further to
availability shortages
in the province.
Less children Child under # # # 2.5 1.7% (1/58) 0.8% Target achieved. Targets were not
under 5 years 5 years’ (1/40) changed.
dying from pneumonia Patient was a 1-year-
pneumonia case fatality and-1-month-old male
rate who presented with
SAM complicated by
acute gastroenteritis.
Quality of health Hospitals ready Ideal # # # 0% 100% 0% Target achieved. The Targets were not
services in public to deliver quality Hospitals hospital achieved changed.

health facilities health care status Silver status.
improved obtained
re-tabling Actual
Quality of health Percentage # # # 100% N/A N/A N/A Indicator discontinued
services in public of hospitals because NDoH
health facilities implementing introduced Quality
improved Quality learning centres to
Improvement prepare facilities for
programme Quality Improvement
initiatives.
Quality of health Incidence of Patient Safety # # # - 4% Staff in QA were Targets were not
services in public harm managed Incident (PSI) (3/75) also affected by changed.
health facilities and reduced case closure COVID-19 which
improved rate disrupted services
and most came back
with residual effects
which slowed down
the Department’s
efficiency with regard
to PSIs.
Most departments
started addressing the
issues of incomplete
reports after Sept
2020.
101
102
Table 4.5.5: Charlotte Maxeke Academic Hospital (RE-TABLED APP)

(as per SP 2017/18 2018/19 2019/20 Target Achievement from planned
2020/21- 2020/2021 2020/2021 target to Actual
2020/2021
Maternal, Women who Maternal mortality # # # 228 314.4 (86.4) Target not achieved.
neonatal, die in health in facility ratio (27/8 588) Same as above reported cases.
(20/8 790
infant and facilities
child mortality reduced
reduced
Maternal, Less children Child under 5 years’ # # # 4.0% 4.1% 0.1% Target not achieved due to
neonatal, under 5 years diarrhoea case (4/100) children with severe dehydration
(6/146)
infant and dying from fatality rate caused by gastroenteritis
child mortality diarrhoea presenting to CMJAH as DOAs
reduced in the casualties, as they are late
presenters to clinics and referred
to the facility late into their
presentation and complications.
Maternal, Less children Child under 5 years’ # # # 5.0% 1.2% (3/256) (3.8%) Target achieved
neonatal, under 5 years pneumonia case
(20/400)
infant and dying from fatality rate
child mortality pneumonia
reduced
Maternal, Less children Severe acute # # # 1.5% 2% (0.5%) Target not achieved due to SAM
neonatal, dying from malnutrition death (4/260) cases being complicated by an
(2/98)
infant and malnutrition under 5 years’ rate additional condition. First case
child mortality was gastroenteritis. Second case
reduced was pneumonia.
Maternal, Number of Death in facility # # # 4.5% 3.8% 0.7% Target achieved.
neonatal, children who under 5 years (680/15 (323/
infant and die in health against live birth 000) 8 495)
child mortality facilities rate
reduced reduced
2020/21- 2020/2021 2020/2021 target to Actual
2020/2021
Quality of Patients Patients’ 76% 65.5% 69% 80% 77.6% (2.4%) Target not achieved due to non-
health services report positive experience of care compliance with staff attitude,
(1 6513/
in public experience of satisfaction rate cleanliness and patient safety.
health facilities care 2 073) Due to COVID-19 pandemic
improved restrictions, the National PEC
Survey Tool was not used.
Instead, the Daily Patient Opinion
Survey Tool (DPOS) was used
which is simple, short, with
straightforward questions.
In addition, the tool used during
the COVID-19 season to assess
understand.
prior to the conduction of PEC
Surveys in Q2.
Facility Support visits conducted.
Quality of Hospitals Ideal Hospitals # # # 100% 100% 0% Target achieved. The hospital
health services ready to deliver status obtained (1/1) achieved Silver status.
in public quality health
health facilities care
improved
103
104
2020/21- 2020/2021 2020/2021 target to Actual

2020/2021
Quality of Prompt Severity # # 60% 100% 53% 47% The reason for deviation is that
health services response to assessment code (64/122) unfortunately departments submit
in public adverse events (SAC) 1 incident section A and B, i.e. notification
health facilities reported within 24 and statements; however, most
improved hours’ rate are not completing section C
and, importantly, root cause
analysis, findings and conclusion,
extending right down to non-
patient outcomes. This makes it
difficult for QA office to close the
PSI. PSI meetings which were
previously held were disturbed
by the advent of COVID-19
and priorities shifted to other
areas as we were dealing with
a new pandemic. Staff in QA
were also affected by COVID-19
which disrupted services and
most came back with residual
effects which slowed down the
Department’s efficiency with
regard to PSIs. Most departments
started addressing the issues
of incomplete reports after Sept
2020.
2020/21- 2020/2021 2020/2021 target to Actual
2020/2021
Quality of Incidence of Patient Safety # # # 40% 18.4% (28.7%) The reasons for deviation is that
health services harm managed Incident (PSI) case (75/408) unfortunately departments submit
in public and reduced closure rate section A and B, i.e. notification
health facilities and statements; however, most
improved are not completing section C
and, importantly, root cause
analysis, findings and conclusion,
extending right down to non-
patient outcomes. This makes it
difficult for QA office to close the
PSI. PSI meetings which were
previously held were disturbed
by the advent of COVID-19 and
priorities shifted to other areas
as we were dealing with a new
pandemic. Staff in QA were
also affected by COVID-19,
which disrupted services and
most came back with residual
effects which slowed down the
Department’s efficiency with
regard to PSIs. Most departments
started addressing the issues
of incomplete reports after Sept
2020.
Leadership and Functional Hospitals with # # # 100% 0% 100% One board member resigned.
governance in governance functional hospital (1/1) (0/1) (0/1) Board activities affected by the
public health structure boards outbreak of COVID-19 and its
facilities restrictions.
enhanced to Board meetings not held due to
improve quality lack of quorum.
of care
105
Table 4.5.6: Steve Biko Academic Hospital (ORIGINAL APP)
106
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from planned deviations to the Outputs/Output
2020/21- 2020/2021 2020/2021 until target to Indicators/Annual
2024/25) date of re- Actual Targets
tabling Achievement
2020/2021
Maternal, Women who Maternal # # # 306.8 286 (20.8) Quarterly performance Target reduced to align to
neonatal, infant die in health mortality in (10/3 259) (3/1 049) not achieved. Patients the Outcome of maternal
and child mortality facilities facility ratio died due to eclampsia mortality reductions.
reduced reduced largely and late
presentation.
Less children Child under # # # 5% 0% 5% Target achieved. Target reduced to align
under 5 years 5 years’ (1.3/2) (0/21) to the Outcome of child
dying from diarrhoea mortality reductions.
diarrhoea case fatality
rate
Less children Child under # # # 154 4% 150% N/A Target reduced to align
under 5 years 5 years’ (20/3.0) (4/100) to the Outcome of child
dying from pneumonia mortality reductions.
pneumonia case fatality
rate
Less children Severe # # # 18 0% (18) N/A Target reduced to align
dying from acute (592/4.1) (0/25) to the Outcome of child
malnutrition malnutrition mortality reductions.
death under
5 years’ rate
Maternal, Number of Death in # # # 8.3% 4.8% 3.5% Target achieved. Target reduced to align
neonatal, infant children who facility under (12/293) (50/1 034) to the Outcome of child
and child mortality die in health 5 years mortality reductions.
reduced facilities against live
reduced birth rate
Quality of health Patients Patients’ # # # 85% N/A N/A N/A PEC conducted from
services in public report positive experience quarter 2.
health facilities experience of of care
improved care satisfaction
rate
Quality of health Hospitals Ideal # # # 100% 100% 0% Target achieved. Hospital was assessed
services in public ready to Hospitals Assessments were in the first quarter,

health facilities deliver quality status done in Q2, hospital however, due to
improved health care obtained obtained Silver status. COVID-19 the target was
changed because of the
uncertainty surrounding
COVID-19.
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from planned deviations to the Outputs/Output
2020/21- 2020/2021 2020/2021 until target to Indicators/Annual
2024/25) date of re- Actual Targets
tabling Achievement
2020/2021
Quality of health Hospitals Percentage # # # - N/A N/A N/A Indicator discontinued
services in public ready to of hospitals because NDoH
health facilities deliver quality introduced Quality
improved. health care learning centres to
prepare facilities for
Quality Improvement
initiatives.
Quality of health Prompt Severity # # 60% 100% 100% 0% N/A Target was revised
services in public response assessment following uncertainties
health facilities to adverse code (SAC) brought by COVID-19
improved events 1 incident and loss of the Quality
reported leader during the period.
within
24 hours’
rate
Quality of health Incidence Patient # # 50% 60% 100% 40% N/A Target was revised
services in public of harm Safety (1/1) following uncertainties
health facilities managed and Incident brought by COVID-19
improved reduced (PSI) case and loss of the Quality
closure rate leader during the period,
which was anticipated
to result in backlog in
capturing PSIs.
107
Table 4.5.7: Steve Biko Academic Hospital (RE-TABLED)
108
2024/25) 2020/2021 target to Actual
Achievement
2020/2021
Maternal, neonatal, Number of Maternal mortality # # # 279 319.6 (40.6) There was an increase in iMMR
infant and child women who die in facility ratio (10/3 584) (11/3 442) in the first 2 quarters due to
mortality reduced in health facilities COVID-19 lockdown. Late
reduced referrals and pregnancy-induced
hypertension complications.
Less children Child under 5 # # # 2.6% 0 2.6% No diarrhoeal death. To continue
under 5 years years’ diarrhoea (4/156) (0/208) monitoring services currently
dying from case fatality rate rendered at the SBAH.
diarrhoea
Less children Child under 5 # # # 3.3% 2.3% 1% No pneumonia death. To continue
under 5 years years’ pneumonia (20/600) (14/604) monitoring services currently
dying from case fatality rate rendered at the SBAH.
pneumonia
Less children Severe acute # # # 1.3% 7.7% (6.4%) Target not achieved. SAM
dying from malnutrition death (4/320) (9/117) children present with other serious
malnutrition under 5 years’ complications, in particular
rate immunosuppression.
Maternal, neonatal, Number of Death in facility # # # 5.7% 6.9% (1.2%) Target not achieved because of
infant and child children who die under 5 years (200/3 (236/3 399) various reasons including late
mortality reduced in health facilities against live birth 514) referrals and complexity (multiple
reduced rate underlying conditions) of the
presenting conditions.
Achievement
2020/2021
Quality of health Patients Patients’ 90% 90% 84% 50% 91.1% 10.1% Target achieved. Due to
services in public report positive experience of (27 126/ COVID-19 pandemic restrictions,
health facilities experience of care satisfaction 29 756) the National PEC Survey Tool
improved care rate was not used. Instead, the Daily
Patient Opinion Survey Tool
(DPOS) was used which is simple,
short and with straightforward
questions.
Target exceeded due to a higher
number of positive responses
obtained from the implemented
survey tool, namely the DPOS.
understand.
prior to the conduction of PEC
Surveys in Q2.
Facility Support visits conducted.
Quality of health Hospitals ready Ideal Hospitals # # # 0% 100% 0% Target achieved. Assessments
services in public to deliver quality status obtained (0/1) were done in Q2, hospital
health facilities health care obtained Silver status.
improved
Quality of health Prompt response Severity # # 60% 60% 85.7% 25.7% Target exceeded due to
services in public to adverse events assessment code (12/14) additional capacity for capturing
health facilities (SAC) 1 incident and to support processing
improved reported within of PSIs of SAC 1. Provincial
24 hours’ rate office conducted training to 21
109
110

Achievement
2020/2021
Quality of health Incidence of harm Patient Safety # # 50% 40% 17.8% (22.2%) Reason for deviation is staff
services in public managed and Incident (PSI) (42/236) shortage within the facility Quality
health facilities reduced case closure rate Assurance Unit resulting in a
improved backlog in capturing PSIs.
Leadership and Functional Percentage of # # # 100% 100% 0% Target achieved

governance in public governance hospitals with (1/1) (1/1) (1/1)
health facilities structure functional hospital
enhanced to improve boards
quality of care
Table 4.5.8: Dr George Mukhari Academic Hospital(ORIGINAL APP)
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from revisions to the
Maternal, Number of Maternal # # # 228 164.4 63.6 Target for the quarter and Target revised to
neonatal, infant women who mortality in (18/7 896) (4/2 433) for the year achieved. align with the priority
and child mortality die in health facility ratio area of reducing
reduced facilities maternal deaths as
reduced per Strategic Plan
and also in line
with previous year
performance level.
Maternal, Less children Child under # # # 0.21 2.6% (2.39%) Target not achieved Target modified to
neonatal, infant under 5 years 5 years’ (1/500) (1/38) because children present make it more realistic
and child mortality dying from diarrhoea with underlying conditions with the general
reduced diarrhoea case fatality and late presentation. trends.
rate
Less children Child under # # # 474 5.6% (2.3) Target not achieved. Information disclosure
under 5 years 5 years’ (3.3/12) (2/36) Three pneumonia-related was incorrectly
dying from pneumonia Deviation deaths. One associated swapped and had to
pneumonia case fatality based on 3.3 with congenital heart be corrected.
rate disease.
Maternal, Less children Severe acute # # # 360 27.3% (23.7%) Target not achieved due Information disclosure
neonatal, infant dying from malnutrition (0.91/2) (3/11) to delays in seeking care was incorrectly
and child mortality malnutrition death under 5 swapped and had to
reduced years’ rate be corrected. Formula
changes.
Maternal, Number of Death in # # # 219 5% 0.06% Target achieved. Information disclosure
neonatal, infant children who facility under 5 (8.9/219) (120/2 392) was incorrectly
and child mortality die in health years against swapped, repeated
reduced facilities live birth rate and had to be
reduced corrected.
Quality of health Patients Patients’ 72.5% 82.1% 80% 82% 75.5% (6.5%) Indicator measured Target changed to
services in public report positive experience (8 575/ annually. align it to previous
health facilities experience of of care 11 354) performance.
improved care satisfaction
rate
111
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from revisions to the
112

Percentage # # # 1 N/A N/A N/A Indicator discontinued
of hospitals because NDoH
implementing introduced Quality
Quality learning centres to
initiatives.
Quality of health Prompt Severity # # 60% 98% 99% 1% We have conducted Target changed
services in public response assessment (171/173) training for QA office because of shift of
health facilities to adverse code (SAC) staff and furthermore focus to COVID-19
improved events 1 incident we have provided on response.
reported the spot teaching to all
within staff involved in PSIs
24 hours’ rate during management of all
prioritised PSIs.
Quality of health Incidence Patient Safety # # 40% 60% 99% 39% We have strengthened Target changed
services in public of harm Incident (PSI) (178/179) the capacity for because of shift of
health facilities managed and case closure management of focus to COVID-19
improved reduced rate closure of PSIs through response
monitoring of institutional
PSI committees.
Table 4.5.9: Dr George Mukhari Academic Hospital (RE-TABLED APP)
(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement from planned
2020/21- 2020/2021 2020/2021 target to Actual
2020/2021
Maternal, Number of Maternal # # # 214.3 377.6 (163.3) Target not achieved. Mothers
neonatal, women who mortality in facility (24/11 200) (37/9 799) come in critical condition from
infant and child die in health ratio referral institutions. COVID-19-
mortality reduced facilities related morbidity.
reduced
Maternal, Less children Child under 5 # # # 2.4% 1.4% 1% Target achieved.
neonatal, under 5 years years’ diarrhoea (12/500) (4/293)
infant and child dying from case fatality rate
mortality reduced diarrhoea
Maternal, Less children Child under 5 # # # 1.1% 3.3% (2.2%) Target not achieved. Deaths
neonatal, under 5 years years’ pneumonia (8/700) (12/368) are due to pneumonia-related
infant and child dying from case fatality rate deaths and associated with
mortality reduced pneumonia congenital heart disease.
Maternal, Less children Severe acute # # # 4% 8% (4%) Target not achieved due to
neonatal, dying from malnutrition (4/100) (4/50) delays in seeking care.
infant and child malnutrition death under 5
mortality reduced years’ rate
Maternal, Number of Death in facility # # # 5.90% 4.3% 1.6% Target achieved.
neonatal, children who under 5 years (200/3 400) (411/670)
infant and child die in health against live birth
mortality reduced facilities rate
reduced
113
114
2020/21- 2020/2021 2020/2021 target to Actual

2020/2021
Quality of health Patients Patients’ 72.5% 82.1% 80% 80% 75.5% (14.3%) Target not achieved;
services in public report positive experience of (8 575/11 354) cleanliness was a challenge.
health facilities experience of care satisfaction Due to COVID-19 pandemic
improved care rate restrictions, the National PEC
Survey Tool was not used.
Instead, the Daily Patient
Opinion Survey Tool (DPOS)
was used which is simple,
questions.
In addition, the tool used
during the COVID-19 season to
assess level of satisfaction was
less cumbersome and easy to
understand.
DGMH Report on pg. 16
indicates that there was a delay
in appointing cleaners, hence
the facility was non-compliant
and there was also dilapidated
infrastructure.
Provincial Team conducted
virtual PEC training prior to the
conduction of surveys in Q2.
Quality of health Hospitals Ideal Hospitals # # # 0% 0% 0% Not planned in this financial
services in public ready to deliver status obtained8 year
health facilities quality health
improved care
Quality of health Prompt Severity # # 60% 60% 97.5% 37.5% Target exceeded due to
services in public response to assessment code (664/681) additional capacity for
health facilities adverse events (SAC) 1 incident capturing and to support
improved reported within processing of PSIs of SAC 1.
24 hours’ rate Provincial office conducted
training to 21 interns involved
in capturing SAC incidents

and provided supervisory visits
during the period under review.
8 Target of Ideal Hospital had no target in the original APP represented by a #

2020/21- 2020/2021 2020/2021 target to Actual
2020/2021
Quality of health Incidence of Patient Safety # # 40% 40% 96.9% 56.9% Capacity was strengthened
services in public harm managed Incident (PSI) (690/712) for management of closure
health facilities and reduced case closure rate of PSIs through monitoring of
teaching to all staff involved in
PSIs during management of all
prioritised PSIs.
Leadership and Community Percentage # # # 100% 100% 0% Target achieved.
governance in involved of hospitals (1/1) (1/1) (1/1)
public health and taking with functional
facilities responsibility hospital boards
enhanced to for the delivery
improve quality of of health
care services
115
The responses on DPOS were negative on the elements for facility cleanliness, and the hospital has
employed cleaners permanently.
• Dr George Mukhari Academic Hospital: Cleaners were appointed permanently.

• Quality Assurance Managers at Bheki Mlangeni and South Rand Hospitals were appointed.
• Quality Assurance Manager at Sedibeng District was also appointed.
• Kalafong: Improve communication with DHS, CHCs, District hospitals and NGOs for early
referrals, antenatal bookings and case detection.
• Chris Hani Baragwanath Academic Hospital: Health outcomes are dependent on other social
determinants of the Department of Health, Department of Social Services and Department of
Education that need to collaborate on strategies to educate on healthy lifestyles and healthy-
seeking behaviours.
Performance in relation to Standardised Outputs and Output Indicators for Sectors with Concurrent
Function
• Chris Hani Baragwanath Academic Hospital: Health outcomes are dependent on other social
Education that need to collaborate on strategies to educate on healthy lifestyles and healthy-
seeking behaviours.
TERTIARY HOSPITAL SERVICES
PERFORMANCE OVERVIEW
The Department through its tertiary platforms was still able to provide essential services during the
year under review despite the challenges that COVID-19 presented to operations of the tertiary
facilities. Notwithstanding these limitations imposed by COVID-19, a Breast cancer awareness
campaign was able to be carried out in Kalafong through the dedicated Radiologist Dr Thebe and
Surgeon Dr Jakel running the service. In addition, Kalafong was able to appoint a dedicated qualified
Mammo-radiographer.
Challenges
The year under review of the Tertiary hospitals’ operations were conducted alongside COVID-19
which introduced complexities. Both Kalafong and Tembisa operations are aligned with the Strategic
Plan of the Department, however targets could not be achieved due to the following reasons,
particularly in Tembisa:
a) Absence or lack of Regional and District hospitals in the area resulting in fragmented referral
system.
b) Overcrowded maternity services with poor down referral pathways.
c) Staff shortages resulting in poor management and close monitoring of severe cases.
d) Impact of COVID-19 on maternal mortality and morbidity.
e) Infrastructure constraints resulting in lack of space for high care paediatrics, Kangaroo Mother
Care (KMC), neonatal transitional unit and antenatal ward.
f) Overcrowded maternity unit resulting in overcrowded neonatal unit.
Table 4.5.10: Tertiary Hospitals (ORIGINAL APP)
Outcome Outputs Output Audited/ Actual performance Planned Actual Deviation Reasons for Reasons for
118
(as per SP Indicators Target Achievement from planned deviations revisions to the
2020/21- 2020/2021 2020/2021 until target to Actual Outputs/Output
2024/25) date of re- Achievement Indicators/Annual
2017/18 2018/19 2019/20 tabling 2020/2021 Targets
Maternal, Number of Death in # # # 6.6% 2.1% 4.5% Target achieved. Target changed to
neonatal, children who facility under 5 (400/ align to outcome.
(129/6 138)
infant and die in health years against 6 000)
child mortality facilities live birth rate
reduced reduced
Percentage # # # 1 N/A N/A N/A Indicator discontinued
of hospitals because NDoH
implementing introduced Quality
Quality learning centres to
initiatives.
Quality of Hospitals Ideal Hospitals # # # 33.3% Not targeted for No deviation Target achieved. N/A
health services ready to status (1/3) Q1
in public deliver quality obtained
health facilities health care
improved
Quality of Prompt Severity # # # 60% 70% 10% Provision of
health services response assessment (58/83) additional
in public to adverse code (SAC) personnel for
health facilities events 1 incident health facilities to
improved reported within support capturing
24 hours’ rate and processing of
PSIs.
Supervisory
support visits to all
facilities that were
non-compliant was
conducted.
Training was
conducted to QA
office staff and on
the spot teaching

to all staff involved
in PSI was done.
2024/25) date of re- Achievement Indicators/Annual
2017/18 2018/19 2019/20 tabling 2020/2021 Targets
Quality of Incidence Patient Safety # # # 60% 53% (7%) Some tertiary
health services of harm Incident (PSI) (131/248) facilities were not
in public managed and case closure capturing PSIs
health facilities reduced rate on the Ideal Web
improved tool citing non-
availability of login
credentials.
Incidence % of Tertiary # # # 4 beds/ N/A N/A N/A Not measured due to
of harm and hospitals with 1 000 live lack of standardised
overcrowding adequate births norms.
in neonatal neonatal beds
health wards capacity
119
120
Table 4.5.11: Tertiary Hospitals (RE-TABLED APP)

(as per SP Indicators 2017/18 2018/19 2019/20 Target Achievement planned target
2020/21- 2020/2021 2020/2021 to Actual
2020/2021
Maternal, Number of women Maternal mortality # # # 116.7 169.4 (52.7) Target not achieved due to un-
neonatal, who die in health in facility ratio (28/24 000) (42/24 791) booked high-risk patients and
infant and child facilities reduced EMS delays.
mortality reduced
Maternal, Less children under Child under 5 # # # 3.3% 2.7% 0.6% Target achieved.
neonatal, 5 years dying from years’ diarrhoea (20/600) (11/411)
infant and child diarrhoea case fatality rate
mortality reduced
Maternal, Less children under Child under 5 # # # 2% 2.5% (0.5%) Target not achieved due to
neonatal, 5 years dying from years’ pneumonia (12/600) (15/611) COVID-19 deaths and HIV.
infant and child pneumonia case fatality rate
mortality reduced
Maternal, Less children dying Severe acute # # # 7.5% 10.7% 3.2% Target not achieved.
neonatal, from malnutrition malnutrition death (12/160) (11/103) Poor socio-economic conditions,
infant and child under 5 years’ late presentation and HIV.
mortality reduced rate
Maternal, Number of children Death in facility # # # 6.7% 2% 4.7% Target achieved.
neonatal, who die in health under 5 years (400/6 000) (481/
infant and child facilities reduced against live birth 24 151)
mortality reduced rate
2020/21- 2020/2021 2020/2021 to Actual
2020/2021
Quality of health Patients report Patients’ 83% 73% 74% 80% 83.9% 3.9% Target achieved by 3.9%. Due to
services in public positive experience experience of (23 824/ COVID-19 pandemic restrictions,
health facilities of care care satisfaction 2 838) the National PEC Survey Tool
improved rate was not used. Instead, the Daily
Patient Opinion Survey Tool
(DPOS) was used which is simple,
questions.
Target exceeded due to a higher
number of positive responses
obtained from the implemented
survey tool, namely the DPOS.
understand.
Quality of health Hospitals ready Ideal Hospitals # # # 0% 33.3% 0% Kalafong Hospital obtained Silver
services in public to deliver quality status obtained (1/3) status.
health facilities health car
improved
Quality of health Prompt response to Severity # # # 40% 64.1% 17% Target exceeded due to
services in public adverse events assessment code (270/421) additional capacity for capturing
health facilities (SAC) 1 incident and to support processing
improved reported within 24 of PSIs of SAC 1. Provincial
hours’ rate office conducted training to 21
121
122
2020/21- 2020/2021 2020/2021 to Actual

2020/2021
Quality of health Incidence of harm Patient Safety # # # 40% 66.9% 26.9% Capacity was strengthened
services in public managed and Incident (PSI) (852/1 274) for management of closure
health facilities reduced case closure rate of PSIs through monitoring of
We have conducted training for
QA office staff and have also
provided on the spot teaching to
all staff involved in PSIs during
management of all prioritised
PSIs.
Leadership and Functional Percentage of # # # 100% 66.6% 33.4% Board members not forming a
governance in governance hospitals with (3/3) (2/3) (2/3) quorum due to absconding, death
public health structures in functional hospital and resignations.
facilities hospitals boards Board activities affected by the
enhanced to outbreak of COVID-19 and its
improve quality restrictions.
of care
TERTIARY HOSPITALS

• Inform the relevant role-players.
• Opening of PICU on 1 July 2021.
• Strengthening of weekend plans for patients in the general wards and continuing to ensure that
all patients are seen over the weekend.
• In-service training of nursing staff. Involvement of dieticians and social workers.
• Support nurses in attaining Champions in the relevant areas, e.g., severe acute malnutrition,
gastroenteritis and pneumonia.
In Obstetrics
• Strengthen the down referral system and up referral system so that we manage high-risk cases
appropriately.
• Network with sister hospitals to have caesarean section hubs and conduct low-risk surgeries in
other institutions.
• Improve efficiencies within our institution and have internal drive to carry out elective caesarean
sections even after hours and weekends.
• Strengthen support from ambulance services on appropriate referrals.
• Booking system on antenatal services.
• Strengthening use of long-acting contraceptives and improving reproductive choices.
Dr George Mukhari Academic Hospital: Cleaners were appointed permanently.

Quality Assurance Managers at Bheki Mlangeni and South Rand Hospitals were appointed.
Quality Assurance Manager at Sedibeng District was also appointed.
Kalafong: Improve communication with DHS, CHCs, District hospitals and NGOs for early referrals,
antenatal bookings and case detection.
Chris Hani Baragwanath Academic Hospital: Health outcomes are dependent on other social
Education that need to collaborate on strategies to educate on healthy lifestyles and healthy-seeking
behaviours.
Table 4.5.12: Institutional response to COVID-19
Budget Intervention Geographic No. of Total budget Budget spent per Contribution to the Immediate outcomes
124
Programme location (Province/ beneficiaries allocation per intervention Outputs in the APP
District/local (where possible) intervention (where applicable)
(R’000)
(where possible)
5. CENTRAL - Compensation of Tertiary and Central 1 590 staff 214 808 281 747 Improved Patient Quality of health services in
HOSPITAL Employees (Staff hospitals in the 3 employed for Safety and public health facilities improved.
SERVICES Appointments towards Metros COVID Outcomes
COVID-19 pandemic)
- Goods & Services Largely provision 269 249 127 705 Reduced

(Consumable supplies of PPE transmission and
and Medical supplies) COVID-19-related
mortality
Machinery and Provision of 0 27 734 N/A Quality of health services in

Equipment (Assistive Ventilators and public health facilities improved.
Device) other medical
equipment
Table 4.5.13: Programme 5: Central Hospital Services Expenditure Table

PROGRAMME 5: CENTRAL HOSPITAL SERVICES
R’000 R’000 R’000 R’000 R’000 R’000

CENTRAL HOSPITALS 14 982 621 14 208 556 774 065 14 810 985 14 603 682 207 303
PROVINCIAL TERTIARY HOSPITAL SERVICES 4 630 012 5 045 496 (415 484) 4 300 215 4 460 759 (160 544)
19 612 633 19 254 052 358 581 19 111 200 19 064 441 46 759
4.6 PROGRAMME 6: HEALTH SCIENCES AND TRAINING (HST)
Programme Purpose
Rendering of training and development opportunities for actual and potential employees of the
Gauteng Department of Health through sub-programmes:
• Nurse training college: Training of nurses at undergraduate and post-basic level. Target group
includes actual and potential employees;
• Emergency Medical Services (EMS) training college: Training of rescue and ambulance personnel.
Target group includes actual and potential employees;
• Bursaries: Provision of bursaries for health science training programmes at undergraduate and
postgraduate levels. Target group includes actual and potential employees;
• Primary Health Care (PHC) training: Provision of PHC-related training for personnel, provided by
regions; and
• Training (other): Provision of skills development interventions for all occupational categories in the
Department. Target group includes actual and potential employees.
Programme Outcomes
• Quality of health services in public health facilities improved
Programme 6 plays an integral part in contributing strategically towards building human capital for high
performance and to enhance service delivery to achieve the Human Resource Development Strategic
Framework by providing strategic leadership, management and skills development programmes for
senior, middle, emerging and foundational managers, including hospital CEOs, facility managers,
supervisors and all other levels of employees to improve health system efficiency. The Programme
manages the production and capacity development of health professionals, that is, medical/ nursing,
allied health and mid-level workers with relevant health qualifications and clinical skills in order
to address the health priority needs of the province. Short courses and Continuing Professional
Development (CPD) in-service trainings for health professionals are provided in keeping up with new
developments, skills requirements and emerging health needs, therefore achieving the education,
training and development mandate.
Significant Achievements of Programme 6
The following were the highlights of the Programme:

• Over 496 managers were trained on various Leadership and Management development
programmes such as: Strategic Teambuilding, SMS: Finance Management and Budgeting, SMS:
Leading Change, SMS: Strategic Planning and Management, ASELPH Leadership and Ethics
• 2004 employees trained on Specialised programmes for improved Human Resource for Health
(HRH) such as Code of Conduct and Ethics Training, Adult Education and Training (AET),
Chairperson and Initiator training, Recruitment, Selection and Employment Equity Policy, Online
PILIR training, RWOPS Training, Presentation and Facilitation Skills, Grievances and Disciplinary
Procedures, Public Sector Trainers Forum – Peer Learning Exchange, etc. (2020/21 target = 500)
• 395 functional managers trained on Specialised programmes for improved Financial Management
and Supply Chain such as Finance Management & Budgeting, Generally Recognised Accounting
Practice (GRAP) e-learning, Finance for Non-Finance Managers, Supply Chain Management
training process for clinical professionals and SCM Officials, etc. (2020/21 target = 200)
• 393 functional managers trained on Specialised training programmes related to the Health
Information System and Computer Literacy such as Health Info System, HIS Train the Trainer
Super Users and End-user Training, Basic Computer Skills, e-learning, HIS Training, etc. (2020/21
target = 200)
• 1 422 newly appointed employees trained on specialised programmes related to GDoH Onboarding,
Orientation and Induction Framework including Accelerated Compulsory Induction Programme,
Orientation and Induction, Compulsory Induction Programme, etc. (2020/21 target = 1 000)
• 1 446 employees trained on Code of Conduct and Ethics for improved Ethical behaviour. (2020/21
target = 1 000)
• 626 employees trained on soft skills to improve customer service experience, i.e., Customer care,
Human Rights Sensitisation Training, Time Management, Report writing, Business writing Skills,
Basic Communication skills etc. (2020/21 target = 500)
• 156 employees participated in the Adult Education and Training (AET) programme (2020/21 target
= 100)
• 3 611 professional nurses participated in HIV and AIDS, TB, STI and other chronic diseases and
related programmes (target = 4 325)
• 130 doctors participated in HIV and AIDS, TB, STI and other chronic diseases and related
programmes (target = 130)
• 61 448 staff of GDoH were trained on COVID-19 infection control practices. This training was
not part of the training plan, but in response to the pandemic training resources had to be shifted
towards training on COVID-19, which is the highlight of the clinical training (target = 0)
• 728 master trainers, 437 final-year medical students, 3 647 professional nurses and 692 doctors
were trained as vaccinators in preparation for the rollout of the vaccine. This training was not in
the initial plan but was achieved as a response to prepare for this rollout (target = 0)
• 506 clinicians were trained on mental health in support of integrating mental health into primary
health care
• 249 doctors and professional nurses were trained on emergency medical care in support of
implementing Ideal Clinic implementation and reduction of adverse events leading to litigations
Contribution towards Gender equality:
A total of 5 281 males and 16 642 females were trained. The Department is contributing to the
development of females.
Contribution to Youth development:
Gauteng Department of Health participated in the Tshepo 1Million initiative, which is the Provincial
strategy for job creation and empowerment of unemployed youth. To ensure that there is access to
job opportunities, GDoH contributes to Tshepo 1Million by ensuring that unemployed youth have
access to internship and learnership programmes. These programmes create a platform for both
relevant work experience to empower youth in becoming employable in the labour market, and
in some instances, direct employment within the host site. The Department also assisted student
interns to complete their work integrated learning programme, which is an academic requirement by
the TVET colleges for students to meet the graduation criteria. Due to the Departmental Recruitment
Policy which supports an open competition for posts, interns are considered for entry-level posts and
encouraged to apply should they meet the requirements of the post. Interns who are placed in GDoH
have access to training opportunities offered by the Department.
At the end of quarter 4, we have 676 internship participants and 636 learnership participants, which
makes up a total of 1 312. The total number of 1 312 active participants comprises 879 females and
433 males.
A total of 797 health professionals were employed for community service, of which 732 were employed
in clinical internship and placed at accredited health facilities.
People living with disabilities:
The total of active youth participants in internship programmes in quarter 4 is 1 312. Of this total,
youth participants from persons living with disability amounts to 92, which makes up 7% of the
participants. The annual target for youth disability for internship and learnership programmes is 5%.
The Department has exceeded this target.
Challenges
The following challenges were experienced:
1. COVID-19 Restrictions
The RTC trainings which were planned for 2020/2021 were suspended due to the COVID-19
restrictions.
2. Delays with the training process
Some projects were delayed due to the tendering process and could not be finalised on time. Such
programmes include, among others: Basic Life Support, Health Promotion Officer (CHW) and Medical
Male Circumcision.
3. Training of Trainers
Some of the courses such as Nurse Initiated Management of Drug-Resistant TB (NIMDR) and
Medical Male Circumcision (MMC) do not have trainers, as trainers are yet to attend Training of
Trainers (ToT) training.
4. Procurement Department Delays
The GDoH procurement section has introduced a new SOP whereby request for Purchase Orders
took more than six months to process, thus delaying the training as RTC did not have training
manuals and catering for the planned trainings, and some training could not be outsourced.
Table 4.6: Health Sciences and Training
Outcome Outputs Output Audited/ Actual Planned Actual Deviation from Reasons for deviations
128
(as per SP Indicators performance Target Achievement planned target

2020/21- 2020/2021 to Actual
2020/2021
Quality of health Positive Employee 80% 54% 60% 59% (1%) Target not achieved.
services in public employee satisfaction Underperformance
health facilities experience rate is related to poor
improved participation of the
employees in the survey.
Quality of health Employees Percentage of # # # 5% 50% 45% Target achieved. The
services in public remote work administration/ (986/19 Department has been
health facilities promoted support 713) implementing the
improved employees Circular which mandates
working that at least 50% of
remotely staff capacity must be
in office whilst the rest
work from home.

Improve participation by senior clinical staff and senior managers, as during 2020/21 participation of
senior managers was less than 1%. Follow-up of participation on a monthly basis.
Institutional response to COVID-19

Budget Intervention Geographic No. of beneficiaries Total budget Budget spent per Contribution to the Immediate outcomes
Programme location (Province/ (where possible) allocation per intervention Outputs in the APP
(R’000)
(where possible)
6. HEALTH - Goods & Services Tshwane PPE at SG Lourens 0 56 N/A Quality of health services
SCIENCES & (Consumable in public health facilities
TRAINING supplies) improved.
Table 4.6.2: Health Sciences and Training Expenditure Table

Programme 6: HEALTH SCIENCES AND TRAINING
R’000 R’000 R’000 R’000 R’000 R’000
NURSE TRAINING 604 619 556 647 47 972 805 951 693 034 112 917
COLLEGES
EMS TRAINING 42 149 36 495 5 654 39 285 29 123 10 162
COLLEGES
BURSARIES 173 948 129 244 44 704 225 665 263 503 (37 838)
OTHER TRAINING 80 552 64 824 15 999 80 842 59 596 21 246
901 268 787 210 114 058 1 151 743 1 045 256 106 487
4.7 BUDGET PROGRAMME 7: HEALTH CARE SUPPORT SERVICES (HCSS)
Programme Purpose
The purpose of this programme is to render support services required by the Department to realise
its aims through sub-programmes:
• Laundry services: Rendering a laundry service to hospitals, care and rehabilitation centres and
certain local authorities; and
• Medical trading account (Medical Supplies Depot): Managing the supply of pharmaceuticals to
hospitals, community health centres and local authorities.
Programme Outcome
The achievement of the enrolment of patients onto the CCMDD programme has a great impact on
service delivery in that it ensures that health facilities are decongested so that clinicians are not
overwhelmed with a high number of patients and can therefore apply a focused approach in the
management of patients.
The availability of vital medicines at all health facilities ensures that patients are managed accordingly,
and that the patients will have confidence in the public health system and will be satisfied with the
services that they are receiving at the public health facilities.
Comments by the programme on its response to prioritising women, youth and persons with disabilities
in its service delivery environment and challenges encountered (if applicable).
Not Applicable.
The directorate has been able to achieve three out of the four output indicators during the period
under assessment.
Challenges
The percentage of essential items available at health care facilities could not be achieved due to
various reasons. For example, the majority of the items are not on contract and therefore security of
supply is never guaranteed.
Table 4.7.1: Health Care Support Services (ORIGINAL APP)
2024/25) 2017/18 2018/19 2019/20 date of re- Achievement Indicators/Annual
tabling 2020/2021 Targets
Quality of Vital medical Percentage of 96.8% 96.3% 95.56% 98% 96.1% (1.9%) Target not The 98% target had
health products and vital medicine (406/418) (424/441) achieved. not been met since
services in equipment availability at 2017/2018 and it
public available health was felt that it would
health facilities at health facilities be reasonable
improved facilities enough to come up
with a target that we
have always been
meeting, which is
96%.
Essential Percentage 97.6% 96.2% 95.73% 98% 96% (2%) Target not The 98% target had
medical of essential (527/538) (534/556) achieved. not been met since
products and medicine 2017/2018 and it
equipment availability at was felt that it would
available at health facilities be reasonable
health facilities enough to come up
with a target that we
have always been
meeting, which is
96%.
Quality of Waiting times in Number of 410 075 490 518 721 350 550 000 782 839 232 839 Target achieved. At the beginning
health services health facilities patients enrolled Increased of the 2020/2021
in public reduced on centralised enrolment of financial year we
health facilities as patients chronic medicine patients on had already met the
improved voluntarily dispensing and the CCMDD target and felt that
collect chronic distribution programme by we should increase
medication at programme the districts and the target in order to
identified pick- (Cumulative) hospitals. achieve more and
up points increase service
delivery to the
patients.
131
Table 4.7.2: Health Care Support Services (RE-TABLED APP)
132

2020/21- 2020/2021 2020/2021 target to
2024/25) Actual
2017/18 2018/19 2019/20 Achievement
2020/2021
Quality of Vital medical Percentage of 96.8% 96.3% 95.56% 96% 97% 1% Target achieved. Suppliers are being
health products and vital medicine (424/441) (428/441) penalised for late deliveries and
services in equipment availability at suppliers are being paid within 30 days.
public available health
health facilities at health facilities
improved facilities
Essential Percentage 97.6% 96.2% 95.73% 96% 95% (1%) Target not achieved. The various
medical of essential (534/556) (528/556) lockdown restrictions have affected the
products and medicine supply of medicines to the province.
equipment availability at Vital items are not for everyday use;
available at health facilities they are lifesaving medication and their
health facilities demand is not so high as compared
to the essential medicines, hence
they are affected differently. The
total number of essential medicines
is higher as compared to the vital
medicines.
Quality of Waiting times in Number of 410 075 490 518 721 350 750 000 1 022 840 272 840 Target exceeded. With the introduction
health services health facilities patients enrolled of lockdown regulations, the
in public reduced on centralised Department vigorously pursued the
health facilities as patients chronic medicine use of the CCMDD programme as
improved voluntarily dispensing and another avenue to enable continuity of
collect chronic distribution care by enrolling outpatient department
medication at programme patients on the programme. As a
identified pick- (Cumulative) result, there was an improvement in
up points enrolled clients on the programme. The
lockdown restrictions have led to the
districts and hospitals increasing the
enrolment of patients to the CCMDD
programme.
Reduced Percentage # # # 75% 93.7% 18.7% Target achieved. National Health
waiting times of COVID-19 (19 431/ (757 407/ Laboratory Service (NHLS) increased

for COVID-19 results available 25 840) 808 357) the capacity to test as many samples
tests results within 48hrs as possible. In addition, capacity
improved as a result of the drop, in
infections during this period. There was
only a high peak in January 2021 and
July 2020.
• Engage the National Department of Health to ensure that all essential medicines are on contract.
• Engage the Director General to engage sole manufacturers to participate in the bidding for the tenders from the National Department of Health.
• Continue to penalise suppliers for late deliveries.

Budget Programme Intervention Geographic No. of beneficiaries Total budget Budget spent per Contribution to the Immediate
location (Province/ (where possible) allocation per intervention Outputs in the APP outcomes
(R’000)
(where possible)
7. HEALTH CARE - Goods & Services 3 Metros Laundry services 5 000 4 631 N/A Quality of health
SUPPORT SERVICES (Consumable services in public
supplies) health facilities
PPE improved.
Table 4.7.4: Health Care Support Services Expenditure Table

PROGRAMME 7: HEALTH CARE SUPPORT SERVICES
2020/21 2019/20
Sub-programme Appropriation Expenditure Expenditure Appropriation Expenditure Expenditure
R’000 R’000 R’000 R’000 R’000 R’000

LAUNDRIES 287 630 294 625 (6 995) 291 993 287 581 4 412
103 633 94 219 9 414 81 363 (3 569)
FOOD SUPPLY SERVICES 77 794
MEDICINE TRADING ACCOUNT 1 - 1 1 - 1
391 264 388 844 2 420 369 788 368 944 844
133
4.8 BUDGET PROGRAMME 8: HEALTH FACILITIES MANAGEMENT (HFM)
Programme purpose
i. Provision of new health facilities and the refurbishment, upgrading and maintenance of existing
facilities.
ii. Community Health Facilities: Construction of new and refurbishment, upgrading and maintenance
of existing Community Health Centres, Primary Health Care clinics and facilities.
iii. Emergency Medical Rescue Services: Construction of new and refurbishment, upgrading and
maintenance of existing EMS facilities.
iv. District Hospital Services: Construction of new and refurbishment, upgrading and maintenance of
existing District hospitals.
v. Provincial Hospital Services: Construction of new and refurbishment, upgrading and maintenance
of existing Provincial/Regional hospitals and Specialised hospitals.
vi. Central Hospital Services: Construction of new and refurbishment, upgrading and maintenance of
existing Tertiary and Central hospitals.
vii. Other Facilities: Construction of new and refurbishment, upgrading and maintenance of other health
facilities including forensic pathology facilities and nursing colleges and schools.
Ooutcome
Infructure maintained and backlog reduced.
Sub-programmes
• District Health Services

• Community Health Facilities
• Provincial Hospital Services
• Central Hospital Services
• Emergency Medical Services
• Other facilities
Funding Sources
The GDoH infrastructure programme is funded through Equitable Share allocations and the Hospital
Revitalisation Grant, thereby constituting the Estimates of Capital Expenditure allocation for the
performance period. The declaration of the State of Disaster in repose to the COVID-19 pandemic
meant a revision of the 2020/21 infrastructure programme. The emphasis on the adjustment of
performance plans is to be deliberately focused on infrastructure suitable to enable the province
through its Department of Health to be in the best position to provide hospital care to patients seeking
relief from COVID-19 critical symptoms. Hence, the adjusted budget allocation of 2020/21 reflected
a majority of the allocation for the COVID-19 sub-programme through Equitable Share, while the
HRFG remained unchanged. This implies that the projects continuing on construction activities from
the previous years remained funded, while new COVID-19 projects received new funding.
Statement on Achievement
The first and second quarters of the 2020/21 financial year were the most difficult period for the
construction industry, and the Department was equally affected by the level 5 and 4 lockdowns.
Hence, the Primary Health Care construction portfolio, the refurbishment of hospital (Chris Hani
Baragwanath Academic) and construction of the Forensic Pathology building in Johannesburg lost
six months of productive days. The planned awarding of the 10 OHS priority refurbishment projects
was delayed to realign with the activeness of the market. Active construction works resumed in July
and gained momentum towards the end of the second quarter of 2020/21.
It is for these reasons that the planned completion dates of Primary Health Care projects, tendering for
OHS projects, targeted progress for Johannesburg Forensic Pathology and Chris Hani Baragwanath
Academic Hospital where rescheduled to the outer years.
Contrasting the performance of the planned project, it can be reported that COVID-19 projects,
which included reconfiguration of identified wards for treatment of COVID-19 patients as well as new
capital projects consisting of 1 400 ICU beds in four hospitals propelled the province to be in the best
position to deliver on its commitment to fight the scourge of the pandemic. Prior to the COVID-19
pandemic, GDoH had 17 518 hospital beds, which was a shortfall of 4 482 from the target of 22 000
beds based on the estimates against the Gauteng population studies. With the establishment of 2
117 COVID-19 beds in 2021/22, the bed count is now at 19 635. The Department is on good grounds
to expand its health care services in response to the needs of the province.
Development Priorities of Women, Youth and Persons with Disabilities
While GDoH is the budget holder, and the initiator of infrastructure projects in line with its strategic
accommodation needs, the actual implementation occurs within the GDID project environment.
The GDID is a government department whose SCM processes are guided by the BBB-EE Sector
Codes and Treasury Notes. In its bidding procedures, the prequalification criteria are mainly based
on functionality, BBB-EE and local subcontracting. The said development priorities could be best
implemented within the GDoH SCM environment, until the point where Gauteng Treasury issues
Policy Directives on how to implement additional prequalification requirements in SCM.
Significant achievements for the year 2020/21 include the completion of 300 COVID-19 ICU beds at
Jubilee hospital, 500 COVID-19 ICU beds at Chris Hani Baragwanath Academic Hospital, and 150
out of the planned 300 COVID-19 beds at Dr George Mukhari Academic Hospital.
In terms of the OHS Programme on Priority Hospitals, Sterkfontein, Carletonville, Yusuf Dadoo,
Leratong, Weskoppies, Dr George Mukhari, Jubilee, Tambo Memorial, Kopanong, Sebokeng,
Edenvale and Bheki Mlangeni Hospitals have progressed to tender evaluation stages, with expectation
that successful bids will be awarded in the first and second quarter of 2021/22. Other hospitals being
referred to as priority two have advanced to the scoping and pretender stages. Should they receive
funding for construction within the 2021/22 MTEF, the process of appointing contractors through
open Tender will commence then.
Challenges
The GDoH through its Infrastructure Branch operates within a fluid and dynamic environment with
conditions that are destructive to the long-term objective of the Health Care Delivery Strategy of
the province. Delay in completion of projects affects the health care programmes as outlined in
the Strategic Plan. Difficulty to secure appropriate land to deliver Primary Health Care facilities is
among the major constraints. As the User Department (as per the Government Immovable Asset
Management Act 19 of 2007 (GIAMA), GDoH is wholly dependent on the ability and capacity of
the Implementing Agent, which is also Custodian (in terms of GIAMA) to implement its building
programme. Performance challenges of any nature in law or in process have strategic and financial
consequences to the Department’s health care strategy.
To improve opportunities of success in the outer year, it is prudent that the Asset Portfolio of the
province is re-evaluated to realign land ownership and zoning of all clinics and hospitals. We need to
improve planning and scoping of projects to ensure that during construction there is minimal variation
of scope. We need to improve skills capacity especially in the Planning Directorates to improve
performance and delivery. Where policy and resources allow, programmes to develop contractors
targeting specific skills must be considered.
Table 4.8.1: Health Facilities Management
Outcome Outputs Output Indicators Planned Target Actual Achievement Deviation from Reasons for deviations
(as per SP 2020/2021 2020/2021 planned target to
2020/21- Actual Achievement
2024/25) 2020/2021
Infrastructure Refurbished Percentage of health facilities 0% N/A N/A N/A
maintained and and maintained with major refurbishment or
backlog reduced health facilities rebuild
Dedicated Number of hospitals with 32 10 22 Nine hospitals had their beds
COVID-19 beds repurposed COVID-19 beds repurposed, namely Kopanong,
in facilities Tshwane District, Discoverers,
Lenasia, Dr George Mukhari, Chris
Hani, Charlotte Maxeke, Tembisa
and Anglo Ashanti. Target was not
achieved, as the hospital services
reduced the number of targeted
facilities for repurposing because
of the need to manage COVID-19
through a cluster system.
Non-Responsive Bids for

Sterkfontein and Carletonville, Yusuf
Dadoo and Leratong (no award); Bid
Evaluation for Weskoppies; Jubilee,
George Mukhari not Completed.
Others are still due for advertising.
Functional Number of COVID-19 field 4 1 (3) The field hospitals in Tshwane Exco
COVID-19 field hospitals Centre, Daveyton and Chloorkop
hospitals could not be implemented as there
was no funding.
Dedicated Number of clusters with 4 3 (1) Completed 500 ICU beds at Chris
clusters’ additional COVID-19 beds Hani, 300 beds at Jubilee and
COVID-19 beds Kopanong contract was terminated
due to underperformance. George
Mukhari completed 150 beds out of
300.
Dedicated Number of clusters with 4 0 (4) Programme cancelled on Instruction
clusters’ COVID-19 fever tents of National Department of Health.
COVID-19
fever tents
137

• Access granted in November 2020. Contract Extended to November 2022.
• GDID is ramping up the bid evaluation process, to present reports to BAC for decisions before
end of fourth quarter of 2020/21.
• The sites for George Mukhari and Jubilee will be handed over for construction in May 2021.
• Non-Responsive Tender to be re-advertised.
• Weskoppies, Yusuf Dadoo, Leratong and Bheki Mlangeni await the finalisation of Probity Audit.
Outcomes due in first quarter of 2021/22.
• Mamelodi Scope Document was approved in March 2021. (The 10 projects are not funded for
construction this financial year.)
• The Decommissioning of Nasrec will be completed in the first quarter of 2021/22 due to stringent
health and safety measures employable to address medical waste.
• George Mukhari to be completed in first quarter of 2021/22.
• Anglo Ashanti will be completed in first quarter of 2021/22.
Kopanong advertised for Completion Contract after termination of non-performing contractor.

Expected to be awarded in first quarter of 2021/22.
Budget Intervention Geographic No. of beneficiaries Total budget Budget spent per Contribution to the Immediate
Programme location (Province/ (where possible) allocation per intervention Outputs in the APP outcomes
District/local intervention (R’000) (where applicable)
(R’000)
municipality)
(where possible)
8. HEALTH - Goods & Services Whole Leasing of 455 053 261 445 Functional Infrastructure
FACILITIES (Contracted Province Nasrec COVID-19 field maintained and
MANAGEMENT maintenance and hospitals. backlog reduced.
new, refurbishment,
rehabilitation,
upgrading and
addition of buildings)
-Building and other 1 777 461 1 760 937 Refurbished Infrastructure

fixed structures and maintained maintained and
health facilities. backlog reduced.
Dedicated
COVID-19 beds
in facilities.
Table 4.8.3: Health Facilities Management Expenditure Table

PROGRAMME 8: HEALTH FACILITIES MANAGEMENT
Final Appropriation Actual Expenditure (Over)/Under Final Appropriation Actual Expenditure (Over)/Under
Expenditure Expenditure
R’000 R’000 R’000 R’000 R’000 R’000

COMMUNITY HEALTH FACILITIES 373 766 421 683 (47 917) 610 273 526 523 83 750
EMERGENCY MEDICAL RESCUE (3 260) 6 813 (10 073) 23 702 19 933 3 769
SERVICES
DISTRICT HOSPITAL SERVICES 157 049 242 631 (85 582) 690 144 564 073 126 071
PROVINCIAL HOSPITAL SERVICES 200 733 377 035 (176 302) 388 450 353 929 34 521
CENTRAL HOSPITAL SERVICES 382 434 604 556 (222 122) 1 503 984 1 520 597 (16 613)
OTHER FACILITIES 979 421 401 167 578 254 1 025 680 1 056 302 30 622
2 090 143 2 053 885 36 258 4 242 233 4 041 357 200 876
139
4.9. TRANSFER PAYMENTS
The table below shows the transfer payments budgeted for in the period 1 April 2020 to 31 March
2021. This section provides information about transfer payments to provinces, municipalities,
departmental agencies (excluding public entities), higher education institutions, public corporations,
private enterprises, foreign governments, non-proﬁt institutions and households. This excludes
payments to public entities.
Table: Transfer payments to other public entities, 2020/21

Name of Type of Purpose for Did the Amount Amount spent Reasons for
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 Yes 353 569 353 569
Care
Local Government Municipalities HIV/AIDS Yes 92 000 92 000
Local Government Municipalities Emergency Yes 74 920 74 920
Medical
Services
Health Welfare and Departmental Learnerships Yes 23 352 23 352
Sector Training Agencies and
Authority Accounts
Universities Higher Training Yes 15 459 12 871 Phasing out of
Education of health old curriculum
Institutions professionals programmes
and COVID-19
pandemic
resulted in
a decrease
in student
population.
Mental Health Non-profit Psychiatric Yes 220 803 186 164 Due to the
institutions Community- COVID-19
Based Services pandemic,
some of the
mental health
centres were
closed and
the users
were taken
care of at their
homes.
Nutrition Non-profit Nutrition Yes 65 115 4 591 Due to the
institutions supplement to COVID-19
crèches pandemic the
ECDs were
not functional.
HIV/AIDS Non-profit Primary Health Yes 104 000 86 362 Process for
institutions Care appointment
of new NGOs
was stopped
due to the
COVID-19
pandemic and
regulations.
Name of Type of Purpose for Did the Amount Amount spent Reasons for
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?
Witkoppen clinic Non-profit Primary Health Yes 14 826 8 593 Payments

institution Care were
processed
after year-end
closure.
Rehabilitation Non-profit Rehabilitation Yes 1 883 0 Due to the
Services institutions COVID-19
pandemic,
a service
provider was
not appointed.
Nelson Mandela Non-profit Paediatric Yes 317 000 317 000
Children’s Hospital institution services
Households Leave Service Yes 352 302 627 677 Increased
gratuities, benefits and payments of
claims against households medico-legal
the state, injury claims against
on duty and the state.
bursaries to
non-employees
4.10. CONDITIONAL GRANTS

Conditional grants and earmarked funds paid
The table below shows the conditional grants and earmarked funds paid by the Department.
4.10.1 Conditional Grant: Health Facility Revitalisation Grant

Department/ Municipality to whom Gauteng Department of Health
the grant has been transferred
Purpose of the grant To help accelerate construction, maintenance, upgrading and rehabilitation of new
and existing infrastructure including health technology, organisational development
systems and quality assurance.
To enhance capacity to deliver health infrastructure.
Expected outputs of the grant • 4 facilities maintained
• 2 facilities identified
• 6 design facilities
• 1 tender facility
• 14 facilities on construction
Actual outputs achieved • 4 facilities maintained (Dr George Mukhari Hospital, Charlotte Maxeke
Hospital, Chris Hani Baragwanath Academic Hospital, Steve Biko Hospital)
• 1 design facility
• 12 facilities on construction
Amount per amended DORA R 968 210

Amount transferred (R’000) R 968 210
Reasons if amount as per DORA not N/A
transferred
Amount spent by the department/ R 968 435
municipality (R’000)
Reasons for the funds unspent by N/A
the entity
Monitoring mechanism by the • Monthly and quarterly reports
transferring department • IRM report
• Project Management Implementation System (PMIS)
4.10.2 Conditional Grant: National Tertiary Services Grant

Department/ Municipality to whom National Department of Health
Purpose of the grant Ensure the provision of tertiary health services in South Africa, and to compensate
tertiary facilities for the additional costs associated with the provision of these
services.
Expected outputs of the grant NTSG - Service Outputs 2020/21 Target output as per SLA 2020/21
Day patient separations - Total 252,019
Inpatient days - Total 2,597,496
Inpatient separations - Total 411,920
Outpatient first attendances 884,670
Outpatient follow up attendances 1,448,593
Actual outputs achieved NTSG - Service Outputs 2020/21 Measured outputs
Day patient separations - Total 243355
Inpatient days - Total 2,304,486
Inpatient separations - Total 392,439
Outpatient first attendances - Total 789184
Outpatient follow up attendances - Total 1,162,822
Amount per amended DORA R 5 144 483
Amount transferred (R’000) R 5 144 483
Reasons if amount as per DORA not
transferred
Amount spent by the department/ R 4 776 790
Reasons for the funds unspent by The spending as at end of the 2020/21 financial year is at 93%. Due to delays in
the entity SCM processes, machinery and equipment to the value of R362.3 million could
not be delivered and paid on 31 March 2021. However, a rollover application has
been submitted to Provincial Treasury.
Monitoring mechanism by the Monthly and quarterly review of expenditures against the budget. The annual
transferring department financial report from both the hospital and provincial financial reporting is in place
and submitted to National Department of Health.
Conditional grants and earmarked funds received.

4.10.3 Conditional Grant: Statutory Human Resources, Training and Development Grant
Department/ Municipality to whom
Purpose of the grant To appoint statutory positions in the health sector for systematic realisation of the
Human Resources for the health strategy and the phase-in of National Health
Insurance, and to support provinces to fund service costs associated with clinical
training and supervision of health science trainees on the public service platform.
Expected outputs of the grant
Actual outputs achieved
Amount per amended DORA R 1 400 294 (R 1 095 020 +R 305 274)
Amount transferred (R’000) R 1 395 274 (R 1 095 020 +R 300 254)
Reasons if amount as per DORA not The R 5 million under HR was not transferred, National Department of Health
transferred incorrectly processed the payments to Mpumalanga Province.
Amount spent by the department/ R 1 351 297 (R 1 046 082 + R 305 215)
Reasons for the funds unspent by The spending as at end of the 2020/21 financial year is at 97%. Due to delays in
the entity SCM processes, machinery and equipment to the value of R46.3 million could not
be delivered and paid on 31 March 2021. However, a rollover application has been
submitted to Provincial Treasury.
Monitoring mechanism by the Monthly and quarterly expenditure reports are submitted to National Department
transferring department of Health.
4.10.4 Conditional Grant: HIV, TB, Malaria and COMM Outreach Grant
Department/ Municipality to whom Gauteng Department of Health
Purpose of the grant The purpose of the Conditional Grant is to support the implementation of the
National Strategic Planning on HIV, STIs and TB 2017 – 2022, and to strengthen
health systems and oversight of the HIV and TB Conditional Grant to achieve
improved cost effectiveness and clinical health outcomes.
Expected outputs of the grant Scale up combination prevention interventions to reduce new infections, including
HTS, male medical circumcision and condom distribution; Use of mass media
platform and HAST communication messaging strategy; Expand PMTCT
coverage to pregnant women by ensuring all HIV-positive Antenatal clients
are placed on ARVs and reducing the positivity rate; Life expectancy improved
through increasing the number of people on ART; TB and HIV combatted through
reducing the co-infection burden and decrease TB morbidity and mortality. HPV
interventions are included under this grant.
Actual outputs achieved Decreased new HIV infections, more clients initiated on ART, reduce HIV-related
deaths, reduced mother-to-child HIV transmission and improved life expectancy.
Amount per amended DORA R 5 928 558 (R4 605 692+R 89 062+R 458 896+R 30 427 + R 744 481)
Amount transferred (R’000) R 5 928 560 (R 744 481+R 4 605 694 + R 89 062+ R 458 896+ R 30 427)
Reasons if amount as per DORA not NA
transferred
Amount spent by the department/ R 5 829 641 (R4 605 692+R 744 481+R 89 325+R 360 328+R 29 815)
Reasons for the funds unspent by The spending as at end of the 2020/21 financial year is at 98.3%. This is mainly
the entity due to non-replacement, payment of stipend to CHWs for first quarter in lieu
of salary at level 02 and non-procurement of uniforms due to late awarding of
uniform tender and ongoing investigation; however, the Department has applied
for a rollover amounting to R4.5 million for the procurement of uniforms.
Monitoring mechanism by the Monthly variance and quarterly reports are submitted to National Department of
transferring department Health and Provincial Treasury.
4.10.5 Conditional Grant: 2020/21 Social Sector EPWP Incentives Grant for the Province – Department of Health
Social Sector EPWP Incentives Grant
Department/ Municipality to whom the Gauteng Department of Health
grant has been transferred
Purpose of the grant To improve service delivery by strengthening and expanding Social Sector
programmes that have employment potential for poverty alleviation.
Expected outputs of the grant • Employment created and stipend paid to participants
• Service delivery improved
• Improved work opportunities for sustainable jobs through work experience
and training.
Actual outputs achieved • 670 work opportunities created and stipend paid to participants
• 670 EPWP participants gained work experience and on-job training
including accredited training
• 191 health facilities serviced by EPWP participants.
Reasons if amount as per DORA not Not Applicable
transferred
Amount spent by the department/ R 30 153 (99%)
Reasons for the funds unspent by the Training was procured and took place, however, there was a delay with the
entity service provider in uploading the invoice. Rollover request was made and
approved by the A/HOD.
Monitoring mechanism by the Monthly In-Year Monitoring Reports and Quarterly Non-Financial Reports.
transferring department
4.10.6 Conditional Grant: National Health Insurance Grant

Department/ Municipality to whom the Tshwane District Health Services
Purpose of the grant To expand the health care servicer benefits through the strategic purchasing of
services from health care providers.
Expected outputs of the grant • To bring down the waiting time at the PHC facilities.
• To reduce unnecessary referrals to higher levels of care.
Actual outputs achieved Adequate coverage of PHC services.
transferred
Amount spent by the department/ R 44 393
Reasons for the funds unspent by the The Department spent 83% due to the non-submission of Travel allowance
entity claims by some doctors. The claims for January, February and March for travel
and substances are still outstanding, since some doctors submit the claims late
to HR.
Monitoring mechanism by the • Monitor number of patients seen as per category.
transferring department • Sign daily registers in facilities.
• Orientate health professionals about Government policies.
4.10.7 Conditional Grant: Covid - 19 Disaster Relief grant

Purpose of the grant To procure Personal Protective Equipment (PPE), ventilators, beds availability
Expected outputs of the grant PPE available to all staff members in health facilities
Actual outputs achieved 3 234 197 COVID-19 tests were conducted
Amount spent by the department/ R115 997
Reasons for the funds unspent by the NA
Monitoring mechanism by the Submission of monthly reports to the National Department of Health and Gauteng
4.10.8 Conditional Grant: EPWP Integrated Grant to Provinces

Purpose of the grant To incentivise provincial departments to expand work creation efforts through the
use of labour intensive delivery methods in the following identified focus arears,
in compliance with Expanded Public Works Programme (EPWP) guidelines:
• Roads maintenance and maintenance of buildings
• Low traffic volume roads and rural roads
• Other economic and social infrastructure
• Tourism and cultural industries
• Sustainable land based livelihood
Waste management
Expected outputs of the grant 100 beneficiaries
Actual outputs achieved 100 beneficiaries appointed
Amount per amended DORA R2 196
Amount transferred (R’000) N/A
Reasons if amount as per DORA not N/A
transferred
Amount spent by the department/ R2 196
Reasons for the funds unspent by the N/A
entity
Monitoring mechanism by the Monthly and quarterly reports
transferring department
4.11. DONOR FUNDS

Donor Fund 1
Name of donor United States Agency for International Development (USAID) donated to Jubilee
Hospital.
Full amount of the funding USAID donated assets (5 x ventilators) to the value of R795 663.
Period of the commitment None
Purpose of the funding 5 x ventilators to be used for patients in the hospital.
Expected outputs Ventilators to assist patients for better health.
Actual outputs achieved Better health for patients.
Amount received in current period R 795 663 worth of assets donated by USAID.
(R’000)
Amount spent by the department None
(R’000)
Reasons for the funds unspent None
Monitoring mechanism by the donor None
Donor Fund 2
Name of donor USAID donated to Chris Hani Baragwanath Academic Hospital
Full amount of the funding USAID donated assets (94 x ventilators-LTV2200) to the value of
R263 963 136.71.
Purpose of the funding 94 x ventilators-LTV2200 to be used for patients in the hospital.
Amount received in current period R 263 963 136.71 worth of assets donated by USAID.
(R’000)
(R’000)
Donor Fund 3
Name of donor USAID donated to Steve Biko Academic Hospital
Full amount of the funding USAID donated assets (45 x ventilators-LTV2200) to the value of
R13 052 871.45.
Amount received in current period R 13 052 871.45 worth of assets donated by USAID.
(R’000)
(R’000)
Donor Fund 4
Name of donor USAID donated to Sebokeng Hospital
Full amount of the funding USAID donated assets (4 x ventilators-LTV2200) to the value of R1 224 835.
Amount received in current period (R’000) R 1 224 835 worth of assets donated by USAID.
Amount spent by the department (R’000) None
Donor Fund 5
Name of donor Defy Appliances (Pty) Ltd donated to: Mamelodi Hospital, Tshwane District
Hospital, Odi Hospital, Dr George Mukhari Academic Hospital, Jubilee
Hospital, Hillbrow Clinic, Charlotte Maxeke Academic Hospital, Tembisa
Hospital, Edenvale Hospital, Lenasia South Hospital, Kopanong Hospital
and Germiston Pathology.
Full amount of the funding Defy Appliances (Pty) Ltd donated assets (6 x tumble dryer machines, 2 x
dryer series machines, 29 x fridges, 37 x microwave ovens and 8 x washing
machines) to the value of R287 273.95.
Purpose of the funding Appliances to be used to improve service delivery.
Expected outputs Improved service delivery.
Actual outputs achieved Service delivery.
Amount received in current period (R’000) R 287 273.95 worth of assets donated by Defy Appliances (Pty) Ltd.
Donor Fund 6
Name of donor Makro donated to Rahima Moosa Mother and Child Hospital.
Full amount of the funding Makro donated assets (1 x television, 1 x microwave, 1 x bar fridge) to the
value of R10 797.
Purpose of the funding To improve service delivery.
Actual outputs achieved Improved service delivery.
Amount received in current period (R’000) R 10 797 worth of assets donated by Makro.
Donor Fund 7
Name of donor Abela Africa Med donated to Rahima Moosa Mother and Child Hospital
Full amount of the funding Abela Africa Med donated assets (1 x Vein Viewer Vision 2 and 50 x cot
beds) to the value of R285 600.
Amount received in current period (R’000) R 285 600 worth of assets donated by Abela Africa Med.
Donor Fund 8
Name of donor Class Three Medical Solutions (Pty) Ltd donated to DR George Mukhari
Academic Hospital
Full amount of the funding Class Three Medical Solutions (Pty) Ltd donated assets (10 x ventilators) to
the value of R550 000.
Purpose of the funding To fight COVID-19 pandemic and improve patient care.
Expected outputs Improved patient care.
Actual outputs achieved Improved patient care.
Amount received in current period (R’000) R 550 000 worth of assets donated by Class Three Medical Solutions (Pty)
Ltd.
Donor Fund 9
Name of donor WECO (Pty) Ltd donated to Leratong Hospital
Full amount of the funding WECO (Pty) Ltd donated assets (1 x JVC LED TV and single-seater brown
leather coach) to the value of R4 500.
Amount received in current period(R’000) R 4 500 worth of assets donated by WECO (Pty) Ltd.
Donor Fund 10
Name of donor USAID donated to Leratong Hospital
Full amount of the funding USAID donated assets (4 x ventilators) to the value of R1 160 255.24.
Purpose of the funding To improve service delivery in the hospital.
Amount received in current period (R’000) R 1 160 255.24 worth of assets donated by USAID.
Donor Fund 11
Name of donor Johannesburg Expo Centre donated to Gauteng Health
Full amount of the funding Johannesburg Expo Centre donated assets (1 417 beds and 1 417 matrasses)
to the value of R6 300 893,29.
Amount received in current period(R’000) R6 300 893,29 worth of assets donated by Johannesburg Expo Centre.
Donor Fund 12
Name of donor 3G Relocations donated to Steve Biko Academic Hospital
Full amount of the funding 3G Relocations donated assets (30 x CPAP/HFO units) to the value of
R2109 928.50.
Amount received in current period R2 109 928.50 worth of assets donated by 3G Relocations.
(R’000)
Donor Fund 13
Name of donor Phoenix Neomed donated to Rahima Moosa Mother and Child Hospital
Full amount of the funding Phoenix Neomed donated assets (1 x cot bed) to the value of R45 425.
Amount received in current period(R’000) R 45 425 worth of assets donated by Phoenix Neomed.
Donor Fund 14
Name of donor BMW South Africa donated to Dr George Mukhari Hospital.
Full amount of the funding BMW South Africa donated assets (168 beds) to the value of R1 974 131.09.
Purpose of the funding To be used for patients in the hospital.
Amount received in current period R 1 974 131.09 worth of assets donated by BMW South Africa.
(R’000)
Donor Fund 15
Name of donor 2Care4Cares donated to Rahima Moosa Mother and Child Hospital.
Full amount of the funding 2Care4Cares donated assets (1 x 3-seater coach and 1 x 2-seater coach) to
Amount received in current period R 6 000 worth of assets donated by 2Care4Cares.
(R’000)
(R’000)
Donor Fund 16
Name of donor Class Three Medical Solutions (Pty) Ltd donated to DR George Mukhari
Academic Hospital.
Full amount of the funding Class Three Medical Solutions (Pty) Ltd donated assets (10 x ventilators) to
Purpose of the funding To fight COVID-19 pandemic and improve patient care.
Amount received in current period R 550 000 worth of assets donated by Class Three Medical Solutions (Pty) Ltd.
(R’000)
(R’000)
Donor Fund 17
Name of donor WECO (Pty) Ltd donated to Leratong Hospital.
Full amount of the funding WECO (Pty) Ltd donated assets (1x JVC LED TV and single-seater brown
leather couch) to the value of R4 500.
Amount received in current period R 4 500 worth of assets donated by WECO (Pty) Ltd.
(R’000)
(R’000)
Donor Fund 18
Name of donor SAME Foundation donated to Chris Hani Baragwanath Academic Hospital.
Full amount of the funding SAME Foundation donated assets (34 x electric beds, 35 x locker bedsides, 2
x trolley emergency and 1 x chair Neotel visitor) to the value of R1 193 003.10.
Purpose of the funding To be used for patients in the hospital.
Amount received in current period R 1 193 003.10 worth of assets donated by SAME Foundation.
(R’000)
(R’000)
Donor Fund 19
Name of donor Isibani Development Partners donated to Ekurhuleni District Office.
Full amount of the funding Isibani Development Partners donated assets (34 x Dell Vostro Complete
Desktop) to the value of R319 465.70.
Amount received in current period R 319 465.70 worth of assets donated by Isibani Development Partners.
(R’000)
Amount spent by the department(R’000) None
4.12. CAPITAL INVESTMENT
Capital investment, maintenance and asset management plan
Table 4.12.1: Infrastructure projects completed during the financial year and progress compared with what was
planned at the beginning of the year
PMIS Name of Brief Start Date End Date Current Challenges Requests for
Project Project description of Status Intervention
Number Project
170 Mandisa Convert Clinic 22 Sep 2017 31 Sept 2021 98% The project Acquisition of
Shiceka to CDC needed more an additional
Clinic – land due to land parcel
Convert to its size and ERF 355
CDC (NHI) additional and 356 (a
P3 parking as portion) as
required by requested to
the City of accommodate
Tshwane for parking for the
compliance clinic.
with the city
by-laws. GDID had
received the
deed of sale
from the City
of Tshwane.
6793119 Phillip Moyo Refurb and 07 Jul 2017 30 Nov 2020 99% Approval GDID is
CHC Additions Achieved of as-built engaging CoE
Practical drawings to resolve
Completion by City of the matters
Ekurhuleni through IGR
(CoE). meetings and
Obtainment outside IGR
of Occupation meetings.
Certificate
from CoE.
143 Boikhutsong New clinic 29 May 2017 30 Sept 2020 95% The project is CoT to fast-
CDC encroaching track the
on adjacent issuing of
site. GDID deed of sale.
have
requested
the additional
land donation;
however, COT
is no longer
donating land
parcels to
GPG and is
now selling
the land.
129 Finetown New Clinic 30 Apr 2019 30 Aug 2021 95% Signing of COJ to fast-
Clinic – new Power of track the
build Attorney signing of
by City of Power of
Attorney.
6793113 Greenspark New Clinic 11 Oct 2016 31 May 2021 98% Availability of GDoH is
Clinic HT. addressing
the challenge.
PMIS Name of Brief Start Date End Date Current Challenges Requests for
Project Project description of Status Intervention
Number Project
291 Kekanastad New Clinic 27 Feb 2018 30 Sep 2021 90% Final approval
of sewer plant
and storm
water CE.
6793128 Sebokeng New clinic 20 Oct 2017 05 Aug 2021 95% No bulk power Eskom to
Zone 17 supply to the fast-track the
Clinic clinic. installation of
the bulk power
supply once
the amount
is paid by the
contractor.
659 Helen New clinic 01 Aug 2018 28 Feb 2022 55% Slow PSPs’ DID to tighten
Joseph response to control of
Hospital contractor PSPs.
Nurses request for
Residence information.
467 New clinic 01 Nov 2016 31 May 2022 65% Construction Investigate
work very possible
slow. Delivery use of local
of imported material.
material.
6793106 Randfontein New CHC 31 Oct 2018 12 Jun 2022 60% Stoppages GDID to
(Mohlakeng) due to meet with the
CHC community contractor
unrest to map a
(business way forward
forum MKVA). on how the
Contractor is project can be
experiencing salvaged and
cash flow fast-tracked.
challenges.
6793111 Khutsong Construction of 12 April 2016 TBC 90% Contactor was Review and
South Ext 2 new clinic terminated endorsement
Clinic due to of remedial
New Clinic contractual work. Value
disputes. Engineering
GDID required on
submitted current PEP
PEPv4a for v4a before
approval to approval by
GDoH, but GDoH. A
the cost is too contractor to
high. be appointed.
Table 4.12.2: Infrastructure projects currently in progress and their expected completion dates
PMIS Project name Stage Construction start Construction end
Project date date
Number
30309905 Atteridgeville CHC Feasibility 30 November 2018 31 August 2021
Construction of new CHC
84 Bertha Gxowa Hospital Design TBC
Upgrading of hospital
31007931 Bheki Mlangeni Hospital Feasibility 01 December 2022 31 March 2025
New nurses residences
6792486 Boitumelo Clinic Construction 1– 25% 01 April 2020 31 March 2023
New clinic
6793105 Braam Fischerville Clinic Pre-feasibility 05 March 2020 31 March 2023
New clinic
445 Bronkhorstspruit FPS Mortuary Feasibility 06 September 2020 06 January 2022
New mortuary
212 Carletonville Hospital Design 30 October 2019 31 January 2022

Refurbishment of TB ward
30309680 Charlotte Maxeke Johannesburg Design TBC
Academic Hospital
Wet services
6793027 Chiawelo Clinic Feasibility 15 June 2022 24 February 2024
Replace asbestos with brick and
upgrade existing clinic to CHC
428 Chris Hani Baragwanath Hospital Construction 01 March 2019 30 November 2023
Critical repairs and refurbishment 55%
of staff accommodation, walkways,
neonatal ICU and labour ward
6793012 Cosmo City Clinic Identified 01 April 2022 31 March 2024
New clinic
103 Dark City CHC Design 02 November 2022 30 September 2024
Additions and rehabilitation
6793117 Daveyton Main Clinic Feasibility 01 April 2022 31 March 2025
Construction of the new clinic
30309906 Dewagensdrift EMS Design 05 August 2022 29 September 2024
New EMS base
6793154 Diepkloof FPS Pre-feasibility 01 April 2022 31 March 2024
Structural defects
105 Dilopye Clinic Design 02 August 2022 31 March 2024
319 Discoverers CHC Design 28 April 2022 01 May 2024
Convert CHC into District hospital
6793031 Dr George Mukhari Hospital Pre-feasibility 30 May 2022 30 July 2024
Construction of helipad
350 Dr Yusuf Dadoo Hospital Feasibility 13 December 2022 31 December 2024
Revitalisation
30309678 Edenvale Hospital Upgrades Design 01 August 2022 01 September 2024
Upgrading and new AET, additional
wards, linen room, additional theatre
113 Ekangala Clinic Design 01 November 2022 01 November 2024
New clinic
6793121 Eldorado CHC Feasibility 01 April 2023 31 March 2025
Construction of new CHC
6793129 Evaton West Clinic Tender 01 April 2023 31 March 2025
Construction of new clinic
31006404 Hillbrow District Hospital Concept design 01 April 2021 31 March 2025
Conversion of CHC into District
hospital
Additions and revitalisation
6793118 J Dumani CHC Design 01 April 2021 31 March 2024
Extensions of the pharmacy
storeroom
753 Jubilee Hospital Identified 01 June 2022 30 June 2027
Revitalisation
760 Kagiso CHC Design 08 December 2022 31 March 2024
New CHC

Project date date
Number
759 Kalafong Hospital Feasibility 01 August 2023 28 May 2027
Revitalisation/construction of new
hospital
292 Kgabo CHC Feasibility 01 October 2022 29 November 2024
New CHC
765 Khayalami Hospital Pre-feasibility 10 March 2022 28 June 2026
Complete refurbishment of existing
unused hospital into a functional
District hospital
31007745 Khayalami Hospital Feasibility TBC
Demolition of current empty hospital
6793107 Kokosi CHC Tender 11 December 2021 31 March 2024
New CHC
849 Kopanong Hospital Tender 01 November 2021 01 May 2023
Refurbishment of Psychiatric wards
1&2
161 KT Motubatse Feasibility 26 October 2023 26 June 2025
New clinic
6793036 Lebone College Design 05 April 2022 03 July 2023
Health council upgrades
6793048 Lehae CHC Feasibility 30 July 2022 28 February 2025
Construction of a new CHC
31008679 Lenasia District Hospital Tender 01 December 2022 01 December 2024
Phase 1 – Gateway Clinic
908 Lenasia South CHC Construction 01 June 2020 31 March 2024
Convert CHC into District Hospital. 90%
Phase 1 – Gateway Clinic
30309679 Leratong Nurses Res Construction 30 June 2020 30 September 2022
Upgrade 40%
31006389 Lillian Ngoyi Hospital Tender TBC
Staff accommodation
53 Lillian Ngoyi Design TBC
Construct new 500-bed District
hospital adjacent to existing CHC
6793112 Mayibuye Clinic Construction 28 October 2020 23 April 2023
Construction of new clinic 9%
180 New Eersterus Clinic Construction 1–25% 31 August 2018 31 August 2023
Construction of new clinic in
Soshanguve
6793120 Northmead Clinic Feasibility 01 April 2022 31 March 2024
Upgrades and additions
OR Tambo MOU Identified TBC
Upgrading and renovation of the
existing clinic using MOU
6793122 Orange Farms Tender 01 December 2022 01 December 2025
Replacement of Ext 7 Clinic
195 Phedisong 4 CHC Design 05 October 2023 05 October 2025
Pholosong Hospital Design 01 April 2022 31 March 2025
Step-down beds
198 Pretoria North Clinic Design 01 April 2022 19 April 2026
202 Ramotse Clinic Design 01 July 2022 31 March 2024
New clinic
6793149 Refentse Clinic Design 01 April 2019 31 March 2021
Additions and rehabilitation.
205 Refilwe Clinic Design 30 April 2022 30 September 2024
Replace small clinic and upgrade to
CHC
629 S G Lourens Nursing College Design 01 April 2022 31 March 2023
Construction of new training facility
739 Sebokeng Hospital Feasibility 25 July 2022 24 July 2027
Revitalisation
South Rand Hospital Identified 01 March 2020 02 June 2022
Maternity homes

Project date date
Number
901 Tambo Memorial Hospital Feasibility 01 August 2022 28 May 2028
Revitalisation
31006387 Tara Hospital Design 01 August 2022 31 August 2024
Construction of new secure
adolescent ward
Tembisa Hospital Design 01 April 2020 31 March 2022
Encroachment and dolomite risk
Tembisa Hospital Design 01 October 2021 30 April 2023
New bulk store
1010 Tshwane Rehabilitation Centre Design 30 November 2022 30 September 2025
Renovation and upgrading of the
facility
245 Weskoppies Hospital Design 16 November 2022 01 June 2025
Condition assessment and
refurbishment of heritage buildings
Winnie Mandela CHC Design 01 April 2022 31 March 2025
Construction of a new CHC
Zola Clinic Feasibility 01 April 2022 31 March 2025
Construction of a new clinic
Plans to close or downgrade any current facilities
There were no plans to close or downgrade any facilities in the 2020/21 financial year.
Progress was made on maintenance of the following infrastructure:

Maintenance category Final appropriation (R’000) Expenditure (R’000) % spent against budget
Maintenance & Repairs 1 426 247 1 419 164 99%

Electro-mechanical 58 453 53 917 92%
EPWP 2 196 2 196 100%
Total 1 486 896 1 475 277 99%
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 2020/21.
Index Number of facilities Percentage

Condition Rating C4 16 5%
Maintenance Projects
In 2020/21, the main allocation towards maintenance was R820 million. This was adjusted upwards
to R1 billion and the entire allocation was spent. The allocation over the 2021/22 MTEF is R2.6
billion. In 2020/21, there were 92 facilities which were maintained and in 2021/22, 93 facilities are to
be maintained. The number of maintenance projects is determined by the number of facilities, where
each facility is considered as one project. Thus, although there may be many small maintenance
projects being implemented at a specific facility, it is still considered as one project.
The following major maintenance projects were undertaken during the period under review.
Table 4.12.3: Maintenance projects, 2020/21

Project Project Name Main budget Adjusted budget Actual
Number expenditure to
(IRM) date for this
financial year
31011196 11 Diagonal street – Planned, statutory and R0 R2 500 000 R0
preventative maintenance
81 Ann Latsky Nursing College – Planned, statutory R2 000 000 R1 600 000 R327 540
and preventative maintenance
175 Auckland Park Medical Supply Depot – Planned, R7 000 000 R5 600 000 R2 912 563
statutory and preventative maintenance
85 Bertha Gxowa Hospital – Planned, statutory and R7 000 000 R7 500 000 R17 223 854
preventative Maintenance
6793065 Bheki Mlangeni Hospital – Planned, statutory R7 000 000 R10 000 000 R10 886 640
87 Bona Lesedi Nursing College – Planned, R3 000 000 R4 200 000 R1 455 697
31007928 Bronkhorstspruit EMS Station – Planned, R50 000 R40 000 R278 457
30309699 Bronkhorstspruit Forensic Mortuary – Planned, R500 000 R400 000 R178 746
30309930 BronkhorstspruitHospital – Planned, statutory R7 000 000 R5 600 000 R3 596 988
88 Carletonville FPS Mortuary – Planned, statutory R1 500 000 R2 000 000 R1 229 479
89 Carletonville Hospital – Planned, statutory and R7 000 000 R5 600 000 R3 956 645
30309693 Charlotte Maxeke EMS – Planned, statutory and R500 000 R4 900 000 R4 841 784
93 Charlotte Maxeke Hospital – Planned, statutory R50 000 000 R80 000 000 R133 818 456
95 Chris Hani Baragwanath Academic Hospital R50 000 000 R80 000 000 R97 397 849
– Planned, statutory and preventative
maintenance
97 Chris Hani Laundry – Planned, statutory and R2 500 000 R4 000 000 R2 350 569
30309441 Chris Hani Nursing College – Planned, statutory R3 000 000 R2 200 000 R159 555
6792275 Cullinan Care Rehab Maintenance R12 000 000 R11 000 000 R15 499 788
30309695 Cullinan EMS – Planned, statutory and R200 000 R3 200 000 R4 045 267
30309697 Diepkloof Forensic Mortuary – Planned, R2 500 000 R3 000 000 R1 775 680
107 Dr George Mukhari Hospital – Planned, statutory R50 000 000 R61 000 000 R70 466 211
108 Dr Yusuf Dadoo Hospital – Planned, statutory R7 000 000 R11 600 000 R8 945 060
110 Dunswart Provincial Laundry – Planned, R2 500 000 R6 000 000 R6 463 695
255 Edenvale Hospital – Planned, statutory and R10 000 000 R15 000 000 R19 564 848
31010596 Edenvale Laundry Maintenance R2 500 000 R1 500 000 R1 557 767
114 Ekurhuleni District CHCs – Planned, statutory R10 000 000 R16 000 000 R19 633 038
117 Ekurhuleni District Clinics – Planned, statutory R15 000 000 R30 000 000 R18 740 925
121 Ekurhuleni District Office (including Pharmacies R1 000 000 R2 500 000 R3 929 218
& EMS) –Planned, statutory and preventative
maintenance
30309931 Emergency Repairs Maintenance R50 000 000 R40 000 000 R59 212 598

(IRM) date for this
financial year
256 Far East Rand Hospital – Planned, statutory and R10 000 000 R8 000 000 R9 710 536
30309694 Fochville EMS Maintenance R1 000 000 R8 000 000 R5 983 494
134 Ga-Rankuwa Forensic Mortuary – Planned, R5 000 000 R1 500 000 R413 517
135 Ga-Rankuwa Nursing College – Planned, R1 000 000 R1 500 000 R2 345 185
30309698 Germiston Forensic Mortuary – Planned, R1 500 000 R800 000 R2 237 833
31009674 Health Facilities Maintenance R0 R0 R15 001 104
30309700 Heidelberg Forensic Mortuary – Planned, R1 500 000 R500 000 R120 750
147 Heidelberg Hospital – Planned, statutory and R7 000 000 R12 000 000 R15 293 578
257 Helen Joseph Hospital – Planned, statutory and R15 000 000 R25 000 000 R40 324 083
149 Johannesburg District CHCs – Planned, R30 000 000 R25 000 000 R52 919 694
151 Johannesburg District Clinics – Planned, R30 000 000 R40 000 000 R34 006 240
154 Johannesburg District Office – Planned, R500 000 R400 000 R1 103 920
30309701 Johannesburg Forensic Mortuary – Planned, R2 000 000 R1 600 000 R1 492 881
4664 Johannesburg Provincial Laundry – Planned, R3 000 000 R2 400 000 R5 333 647
159 Jubilee Hospital – Planned, statutory and R7 000 000 R9 600 000 R15 422 246
258 Kalafong Hospital – Planned, statutory and R30 000 000 R17 000 000 R22 741 865
163 Kopanong Hospital – Planned, statutory and R9 000 000 R26 000 000 R17 658 363
166 Lebone College of Emergency Care – Planned, R5 000 000 R2 000 000 R2 647 776
294 Lebone EMS College Maintenance R500 000 R400 000 R3 929 033
259 Leratong Hospital – Planned, statutory and R3 000 000 R13 000 000 R18 198 810
31009236 Life Centre Building (45 Commissioner) R4 000 000 R2 200 000 R2 248 261
Maintenance and repairs
171 Masakhane Cook Freeze – Planned statutory R4 000 000 R3 200 000 R1 032 705
173 Masakhane Laundry – Planned, statutory and R12 000 000 R4 000 000 R7 680 066
260 MEDUNSA Oral Health Centre Hospital R3 000 000 R1 500 000 R4 443 812
– Planned, statutory and preventative
maintenance
184 New Mamelodi Hospital – Planned, statutory R5 000 000 R18 000 000 R29 208 451
186 Nicol House – Planned, statutory and R5 000 000 R2 000 000 R2 594 673
188 Odi Hospital – Planned, statutory and R7 000 000 R10 000 000 R11 107 484
190 Old Germiston Hospital – Planned, statutory and R1 000 000 R2 000 000 R4 877 059
192 Old Mamelodi Hospital – Planned, statutory and R2 000 000 R10 000 000 R13 354 507

(IRM) date for this
financial year
266 Pholosong Hospital – Planned, statutory and R25 000 000 R30 000 000 R32 809 696
30309702 Pretoria Forensic Mortuary – Planned, statutory R1 500 000 R3 000 000 R3 157 545
31008657 Pretoria Oral & Dental – Planned, statutory and R50 000 R4 000 000 R1 378 039
199 Pretoria West Hospital – Planned, statutory and R14 000 000 R11 200 000 R15 927 961
201 Radio Communication System – Planned, R6 000 000 R4 560 000 R0
268 Rahima Moosa Mother and Child Hospital – R20 000 000 R20 000 000 R18 474 998
Planned, statutory and preventative
101 Rahima Moosa Nursing College – Planned, R3 000 000 R2 400 000 R5 645 489
30309703 Roodepoort Forensic Mortuary – Planned, R1 500 000 R1 200 000 R867 182
300 S G Lourens Nursing College – Planned, R3 000 000 R1 000 000 R560 432
30309696 Sebokeng EMS – Planned, statutory and R1 500 000 R2 000 000 R1 446 627
737 Sebokeng Forensic Mortuary – Planned, R500 000 R1 000 000 R525 349
270 Sebokeng Hospital – Planned, statutory and R9 000 000 R16 000 000 R25 212 867
213 Sedibeng District CHCs – Planned, statutory R5 000 000 R10 000 000 R12 423 736
215 Sedibeng District Clinics – Planned, statutory R7 000 000 R36 000 000 R52 125 011
220 Sedibeng District Office(Including EMS R500 000 R100 000 R0
& Pharmacies) –Planned, statutory and
271 Sizwe Tropical Diseases Hospital – Planned, R10 000 000 R6 000 000 R8 119 788
4651 South Rand Hospital – Planned, statutory and R12 000 000 R9 600 000 R6 716 823
30309690 Springs Forensic Mortuary – Planned, statutory R1 500 000 R1 200 000 R1 045 796
275 Sterkfontein Hospital – Planned, statutory and R3 000 000 R2 400 000 R3 844 556
229 Steve Biko Academic Hospital – Planned, R35 000 000 R28 000 000 R43 763 403
277 Tambo Memorial Hospital – Planned, statutory R5 000 000 R15 000 000 R11 521 083
279 Tara H Moross Hospital – Planned, statutory and R12 000 000 R9 600 000 R4 499 474
281 Tembisa Hospital – Planned, statutory and R20 000 000 R35 000 000 R67 316 744
4640 Thelle Mogwerane – Planned, statutory and R35 000 000 R36 000 000 R84 705 583
234 TMI boiler house – Planned, statutory and R200 000 R50 000 R34 155
236 Tshwane District CHCs – Planned, statutory and R5 000 000 R6 000 000 R8 574 561
238 Tshwane District Clinics – Planned, statutory R20 000 000 R24 000 000 R23 107 405
4658 Tshwane District Hospital – Planned, statutory R7 000 000 R4 000 000 R3 189 735

(IRM) date for this
financial year
243 Tshwane District Office (Pharmacies & EMS) R500 000 R1 000 000 R1 622 315
Maintenance
6792272 Tshwane Rehabilitation Centre – Planned, R10 000 000 R6 500 000 R5 815 953
301 Utilisation of EPWP Grant R2 196 000 R2 196 000 R2 195 931
288 Weskoppies Hospital – Planned, statutory and R10 000 000 R24 000 000 R26 225 934
246 West Rand District CHCs – Planned, statutory R5 000 000 R4 000 000 R5 919 228
248 West Rand District Clinics – Planned, statutory R12 000 000 R21 000 000 R52 867 476
6793146 West Rand District Office (Pharmacies & EMS) R2 000 000 R1 600 000 R241 709
Maintenance
Data Source: PMIS
Table 4.12.4: Progress made in addressing maintenance backlogs during the period under review
Infrastructure 2019/2020 2020/2021
projects
Appropriation Expenditure expenditure Appropriation Expenditure expenditure
R’000 R’000 R’000 R’000 R’000 R’000
New and
replacement
assets 374 280 443 822 362 139 1 492 765 1 301 398 191 364
Existing
infrastructure
assets 1 284 748 1 535 409 (250 661) 2 623 808 2 556 633 67 175
Upgrades and
additions 170 300 130 968 75 107 288 977 273 630 15 347
Rehabilitation,
renovations and
refurbishments 68 500 394 474 376 494 915 083 953 562 (38 479)
Maintenance
and repairs 1 045 948 1 009 967 1 150 206 1 428 443 1 421 360 7 083
Infrastructure
transfer
Current 1 045 948 1 009 967 1 150 206 1 428 443 1 421 360 7 083
Capital 613 080 969 264 (356 184) 2 696 825 2 528 590 168 235
Total 1 659 028 1 979 231 1 963 946 4 125 268 3 949 950 175 318
The Department
has sustained an
unqualified Audit
opinion and aims
to improve other
governance matters.
PART C
PART A:
GOVERNANCE
1. Governance
1. Introduction
The Gauteng Department of Health is committed Through the RMC as well as the Audit
to sound corporate governance in its delivery Committee, assurance was provided that
of health care services to the public. The the organisation’s strategic risks were being
Department subscribes to a multi-disciplinary adressed but not fully implimented. Despite the
combined assurance model, relying on internal challenging environment the organisation finds
as well as external assurance providers, to itself in, the organisation was able to reduce
assess and provide assurance on its internal the residual risk rating for many of the strategic
control environment. risks. However, much work still needs to be done
to further strengthen the control environment,
2. Risk Management especially with regard to irregular expenditure
and governance in general.
The Department has in place an approved risk
management framework, policy and strategy 3. Fraud and Corruption
which guides the risk management process. The
organisation’s Risk Management Committee
(RMC) provides oversight of the organisation’s As part of fraud prevention and ethics initiatives
risks and its control environment. The undertaken, the Department commenced with
organisation’s approach to risk management is the roll-out of the Remunerative Work Outside
based on established governance processes Public Service (RWOPS) online application to
and relies on both individual responsibility prevent deemed approvals and streamline the
and collective oversight, supported by process, thus minimising conflicts of interest.
comprehensive reporting. Acknowledging
In addition, a compulsory certificate of
the complex and changing risk environment,
declaration in which the officials acknowledge
continuous risk assessments are conducted to
the Public Service Administration Management
identify any emerging risks that could negatively
Act 8(2), the Public Service Code of Conduct
impact on the organisation achieving its stated
and noted the content of the Public Service
objectives and outcomes. The organisation
Regulations 2016, in particular REG 13(c), “An
continues to re-evaluate its risk processes to
employee shall not conduct business with any
ensure continuous improvement.
organs of state”, was rolled out to all health
institutions. This certificate had to be signed in
The Accounting Officer (AO) of the Department
the presence of a commissioner of oaths.
takes responsibility for implementing Enterprise
Risk Management (ERM) in accordance with Virtual training along with articles on fraud
the National Treasury Public Sector Risk prevention, receiving of gifts, curbing unethical
Management Framework (PSRMF). The conduct, fraud and risk, e-disclosure and
Chief Director: Risk Management and Internal cybercrime were published in the departmental
Control is the Chief Risk Officer (CRO) for the weekly news bulletin.
Department.
Training on Ethics and Fraud Prevention was
In improving its risk management capability, the also conducted for Finance and Supply Chain
organisation recently appointed an independent Management officials in light of procurement
person as Chairperson of the RMC, thereby scandals. Each official who attended signed a
holding management more accountable for the pledge committing to integrity.
management of their risks.
4. Minimising Conflicts of Interest
Senior Management Services (SMS) members The COVID-19 pandemic was also a great
disclose their financial interests using contributor to the increased generation of
the e-Disclosure system managed by the waste in Gauteng Province, with increases
Department of Public Service and Administration in generation rates documented as high
(DPSA). In 2020/21, the Department achieved as 80%. This has contributed to a general
100% (118 employees out of 118) disclosure by burden on service providers and expectations
the SMS members. However, the Department for a sustained quality service, which was at
only achieved a 29% disclosure rate of other times hampered by issues related to delayed
categories of staff. Some employees were payment of service providers and stringent
never registered on the system from date of protocols for managing COVID-19 waste as
inception and there is a lack of understanding a means to protect the public at large. During
or appreciation of the regulations. In addition, the third wave of the COVID-19 pandemic,
some officials have limited access to computers Phase 2 of the vaccine rollout campaign is
and data. It is noted that 90% of the officials currently taking place and plans have been
who should disclose are professionals, and that put in place to ensure the coordination and
their reason for not disclosing for the year under effective management of COVID-19 vaccine
review is because they are frontline workers and waste. Vaccine administration is also expected
were inundated with the coronavirus pandemic to increase waste generation rates, therefore
that the country is dealing with. sufficient stock of consumables should be made
available for the proper disposal of COVID-19
5. Code of Conduct vaccine waste.
All employees are expected to comply with In line with the above, very effective and further
the Code of Conduct. The Public Service Act refined monitoring and evaluation tools with
requires that employees adhere to the Code. specific indicators have been developed over
The Department has trained 2 923 employees the last few years, and through internal auditing
on the Code of Conduct and Ethics during the and inspection activities the identified risks are
2020/2021 financial year. Training of awareness amicably addressed and mitigated through
of the Code of Conduct and Ethics is ongoing to regular feedback of findings and required
ensure a strong ethical culture underpinned by feedback from facilities. Where required and
the values of the Code within the organisation. identified, specific onsite training is carried out
targeting specific areas of concern.
6. Health Safety and
The latter is also included in our monthly risk
Environmental Issues register, reported on and discussed in the
Departmental RMC. Substantial progress has
been made in reducing risks, however, the
Occupational Hygiene Risk Management
late payments to contracted service providers
remain a serious challenge. When such services
Health Care Waste (HCW) Management
are suspended, serious life-threatening and
public health nuisances are created, which have
All HCW services for collection, transportation,
proven to be very difficult to manage effectively.
treatment and final disposal of the residue/
The GDoH is also regarded as the benchmark
ashes and supply of reusable and disposable
province in the country, with other provinces
containers have been outsourced to private
relying on some of our methodologies, standard
contracted service providers. This scenario has
operating procedures, technical guidelines
been reviewed over the past few years, and
and our provincial tender specifications, a
the outcome of due diligence processes has
motivational situation for all in the GDoH and
supported these arrangements as still being
something we should be proud of.
the most cost-effective and efficient for the
Department, which generates approximately
4.7 million kilograms of HCW per annum.
Challenges • Shortage of staff

• Insufficient tools of trade, e.g. working
COVID-19 pandemic related challenges: printers and scanners
• Gradual increase in generation rates required • Lack of policies from national departments
more frequent collections from the service
providers Effects
• Service providers were overwhelmed due to
sudden increase of COVID-19 health care • Delayed creation of purchase orders and
risk waste late payments of service providers lead
• Collection and delivery of normal health care to suspension of services by the service
risk waste was affected by the collection of provider. Serious public health nuisances
COVID-19 waste created
• Delivery of consumables to health care • Non-collection of waste leads to obnoxious
facilities was affected due to delayed smells, increased spread of infections and
payment to the service providers contravention of HCW statutory requirements,
• Central storage areas – insufficient size and which will cause serious financial and legal
availability implications for the Department
• Attendance of meetings was affected – not all • Partial functioning of container tracking
facilities have access to working computers system will lead to financial loss for the
with internet Department, as the Department is paying for
• Negative publicity regarding the management the system which is not functioning properly.
of health care risk waste This will also cause legal implications for
• Awareness campaigns and training sessions the Department, especially during illegal
restricted due to lockdown requirements dumping if the service provider fails to track
• Minimal stakeholder integration regarding the exact location of the health care waste
procedures for management of COVID-19 containers
waste • Delay of the new tender award, which results
in extension of the current tender, will cause
General health care waste challenges: irregularities in the tender and contraventions
of the Public Finance Management Act
• Late payment of service providers (sometimes (PFMA) requirements, etc., which will lead to
up to 120 days behind) and delayed creation audit queries
of POs • Non-compliance of HCW consumables with
• Non-collection of generated HCW due to late tender requirements – this will lead to audit
payment queries and financial loss for the Department,
• Non-compliance of HCW consumables with as inferior-quality containers are provided to
tender requirements facilities
• Electronic tracking system used for containers • Lack of policies from national departments
was not 100% reliable lead to each province managing HCW
• Delays in processes for the new tender differently. Auditors are thus confused
award, resulting in continuous extensions due to the various sets of legal and other
of the existing contracts and exposing the requirements which differ in many cases,
Department to possible litigation. Efficiency resulting in disparity
of the penalty implementation for service • Shortage of staff may lead to backlog of
failure was negated due to the late payments responsibilities, work overload and burnout
• Exact role clarity with reference to roles, of staff carrying extra responsibilities as well
responsibilities and functions in hospitals, as delayed submission of reports
districts and other health facilities • Insufficient tools of trade lead to hampered
• Challenges with organisational structures work performance, and delay and/or inability
and HCW not being integrated with to submit reports and carry out daily work
Environmental Health responsibilities
• Unavailability of national policies to guide the
management of HCW in a coordinated and
uniform manner
Achievements
• Development of COVID-19 waste guidelines at clinics and hospitals in preparation for

for Gauteng Province health care facilities vaccine rollout
and extensive training of the procedures at • Successful awareness event held at
various hospitals (guidelines approved by Carletonville Hospital, which was published
the acting HOD) in the Gauteng Health internal newsletter
• Review of COVID-19 waste guidelines for • Global Green and Healthy Hospitals project
Gauteng Province health care facilities was at Sizwe Hospital – replacement of mercury
carried out following lessons learned from devices with mercury-free digital blood
the first wave (approved by the Acting HOD) pressure monitors for improvement of quality
• Active involvement in the commissioning, health care and compliance to the United
management and decommissioning of Nations Development Programme Minamata
quarantine/isolation facilities Convention on Mercury published on 16
• Clean audits from Gauteng Audit Services – August 2017. Regular audits and support
quarantine facilities visits conducted at health care facilities
• Duties performed diligently by staff beyond resulted in continuous improvement of
their scope of practice facilities and management of HCW
• Guidance and training on HCW and • Establishment of a reliable and scientific
COVID-19 provided to NGOs and other comprehensive HCW database with a
governmental departments confidence interval of 95%. Information
• Development of HCW vaccine rollout plan for provided is a reliable strategic management
all Gauteng health care facilities tool for budgeting, planning, determining
• Support provided by staff at dry runs held trends and decision-making
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 April 2020 • Presentation by the Gauteng Department Department responded to all matters raised by
of Health on the update and responses on the Committee including follow-up submissions
COVID-19. that were requested.
5 May 2020 • Presentation by the GDoH on the update and Department responded to all matters raised by
responses on COVID-19. the Committee including follow-up submissions
that were requested.
21 May 2020 • The progress on all health infrastructure Department responded to all matters raised by
projects to date. the Committee including follow-up submissions
• The progress report on the medico-legal that were requested.
cases.
• The progress on the challenges identified on
the oversight visits undertaken to Dr George
Mukhari Hospital, Jubilee Hospital, Thembisa
Hospital, Bheki Mlangeni Hospital, Winnie
Mandela Clinic and Phillip Moyo CHC.
• The update on the status of COVID-19 in
Gauteng.
28 May 2020 • Presentation of the Budget Vote 4 report of Department responded to all matters raised by
2020/21 by GDoH. the Committee including follow-up submissions
• Presentation of the fourth quarterly report for that were requested.
2019/20 by GDoH.
• Presentation on the FIS topic by GDoH.
9 June 2020 • Health Portfolio Committee Stakeholder Department responded to all matters raised by
Engagement Virtual Session with CHWs. the Committee and stakeholders.
19 June 2020 • Presentation by the GDoH on update on The Committee accepted the report.
COVID-19.
28 July 2020 • Presentation by the GDoH on update on The Committee accepted the report. However,
COVID-19. additional information was requested by the
meeting which was provided by the Department.
6 August 2020 • Presentation by GDoH on update on
COVID-19.
• The progress on all health infrastructure
projects to date.
• The progress report on the medico-legal
cases.
20 August 2020 • Presentation by GDoH on the First Quarter Department responded to all matters raised by
Report for 2020/21FY. the Committee including follow-up submissions
• Presentation by GDoH on the revised Budget that were requested.
for 2020/21FY.
• Presentation by GDoH on the Committee FIS
on laundries.
• Presentation by GDoH on the status of
COVID-19.
• Presentation by GDoH on the Report of the
Public Service Commission.
27 August 2020 • Health Portfolio Committee Stakeholder Department responded to all matters raised by
Engagement Virtual Session with the the Committee and stakeholders.
Laundry Services Management.
4 September 2020 • Health Portfolio Committee Stakeholder Department responded to all matters raised by
Engagement Virtual Session with the Labour the Committee and Labour Representatives.
Representatives.
Date of Meeting Matters raised How matters were addressed

30 October 2020 • Feedback on the oversight visit previously Department responded to all matters raised by
undertaken by the Committee to Bheki the Committee at the oversight visit meeting at
Mlangeni Hospital. Bheki Mlangeni.
• Feedback on the rape cases reported to
have taken place in the facility.
• The matter concerning the CEO of Bheki
Mlangeni and the measures that have been
taken to address this.
• The status of COVID-19 in the facility.
17 November 2020 • Presentation on the Department’s 2nd Department responded to all matters raised by
quarterly report for 2020/21FY. the Committee including follow-up submissions
• Update by GDoH on COVID-19. that were requested.
• Presentation by GDoH on Infrastructural
Matters.
• Presentation by GDoH on Oversight Visits
reports to Chris Hani Baragwanath Hospital
and Tembisa Hospital.
• Presentation by GDoH on medico-legal
cases.
• Presentation by GDoH on Report by the PSC
and update on CFO matter.
12 January 2021 • Update by GDoH on COVID-19. Department responded to all matters raised by
the Committee.
18 February 2021 • Presentation by GDoH on the update on Department responded to all matters raised by
COVID-19. the Committee.
8. Scopa Resolutions
REPORT OF THE AUDITOR-GENERAL TO THE GAUTENG PROVINCIAL LEGISLATURE ON

THE FINANCIAL STATEMENTS AND PERFORMANCE INFORMATION OF THE DEPARTMENT
OF HEALTH FOR THE YEAR ENDED 31 MARCH 2021
RESOLUTION AREAS OF CONCERN RESPONSE AND ACTION PLANS BY THE

NO. DEPARTMENT
1. Errors in financial statements at the end of Contingent liabilities-opening balance reduced by value
31st March 2020 of letters of demand balance included in the prior year.
2. Plans to prevent or limit errors that could lead Reporting officials have been attending training on
to the need for restatement of corresponding the preparation of Annual Financial Statements (AFS)
figures provided by GPT
3(a). Provide a list of all lawsuits which GDoH is a List of lawsuits provided to SCOPA
defendant by 31st March 2020
3(b). The list of all lawsuits for the current financial List of lawsuits provided to SCOPA
year, i.e. period from 01st Apr to 31st Dec 2020
4(a). Summary of matters of these lawsuits Information provided to SCOPA
4(b). Progress in resolving each lawsuit by 31st Dec Detailed information provided to SCOPA
2020
5. Provide corrective measures in place to CD: Legal on corrective measures spot on
minimize future lawsuits where possible to
mitigate damages
6. Provide a breakdown of legal costs incurred Claims against GDoH are defended by Offices of State
by GDoH in defending the claims Attorney JHB and Pretoria in terms of State Attorney Act
56 of 1957. These offices are responsible for legal fees
occasioned whilst defending the matters. The request
is that information can be requested directly for State
Attorneys.
7(a). Provide details of payables of R 1 670 830 Details of payables provided to SCOPA
having exceeded payment of 30days in line
with NT Regulation 8.2.3

NO. DEPARTMENT
7(b). Provide details for exceeding voted funds GDoH did not exceed voted funds to be surrendered and
to be surrendered by R 1 082 121 as per there was no unauthorised expenditure incurred. GDoH
statement of financial performance had a 3-yrs payment plan with SPs and 2020-21 is the
last year of the plan. These transactions are in the R1B,
hence they are accounted as payables per the Modified
Cash Standards (MCS)
7(c). Provide the actions taken or to be taken by Not applicable
GDoH to correct the above
8(a). Provide plans to deal with payables exceeding Payment plans with big SPs to settle their long
30days payment as required by Treasury outstanding debts has assisted in paying other suppliers
regulations within 30days
9. Provide details of how material losses of R These were written-off in July-2020 as adjusting event
1 685 135 incurred as a irrecoverable patient after reporting date. An adjusting event is an event that
debts relates to the 2019-20 financial year, takes place after the financial year-end, but before the
since the effects of Covid-19 should have financial statements were submitted on the 31st of July-
been felt at least a few days before end of 2020
2019/20 financial yea
10 Provide details for not availing to the AGSA For the year under review, slight modifications were put
sufficient appropriate audit evidence for the in place to allow AGSA to access health facilities patient
reported achievements of all the 31 material registers at Central Office instead of direct access at
indicators relating to Programme 2: DHS for: health facilities to minimize COVID risk for the AGSA
staff. The facilities provided the registers as requested.
(a). Utilization rate-related indicators (4) However due to some of the records still being in use in
(b). HIV and TB related indicators (10) the consulting rooms at the time of request, coupled with
(c). Maternal health-related indicators (10) insufficient capacity for the management of records in the
(d). Fatality rate indicator (3) identified facilities, some registers were not provided on
(e). School health programme indicator (4) time to AGSA and thus could not be considered.
11. What is GDoH doing to capacitate the Committed to strengthening the capacity of the M&E
Directorate M&E to curb findings on AOPO unit across all levels of the health system (Hospitals and
Sub-district levels). Senior Management and Middle
Management and technical positions are in the process
of being advertised and filled. This decentralized model
of performance information oversight and management
would ensure that challenges are addressed at the
coalface and timely and enable implementation of all
performance information initiatives to improve operational
levels effectiveness.
12. What remedial action has the HOD taken HOD will approve a workable plan, inclusive of all
against the CD: M&E for failing to implement necessary dependencies, key among these will
effective controls to ensure requirements be decentralization of delegations and stringent
of performance management and reporting accountability measures when signing performance
framework (PMRF) are adhered to contracts with all managers at all levels.
13. What remedial action will be taken against This will be outlined in the contracting of the HOD with
HOD for failure to exercise oversight over the MEC
performance reporting and that systems were
in place to support planned targets
14 Provide details for placing limitations in the Compliance reporting and escalations will be embedded
work of the AGSA, which led to GDoH not in the regular Risk reporting on a monthly and quarterly
availing sufficient appropriate audit evidence basis.
to support the reasons for the variance
between planned targets and reported
performance in the Annual Performance
Report (APR) for Programme 2

NO. DEPARTMENT
15. Provide details why insufficient supporting Acknowledge the challenges in the reliability and the
evidence for the AGSA to verify that systems swiftness of providing data and information .The
and processes were not established to Departmental performance monitoring will be anchored
enable consistent measurement and reliable on ethical leadership and contracting to engender a
reporting of actual achievement for the culture and climate of accountability.
following indicators:
(a). School Grade 1 Learners screened

(74 222)
(b). School Grade 8 Learners screened
(54 357)
(c). HPV 1st Test dose (21 527)
(d). HPV 2nd Test dose (74 633)
16. Provide details for not availing to the AGSA Same as 15 above
sufficient and appropriate audit evidence that
systems and processes were established to
enable consistent measurement and reliable
reporting of the actual reported achievement
of 93%
17(a). Provide details for the reported 60% target as The error and clumsiness during the write up at the
per the APR not agreeing with the planned Annual Report writing, the correct figure remains 65
target of 65% as per approved annual
performance for TB MDR treatment success
rate
17(b). Details for changing the information without Only the MEC and HOD approves changes to the set
the necessary approval targets on the APP and the vetting will ensure that the
necessary approvals is provided before any arbitrary
changes are made without following the legislated
process. Annual Report to be proofread and authorised
by the HOD and MEC
17(c). Plans taken or to be taken by the Department Same as 17 (b)
to deal with the abovementioned
18(a). Provide details for not clearly defining the Same as 17 (b)
method of calculation for achieving the
planned indicator related to Measles 2nd dose
18(b). Provide details for submitting the reasons for The Department acknowledges that when the strategic
the variance between the planned target of objectives were revised, the changes were not
98% and the reported achievement of 79,9% consistently carried through in the approved APP. The
which did not agree with the supporting Strategic Objective Statement modifications made in
evidence provided the Programme and Sub-Programme Plans section of
the 2019/20 Annual Performance Plan were thus not
included in the Annual Performance Plan Annexure
outlining changes to the Strategic Plan
19. To provide reasons why the reported the Same as 18 (b)
DHS reported Strategic Objectives were not
consistent when compared with the strategic
objectives in the approved APP
20. Why financial statements submitted for The financial statements were prepared in accordance
auditing were not prepared in accordance with with the Modified Cash Standard (MCS) as prescribed
the prescribed financial reporting framework by National Treasury. Adjustments based on the Auditor
as required by Section 40(1)(b) of the PFMA General findings were made on the final audited financial
statements
21. Why did the HOD not exercise oversight The Accounting Officer did exercise oversight and the
to ensure that financial statements were financials were reviewed by the Gauteng Provincial
prepared in accordance with the prescribed Treasury and were subjected to the endorsement of the
financial reporting framework as required by Audit Committee.
Section 40(1)(b) of the PFMA
22. What remedial action has the HOD taken Not applicable
against the officials responsible for this matter

NO. DEPARTMENT
23. As this matter is recurring in the previous The financial statements were reviewed internally within
financial years, why did Management not the Department and further reviewed by the Gauteng
ensure that financial statements were Provincial Treasury before they were submitted for audit.
adequately reviewed before they were
submitted for audit.
24. What remedial action will be taken against The AO accountable for the year under review is no
the accounting officer (AO) for not ensuring longer employed at GDoH, however, the MEC put
that financial statements were adequately processes in place for appoint of a permanent HOD and
reviewed before they were submitted for audit other senior managers as a matter of priority.
25. Why were some of the goods and services GDoH did not always obtain price quotations as a
with a transaction value below R500 000 result of emergencies. The Treasury Regulations gives
procured without obtaining the required price allowance for deviation in cases of emergencies,i.e.
quotations, as required by NT regulations where there is threat to life or loss of life. In addition,
16A.6.1, noting that similar non-compliance there are machinery and equipment that had to be
was also reported in the prior year repaired and maintained by the original equipment
manufacturers and therefore no quotations will be
obtained, as repairs and maintenance are included in the
contractual agreement with the original service provider.
26. Why were some of the contracts awarded to The Department participates in contracts of other
bidders based on functionality criteria that provinces and departments. In instances where this is not
was not stipulated in the original invitation for the case, deviation approvals are obtained through the
bidding, as required by the 2017 preferential Gauteng Provincial Treasury
procurement regulation 5(1) and (3).
27. Why were some contracts awarded to The financial statements are prepared by the financial
bidders based on functionality criteria that reporting team and are reviewed at differently levels
internally. The Director financial reporting reviews and
was not stipulated in the original invitation for
bidding, as required by the 2017 preferential then by the Chief Director financial accounting. The
procurement regulation 5(1) and (3). CFO reviews and approves the financial statements.
The Internal Control unit also reviews the financial
statements. Externally the financial statements are
reviewed by Gauteng Provincial Treasury and are
authorised by the Audit Committee before submitting to
the Auditor General
28. Why were some of the contracts awarded to The contracts in question are those related to COVID
bidders who did not submit a declaration on transactions, of which the SIU is currently investigating. It
whether they are employed by the state or should however be noted that where employees conduct
connected to nay person employed by the business with the state, letters are issued by the Integrity
state, which is prescribed in order to comply Unit to the relevant employees who must formally
with NT regulations 16A6.3(a) respond to why disciplinary steps must not be taken
against them. An application is currently in testing phase
whereby all employees can apply and automatic referral
to next level manager occurs within a specified time. This
will enable the Department to take the appropriate steps
for consequence management.
29. Why were some contracts extended or The contracts were not extended nor modified as
modified without the approval of a properly stated on the report. An audit finding from the Auditor
delegated official as required by Section 44 of General’s report was as follows “Payments were made
the PFMA and NT regulations 8.1-8.2. Similar to the suppliers in the year under review however no
non-compliance was also reported in the prior evidence of contract extension”. It should be noted that
year the services were rendered within the contract duration
and some of the payments were made after the contract
expiry (late payments).

NO. DEPARTMENT
30. Why effective steps were not taken to prevent With regard to Consignment stock: The department is
irregular expenditure (IE) to the annual in the process of renewing the contract for Orthopaedic
financial statements as required by Section Consignment stock including amongst others a new
38(1)(c)(ii) of the PFMA and NT regulation tender for Cardiac Consumables and Radiology
9.1.1 Consumables.
In respect of the security contracts, the Department

advertised a tender for security services. The tenders
were cancelled and never awarded. New Security
tenders were advertised, during the bid evaluations
process, the Probity Auditors raised some concerns
regarding the bid evaluations process and requested a
forensic investigation into the matter, the Department
had no option but to extend the contracts, which then
resulted in irregular expenditure. The department has
since advertised the tender for security and the tender is
currently being evaluated.
31. Considering the numerous turn-around Using the security contracts as a case study, GDoH
strategies in the Department including setting advertised a tender for security services, but these were
up IE Committee, explain why IE increased cancelled and never awarded. New Security tenders
significantly were advertised, during the bid evaluations process,
the Probity Auditors raised some concerns regarding
the bid evaluations process and requested a forensic
investigation into the matter, the Department had no
option but to extend the contracts, which invariably
resulted in irregular expenditure. The department has
since advertised the tender for security and the tender is
currently being evaluated
32. What remedial action will be taken against The Accounting Officer has since resigned. The matter
HOD for non-compliance with Section 38(1) of V-Blocks was reported to the National Prosecuting
(c)(ii) of the PFMA and NT Regulation 9.1.1 Authority and to the State Attorney to consider civil claims
against implicated officials. Disciplinary action was also
taken against other implicated officials.
33. Why were effective steps not taken to prevent The fruitless and wasteful expenditure consists of interest
Fruitless and Wasteful expenditure (F&WE) paid on medico- legal claims. The Gauteng Department
amounting to R 9 353 000 as required by of Health has been struggling with medico-legal claims
Section 38(1) (c)(ii) of the PFMA and NT for longer than a decade. In all this time, the Department
regulation 9.1.1 has never been in a financial position to service all
the claims within the required 30 days. In addition,
the medico- legal medical claims are not budgeted for
making it more challenging to settle within 30 days.
Any payment towards a medico legal claim has a direct
impact on service delivery since monies are taken from
core services to pay for these claims
34. By when will GDoH be able to process the The Accounting Officer will approve the condonation of
condonation of F&WE amounting to R 9 353 the fruitless and wasteful expenditure of R9 353 000 by
000 the end of the financial year.
35. What investigations have been undertaken A service provider was appointed to investigate the
regarding FEW reported in 2019/20 financial Department’s fruitless and wasteful expenditure. The
year and what disciplinary measures have Auditor General had raised the fruitless and wasteful
been taken against those responsible for expenditure as a Material Irregularity. A report was
irregular expenditure. submitted to the Auditor General following which the
Material Irregularity was cleared and there was none
raised for 2019/20 financial year.
36. What remedial action will be taken against the The Accounting Officer has since resigned
HOD for non-compliance with Section 38(1)(c)
(ii) of the PFMA and NT regulation 9.1.1

NO. DEPARTMENT
37. Why contractual obligations and money owed The demand for health services and the pressure it
by GDoH were not met and or settled within puts on the budget of the department results in the
30days, as required by Section 38(1) (c)(ii) of Department experiencing challenges in paying suppliers
the PFMA and NT regulation 8.2.3 within the required PFMA requirement of 30 days. The
monies that are used from goods and services to pay
medico legal claims also has an impact on the payment
of suppliers. Unfunded mandates and compliance to
the constitution where anyone who wants to access
health services within the province must be attended
to. Demand for services from other provinces also puts
pressure on the funds allocated to the Department. The
uninsured population of the province has also increased
because of the economic conditions in the country.
Medical inflation is always above the Consumer Price
Index based allocation received as the budget. Often
the Department receives invoices from suppliers that
are incorrect or where delivery has not even taken
place. These must first be resolved with suppliers before
payment can be made.
38. The late payment of invoices impacts The Department is trying to get assistance from
negatively on SMME’s. Provide a list and age Provincial Treasury to differentiate between BBBEE and
analysis of the amount not paid within 30days SMME suppliers, as the Department does not have a
and include the list of SMME’s and their system-generated report on tracking of payments within
BBBEE status 30 days for SMME’s.
39. Have the prescripts of the PFMA and For the reasons indicated in the response to question 37
Treasury Regulations been applied in terms of and the burden on the health system no consequence
consequence management against officials, management against officials has been instituted for the
in relation to non-payment of suppliers in non-payment of suppliers. Institutions that do not clear
30days the web cycle are issued with non-compliance letters.
The challenge remains the limitations on cash available
resulting in non-compliance with meeting the 30 days
settlement.
40. Considering that the measures were put The historical debt that caused the accruals over the
in place to previously address the 30days years has contributed to the non-compliance on 30
payment, provide reasons why the recurrence days payment, however the Department is clearing the
accruals as per the payments plans with various service
providers.
41. Why were there no investigations conducted The Department appointed a law firm that is in the
and remedial action taken against officials process of investigating irregular, fruitless and wasteful
responsible for irregular expenditure expenditure with the aim of initiating disciplinary and civil
proceedings
42. Why were specific information regarding The CD: Strategic planning and M&E reports to the DDG:
Strategic Planning were not implemented Corporate services, who will be contracted in the new
to enable the monitoring of progress made financial year with the HOD on the issues raised in the
towards achieving the targets, core objectives AG report
and service delivery as required by Public
Service Regulation 25(1)(e)(i) and (iii)
43. Why were Internal control deficiencies These are internal controls in relation to procurement,
identified not prompted an action plan to contract management and expenditure management,
address audit findings not monitored on which is an exercise that we have enhanced with Risk
a timely basis by the appropriate level of and Governance vetting
management
44(a). What action is being taken to enhance The Governance and Compliance unit will be
leadership with emphasis on ensuring operationalising the PMA of the CFO signed
monitoring controls to ensure compliance with with the HOD, amongst which is going to be AG
laws and regulations recommendations
44(b). Procurement and contract management The Governance and Compliance unit will be
operationalising the PMA of the CFO signed
with the HOD, amongst which is going to be AG
recommendations

NO. DEPARTMENT
44(c). Expenditure management and revenue The Governance and Compliance unit will be
management operationalising the PMA of the CFO signed
with the HOD, amongst which is going to be AG
recommendations
45(a). Provide a list of Investigations relating to the The list of investigations provided to SCOPA
period which ended 31st March 2019
45(b). Investigations relating to the year under The list of investigations provided to SCOPA
review, 2019/20
45(c). Investigations relating to the current financial The list of investigations provided to SCOPA
year i.e. April 2019 to 31st December 2020
46(a). Summary of the nature of investigations Community disruption of construction insisting on 30%
Sub-contracting, alleged theft of patient medication and
in most instances procurement irregularities
46(b) Stage of the investigation by the 31st Of the six (6) investigations sighted in this report all are
December 2020 at an advanced stage except the alleged procurement
irregularities at Far East Rand Hospital, which has not
commenced
47. Where the investigations are completed, 47.1 Boitumelo Probity Report- Re-advertise and
provide summary of measures which appointment of a new Service Provider and align the 30%
were recommended and the stage of Sub-contracting to prescripts
implementation of these recommendations by
the 31st December 2020 47.2 Gobodo Forensic at DGMAH- Various
recommendations including consequence management
against the CEO
47.3 Alleged theft of Medication at CHBAH- Disciplinary

face for the culprits
47.4 Alleged procurement irregularities at Health

Programmes at GDoH completed
47.5 ST Consulting on PPE procurement and CHWS

appointment are both at final preliminary stages
47.6 Legal matters arising out of the PPE procurement

investigation- finalization
48. Where the investigations were not completed, Summary provided to SCOPA
please provide estimated period the
investigations are anticipated to take
49. Provide the plan to minimise/eliminate GDoH has the following key objectives in terms of
financial irregularities, financial misconduct, minimising or eliminating the risks associated with
and fraud financial irregularities, financial misconduct and fraud;
• Development of a culture of ethical behaviour and

instilling zero-tolerance to fraud and corruption
• Sending a clear message to all GDoH employees and
members of the public who interact with it that GDoH
is committed to fighting fraud and corruption
• Improving accountability, efficiency and effective
administration and deal decisively with acts of fraud
and corruption
• Improving the application of systems, policies,
procedures and regulations
• Changing aspects of GDoH, which could facilitate
fraud and corruption and allow these to go unnoticed
or unreported and
Lastly encourage all employees and other stakeholders

to strive towards the prevention and detection of fraud
and corruption impacting or having the potential to impact
GDoH.
50(a). Provide the closing balance for Unauthorized The balance was zero
Expenditure (UE) by 31st March 2018

NO. DEPARTMENT
50(b). The total amount of UE in 2019/20 financial No Unauthorized Expenditure was incurred in 2019/20
year including the details (what gave rise to financial year.
such UE)
50(c). The amounts of UE condoned in 2019/20, No amounts of Unauthorized Expenditure were condoned
including the process followed and reasons in 2019/20 financial year as there was no UE as per
for condoning such amounts response in b) above.
50(d). The actions taken to implement None
recommendations of the findings of the
investigations on UE if any
50(e). Where the UE has not been condoned, An amount of R10, 7 million incurred in 2005/6
please provide the reasons for not condoning financial year has not been condoned. A submission for
such UE condonement has been submitted to Treasury and the
Department awaits approval.
51(a). Provide the closing balance of the F&WE by The closing balance for the 2018/19 was R 484 million
31st March 2018
51(b). The total amount of F&WE incurred in The total F&WE incurred in 2019/20 financial year was
2019/20 financial year, including the details R9,3 million. This constitutes interest paid on medico-
(what gave rise to such F&WE) legal claims
51(c). Amounts of F&WE condoned in 2019/20, R484 million from previous financial years was
including the process followed and reasons condoned in the 2019/20 financial year. The Accounting
for condoning such amounts Officer approved the request to write-off the fruitless
and wasteful expenditure disclosed in the financial
statements. (Submission attached Annexure H)
51(d). Actions taken by to implement the A law firm has been appointed to investigate matters
recommendations of the findings of the related to fruitless and wasteful expenditure. The
investigations on F&WE, if any investigations are underway.
51(e). Where the F&WE has not been condoned, The 9, 3 million F &WE incurred in the 2019/20 has not
please provide the reasons for not condoning yet been condoned as the audit process concluded late
such F&WE 2020. The Department is in the process of investigating
F&W and will ensure condonement is done by no later
than 31 March 2021.
52(a). Provide the closing balance of the Irregular The closing balance for IE as at 31 March 2018 was R
Expenditure (IE) by 31st March 2018 10 688 489 000
52(b). The total amount of IE incurred in 2019/20 The total amount incurred in 2019/20 financial year is R
financial year, including the details (what gave 2, 3 billion. Non- compliance with the legislation, SCM
rise to such IE) policies and prescripts and extension of contracts gave
rise to the IE. The Department is committed to reducing
irregular expenditure.
52(c). Amounts of IE condoned in 2019/20, including There were no amounts condoned in the 2019/20
the process followed and reasons for financial year
condoning such amounts
52(d). Actions taken by to implement the None as each matter must be investigated and the
recommendations of the findings of the recommendations implemented.
investigations on IE, if any
52(e). Where the IE has not been condoned, please There are capacity challenges within the Department to
provide the reasons for not condoning such IE investigate each matter, make recommendations and
submit for condonation. Steps are currently underway to
appoint a committee to address this matter.

NO. DEPARTMENT
53. For each of the UIF&W investigation, please The gist of TR 12.2 is management of losses and claims
comment on the relevance of Treasury against the state through acts of omission or negligence.
Regulation 12.2 and how the Department has There is currently a Loss Register that is kept and is
implemented it, where necessary updated on a regular basis. The department endeavors
at all times to ensure that where identified officials are
responsible for causing a loss and the investigation finds
that such an official acted outside of the legal framework,
such Official will be subjected to the normal civil litigation
process for the recovery of the loss.

The appointment of an appropriate Loss Control
Function officer and the establishment of a strengthened
Compliance unit will enhance compliance with the
provisions of TR 12.2

Where Officials are responsible for causing a loss and the
investigation finds that such an official acted outside of
the legal framework, such Official will be subjected to the
normal civil litigation process for the recovery of the loss.
53. For each of the UIF&W investigation, please The gist of TR 12.2 is management of losses and claims
comment on the relevance of Treasury against the state through acts of omission or negligence.
Regulation 12.2 and how the Department has There is currently a Loss Register that is kept and is
implemented it, where necessary updated on a regular basis. The department endeavors
at all times to ensure that where identified officials are
responsible for causing a loss and the investigation finds
that such an official acted outside of the legal framework,
such Official will be subjected to the normal civil litigation
process for the recovery of the loss.

The appointment of an appropriate Loss Control
Function officer and the establishment of a strengthened
Compliance unit will enhance compliance with the
provisions of TR 12.2

Where Officials are responsible for causing a loss and the
investigation finds that such an official acted outside of
the legal framework, such Official will be subjected to the
normal civil litigation process for the recovery of the loss.
54(a). Provide a list of all lawsuits which GDoH is a The list was provided to SCOPA
defendant by 31st March 2020
54(b). The list of all lawsuits for the current financial The list was provided to SCOPA
year i.e. period from 01st April – December
2020
55(a). Summary of matters of these lawsuits Summary of matters provided to SCOPA
55(b). Progress in resolving each lawsuit by 31st Progress provided to SCOPA
December 2020
56. For each investigation, please comment on Same response as 53
the relevance of NT Regulation 12.2 and how
the Department has implemented it.
57. On the ICT Governance Framework, were Yes, outdated versions of Microsoft Windows Operating
any outdated Microsoft Windows Operating Systems are still in use within the Department. The
versions used. Why? And What is in place to reason, for the said use, is that the Department is still
prevent this from happening using legacy information systems, such as Medicom,
which impose the use of these outdated desktop
operating systems, in order for users to gain access to
these information systems. The Department is however
in the process to implement a new Health Information
System, which will eliminate the use of these outdated
operating systems, within the next 24-months.
58. Does GDoH have a back-up policy plan Yes, the Department does have a back-up policy
59. Is the Disaster Recovery Plan documented Yes, the Department does have a Disaster Recovery Plan
documented. The document is currently being reviewed.
60. Is the User Admin Policy complete or not The user admin policy is completed.
9. Prior Modifications to Audit Reports
The table below shows steps taken to address matters in the AGSA’s report for the previous financial
year.
Nature of qualification, disclaimer, The financial year in which it first Progress made in resolving the
adverse opinion and matters of arose matter
non-compliance
None. N/A N/A
10. Internal Control Unit

The Internal Control Unit facilitated, to the extent possible, that the Department maintains an effective,
efficient and transparent internal control system liaising with the Auditor-General and hosting of the
Audit Steering Committee meetings during the year under review.
The main functions performed by the Internal Control Unit covered the following areas:
• Facilitated the internal and external audit processes.
• Reviewed and monitored the Audit Action Plans of head office branches and health institutions.
• Performed key control assessments at tertiary and major hospitals.
• Special assessments on the eligibility of payment transactions.
• Lead assessments on matters referred for further investigation.
• Assessment on matters relating to non-compliance with policies and prescripts.
11. Internal Audit and Audit Committees
Internal audit services are provided by the Gauteng Audit Services (GAS) under the jurisdiction of
the Gauteng Provincial Treasury. The internal audit services follow a risk-based approach where
identified risks to be addressed are incorporated into a three-year rolling plan presented to the Audit
Committee for approval.
The table below provides details of the Audit Committee members.
Name Qualifications Internal If internal, Date Date

or position appointed resigned
external in the
Department
Stanley Ngobeni • Master of Business External - 01 March Current
Administration 2019
• Master of Commerce in
International and Domestic
Taxation
• B. Accounting Science
(Hons)
• B. Com- Accounting
• Higher Diploma in
Computer Auditing
• Higher Diploma in
Computer Auditing
Lungelwa Sonqishe • Bachelor of Accounting External - 11 August Current
Science. 2020
• MBA
• Certificate in Governance
Name Qualifications Internal If internal, Date Date

or position appointed resigned
external in the
Department
Shelmadene Petzer • Chartered Accountant (SA) External - 01 September Current
• Certificate in the Theory of 2018
Accountancy
• Advanced Executive
Programme
Janice Meissner • Chartered Accountant (SA) External - 01 October Current
• B.Com 2014
• B.Com. Honours
Leon • B.Compt. Honours External - 08 November Current
Langalibalele • B.Compt. (Accounting) 2017
12. Audit Committee Report
GAUTENG PROVINCIAL GOVERNMENT (GPG)

Report of the Audit Committee – Cluster 03
We are pleased to present our report for the financial year ended 31 March 2021
Audit Committee and Attendance
The Audit Committee consists of the external Members listed hereunder and is required to meet a
minimum of at least two times per annum as per the provisions of the Public Finance Management
Act, 1999 (Act Number 1 of 1999) (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
Mr. Stanley Ngobeni (Chairperson) 05

Mr. Leon Langalibalele 02
Ms. Lungelwa Sonqishe * 03
Ms. Shelmadene Petzer 05
*Stand in member from another cluster
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 Period

Meetings
attended
Dr. Mkhululi Lukhele (Accounting Officer) 1 01 October 2020( resigned)
Mr. Arnold Malotana (Acting Accounting Officer) 3 1 October 2020 - 30 June 2021
Dr. Sibongile Zungu (Acting Accounting Officer) 1 Appointed 1 July 2021
Ms. Babita Deokaran (Acting Chief Financial Officer) 2 1 November 2020 - 30 April 2021
Ms. Lerato Madyo (Acting Chief Financial Officer) 2 1 May 2021 - 31 December 2021
Mr. Chris Du Preez (Chief Risk Officer) 1 Last day-14 October 2021
Mr. Canada Matsaneng (Acting Chief Risk Officer) 4 From 01 November 2020
Ms. Kabelo Lehloenya (CFO) 1 Resigned June 2020
Mr. Mphume Llale 1 July 2020 – AFS submission
The Audit Committee noted that the different Acting Accounting Officer/s attended five (05) scheduled
Audit Committee meetings Therefore, the Audit Committee is satisfied that the Department adhered
to the provisions of the GPG Audit Committee Charter in relation to ensuring that there is proper
representation by the Accounting Officer. Of concern is the number of acting persons at senior
management level during the year and it is critical that this be resolved in this key department.

The Members of the Audit Committee met with the Senior Management of the Department and
Internal Audit, collectively to address risks and challenges facing the Department. A number of in-
committee meetings were held to address internal 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 is concerned with the regression in the internal control environment of the
Department. The regression in the internal control environment of the Department mainly relates
to the failure to implement prior year recommendations of the AGSA and internal audit, inadequate
review of performance information and compliance with laws and regulations in the Supply Chain
Management function (SCM).
The Audit Committee was concerned with the high number of employees who have registered
businesses on the CIPC and CSD and the slow implementation of consequence management
implemented against such employees by the Department.
The Audit Committee also reviewed the progress with respect to the IT Governance in line with the
ICT Framework which confirms that the Department maintains adequate IT Governance controls.
Some progress was made by the Department to implement and monitor its Disaster Recovery Plan
and Business Continuity Processes, however this requires specific attention especially in light of the
cause and consequence of the fire at Charlotte Maxeke hospital which occurred after year end.
The department continues to incur irregular expenditure as a consequence of poor SCM which has
resulted in material irregularities being identified by the AGSA. Whilst certain actions are in process
of address these the department is encouraged to take further steps to prevent their recurrence.
The department also continues to experience significant difficulty in collecting debtors resulting in the
impairment of 96% of its debt. This further exacerbates the financial problems of the department that
emanate from the problem of old unpaid accounts payable accumulated in prior years.
Internal Audit
The Audit Committee is satisfied that the Internal Audit plan represents a clear alignment with the
key risks and has adequate information systems coverage. The Audit Committee is satisfied that
the internal auditors consulted with Management, Auditor General and the Audit Committee on its
Internal Audit Plan and that the plan was completed in full. Internal audit continues to follow-up on
previous audit recommendations.
The AGSA and Internal audit are urged to improve their collaboration with the aim of maximizing
combined assurance initiatives.
The Audit Committee will continue to monitor the capacity and the resources allocated to the Internal
Audit function.
Risk Management
Progress on the departmental risk management was reported to the Audit Committee on a quarterly
basis. The Audit Committee notes the effort made by the Department to improve its risk management
processes, however, the risk mitigations and implementation plans are not fully implemented which
increases the risk exposure of the department. Management should take full responsibility for the
entire Enterprise Risk Management Process and continue to support the Chief Risk Officer to
enhance the performance of the Department.
Forensic Investigations and Medico-legal claims
Investigations into alleged financial irregularities, financial misconduct and fraud were performed
during the year under review. There are still a number of cases which have not yet been investigated
and the department should formulate a strategy to deal with this. In addition, the department should
ensure that recommendations are implemented timeously, and that progress is monitored.
The matters given rise to the forensic investigations and medico-legal claims result in the significant
contingent liabilities of the department. The department is urged to address the root causes of these
matters urgently as the financial implications are impacting its ability to function optimally.
The quality of quarterly reports submitted in terms of the PFMA and the Division of Rev-
enue Act
The Audit Committee notes 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 emphasise that the Department must improve the quality of its financial, non-financial reports
and record management system.
Evaluation of Annual Financial Statements
Following the review by the Audit Committee of the Annual Financial Statements for the year ended
31 March 2021 before and after the audit, the Audit Committee is of the view that, in all material
respects, it complied with the relevant provisions of the PFMA and Generally Recognised Accounting
Practice (GRAP) and fairly presents the financial position at that date and the results of its operations
and cash flows for the year then ended. Furthermore, the Audit Committee agrees with the inclusion
of the annual financial statements in the Annual Report.
Evaluation of Annual Performance Report
The Audit Committee did not review the Annual Performance Report before submission to AGSA
as the report was not complete at the time of the meeting. However, a Annual Performance Report
was reviewed by the Audit Committee after the audit and Audit Committee is of view that it can be
included in the annual report whilst noting and concur with the issues raised by the AGSA which
needs attention.
Final Auditor General’s Report
The Audit Committee concurs and accepts the conclusions of the Auditor-General on the Annual
Financial Statements, which is the unmodified audit opinion with findings (unqualified audit with
emphasis of matters and non-compliance). Consequently, the Audit Committee is of the opinion
that the audited annual financial statements and annual performance report be accepted and read
together with the report of the Auditor-General.
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 met with the Executive Authority for the Department to apprise the MEC on the
performance of the Department, the Audit Committee believes that the frequency of these interactions
would be more beneficial to the Executive Authority.
Auditor-General of South Africa
The Audit Committee has met with the AGSA to ensure that there are no unresolved issues.
Mr. Stanley Ngobeni

Chairperson of the Audit Committee
Date: 9 September 2021
Additional HR posts,
both clinical and
administrative were
created to improve
capacity at the coalface.
A total of 7 374 posts
were created during
2020/2021.
PART D
PART A:
HUMAN
RESOURCE
OVERSIGHT
STATISTICS
Part D: Human Resources

Oversight Statistics
The information contained in this part of the Annual Report has been prescribed by the Minister for
the Public Service and Administration for all departments in the public service.
1. Introduction
The Human Resources Unit predominantly focussed on supporting the Covid-19 response during
the past year. Directed by clinical needs, the Unit supported the Covid-19 response through the
enhancement and fast-tracking of post creation for both clinical and non-clinical posts. The latter
enabled health facilities to recruit and appoint appropriate capacity throughout the various waves
of the Covid-19 pandemic. The total Covid-19 budget allocated for post creation amounted to R2,5
billion, which therefore necessitates a more prudent approach to the management of Covid-19 Cost
of Employees to ensure facilities obtain maximum support whilst expenditure is closely monitored.
Along with the above area of focus, the unit also implemented strategies to reduce the high vacancy
rate within the Senior Management cadre. While significant progress was made in addressing
vacancies at a Senior Management level, more significant effort will be placed on eliminating the
said vacancy gaps, especially regarding female Senior Management appointments and people with
disabilities in general. Compliance with Human Resource prescripts continues to be a challenging
area, and greater emphasis is needed to ensure said compliance across Gauteng Health.
Whilst some progress was made within the Labour Relations area, more significant interventions
are required to strengthen this function at head-office, district, and facility levels. It is envisaged that
capacitation at district health services; through decentralising grievance and discipline management
and building a cadre of presiding officers internally and externally will improve turn-around times on
all labour matters.
In terms of the organisational structure, the Department has progressed towards concluding the
updated organisational structure, and it is anticipated that approval of the new structure will happen
within the 2021/2022 financial year.
2. Human Resources Oversight Statistics
The following tables provide key information on the Department’s Human Resources for the financial
year 2020/2021.
Table 2.1.1: Personnel expenditure by programme: 1 April 2020 to 31 March 2021
Programme Total Personnel Training Professional Personnel Average Employment
Budget Expenditure Expenditure and costs as Personnel (b)
(R’000) (R’000) (R’000) Special percent of Cost per
Services Total Employee
(R’000) Expenditure (R’000)
1. Administration 3 697 845 442 838 230 29 181 12% 254 1 743
2. District health
services 18 366 611 10 019 369 7 121 73 684 54,5% 336 29 804
3. Emergency
medical services 1 684 370 757 890 146 - 45,0% 291 2 607
4. Provincial
hospital services 9 942 279 7 125 491 1 134 107 740 71,7% 294 24 207
5. Central hospital
services 19 612 633 12 331 230 131 86 016 62,8% 599 20 581
6. Health sciences
and training 901 268 556 097 3 893 1 147 61,7% 257 2 163
7. Health care
support services 391 264 201 583 3 - 51,5% 268 751
8. Health facilities
management 4 242 233 40 352 - - 1,0% 448 90
- HWSETA
accounts - - - - * *
MedSAS trading
account - - - - * *
Total 58 838 503 31 474 851 12 658 297 768 53,4% 384 81 946
Table 2.1.1: Professional and Special Services Consisting of: A&S/O/S: Medical Services, Nursing
Staff, Personnel&Labour, Admin&Supprt Staff, Cns:bus&Adv Ser: Human Resource, Organisational,
Qualification Verification, Board &Committee Member, Research&Advisory, Financial Management,
Accountants&Auditors And Contractors: Medical Services as per The Standard Chart of Accounts
(SCOA).
Table 2.1.2: Personnel costs by salary band: 1 April 2020 to 31 March 2021
Personnel % of total No. of employees Average personnel
Salary band expenditure personnel cost per employee
(R’000) cost (R’000)
Lower skilled (Level 1-2) 1 825 126 8.09% 16 968 0
Skilled (Level 3-5) 3 588 756 15.91% 21 796 259
Highly skilled production
(Level 6-8) 4 575 593 20.29% 17 480 395
Highly skilled supervision
(Level 9-12) 8 668 504 38.44% 12 998 878
Senior and Top management
(Level 13-16) 113 244 0.50% 96 1 233
Contract (Level 1-2) 153 840 0.68% 1 581 76
Contract (Level 3-5) 418 635 1.86% 2 662 1 514
Contract (Level 6-8) 465 787 2.07% 1 793 352
Contract (Level 9-12) 2 714 950 12.04% 3 925 892
Contract (Level 13-16) 25 273 0.11% 19 1 278
Periodical remuneration 0 0.00% 749 0
Abnormal appointment 0 0.00% 1 879 0
Total 22 549 707 100.00% 81 946 371
Table 2.1.3: Salaries, Overtime, Home Owners’ Allowance and Medical Aid by programme: 1 April 2020 to 31
March 2021
Programme Salaries Salaries Overtime Overtime HOA HOA as % of Medical Medical Total
(R’000) as % (R’000) as % (R’000) personnel Ass. Ass. as % personnel
of personnel of costs (R’000) of cost
costs Personnel personnel (R’000)
costs costs
Administration 409 013 1,3% 7 451 0,0% 8 464 0,0% 17 910 0,1% 442 838
District health
services 8 771 240 27,8% 496 738 1,6% 275 173 0,9% 476 219 1,5% 10 019 369
Emergency
medical
services 644 121 2,0% 18 388 0,1% 32 201 0,1% 63 179 0,2% 757 889
Provincial
hospital
services 5 860 542 18,6% 732 689 2,3% 202 638 0,6% 329 621 1,0% 7 125 491
Central
hospital
services 10 058 407 32,0% 1 481 472 4,7% 309 370 1,0% 481 980 1,5% 12 331 230
Health
sciences and
training 518 353 1,6% 2 746 0,0% 11 872 0,0% 23 126 0,1% 556 097
Health care
support
services 145 190 0,5% 18 135 0,1% 14 129 0,0% 24 128 0,1% 201 582
Health
facilities
management 37 518 0,1% 765 0,0% 502 0,0% 1 568 0,0% 40 353
HWSETA
accounts - -
Total 26 444 384 84,0% 2 758 384 8,8% 854 349 2,7% 1 417 434 4,5% 31 474 850
Table 2.1.4: Salaries, Overtime, Home Owners’ Allowance and Medical Aid by salary band: 1 April 2020 to 31
March 2021
Salary band Salaries Overtime Home Owners Medical Aid
Allowance
Salaries Salaries Amount Overtime Amount HOA as Amount Medical aid
(R’000 as a % of (R’000) as a % of (R’000) a % of (R’000) as a % of
personnel personnel personnel personnel
costs costs costs costs
Lower skilled (Level 1-2) 2 867 043 10.33% 62 517 2.19% 128 498 15.03% 210 144 14.84%
Skilled (Level 3-5) 4 973 812 17.92% 254 188 8.92% 324 230 37.91% 503 319 35.54%
(Level 6-8) 6 195 729 22.32% 303 951 10.66% 258 279 30.20% 430 905 30.43%
(Level 9-12) 13 581 140 48.93% 2 133 672 74.84% 142 786 16.70% 268 488 18.96%
Senior and Top
management
(Level 13-16) 137 092 0.49% 96 690 3.39% 1 385 0.16% 3 271 0.23%
Total 27 754 817 100.00% 2 851 017 100.00% 855 178 100.00% 1 416 127 100.00%
* Excludes BAS payments
Table 2.2.1: Employment and vacancies by programme as at 31 March 2021

Programme Number of posts Number of
Number of posts
on approved Vacancy rate employees additional
filled
establishment to the establishment
01 – Health Administration 1 635 988 39.57% 73
02 – District Health Services 33 453 29 455 11.95% 3 530
03 – Emergency Medical Services 3 615 2 600 28.08% 5
04 – Provincial Health Services 25 791 23 754 7.90% 3 906
05 – Academic Health Services 22 762 20 423 10.28% 2 874
06 – Health Sciences and Training 2 613 1 195 54.27%
07 – Health Care Support Services 800 751 6.13%
08 – Health Facility Management 104 90 13.46% 7
Grand Total 90 773 79 256 12.69% 10 395
* Data extracted from the staff establishment report and not the same as the headcount of 81946.
Table 2.2.2: Employment and vacancies by salary band as at 31 March 2021

Salary band description Number of posts Number of posts Vacancy rate Number of
on approved filled employees
establishment additional to the
establishment
Lower skilled (Level 1-2) 18 463 17 529 5.06% 1 441
Skilled (Level 3-5) 31 680 27 378 13.58% 2 981
Highly skilled production (Level 6-8) 21 804 17 995 17.47% 3 027
(Level 9-12) 18 668 16 238 13.02% 2 942
Senior management (Level 13-16) 158 116 26.58% 4
Total 90 773 79 256 12.69% 10 395
* Data extracted from the staff establishment report and not the same as the headcount of 81946.
Table 2.2.3: Employment and vacancies by critical occupation as at 31 March 2021

Critical occupation Number of posts Number of posts Vacancy rate Number of
on approved filled employees
establishment additional to the
establishment
01. Medical Practitioner 2 959 2 505 17.57% 711
02. Medical Intern 1 281 1 215 14.83% 1 206
03. Medical Specialist 2 912 2 575 2.34% 251
04. Dental Practitioner 259 231 10.81% 20
05. Dentist / Specialist 154 127 17.53%
06. Emergency Care Practitioner 3 416 2 508 26.58%
07. Professional Nurses 19 570 16 824 14.03% 2 427
08. Staff Nurses 8 687 8 082 6.96% 1 103
09. Nursing Assistant 7 816 7 418 5.09% 883
10. Student Nurses 2 144 797 62.83%
11. Pharmacist 596 554 7.05% 138
12. Pharmacist intern 67 64 4.48% 65
GRAND TOTAL 49 861 42 900 13.80% 2 564
*Staff establishment - excludes administration, support and other allieds.
Table 2.3.1: SMS post information as at 31 March 2021

SMS level Total number Total number % of SMS Total number % of SMS
of funded of SMS posts posts filled of SMS posts posts vacant
SMS posts filled vacant
Head of Department 1 0 0.00% 1 100.00%
Salary Level 16 1 1 100.00% 0.00%
Salary Level 15 8 5 62.50% 3 37.50%
Salary Level 14 39 28 71.79% 11 28.21%
Salary Level 13 109 82 74.31% 27 24.77%
Total 158 116 42
Table 2.3.2: SMS post information as at 30 September 2020

SMS level Total number Total number % of SMS Total number % of SMS
of funded SMS of SMS posts posts filled of SMS posts posts vacant
posts filled vacant
Head of Department 1 1 100.00% 0.00%
Salary Level 16 1 1 100.00% 0.00%
Salary Level 15 8 6 75.00% 2 25.00%
Salary Level 14 39 28 71.79% 11 28.21%
Salary Level 13 108 84 77.78% 24 22.22%
Total 157 120 37
Table 2.3.3: Advertising and filling of SMS posts: 1 April 2020 to 31 March 2021
SMS Level Total Total Total % of SMS Total % of SMS
number number of number of posts filled number posts
of funded SMS posts SMS posts of SMS vacant
SMS posts filled advertised vacant
funded
posts
Head of Department 1 0 0,00% 1 0,00%
Salary Level 16 1 1 100,00% 0 0,00%
Salary Level 15 8 5 62,50% 3 12,50%
Salary Level 14 39 28 71,79% 11 15,38%
Salary Level 13 109 82 74,31% 27 10,09%
Total 158 116 0 42
Table 2.3.4: Reasons for not having complied with the filling of funded vacant SMS posts advertised within six
months and filled within 12 months after becoming vacant: 1 April 2020 – 31 March 2021
Reasons for vacancies not advertised within six months
SMS positions are advertised within 6 months after being vacant
Reasons for vacancies not filled within six months

SMS posts are filled within six months after being vacant.
Table 2.3.5: Disciplinary steps taken for not complying with the prescribed timeframes for filling SMS posts
within 12 months
The prescribed timeframe for filling within twelve months
Vacancies are advertised within six months after being vacant
Reasons for vacancies not filled within twelve months

vacant SMS posts are filled on time within 12 months
Table 2.4.1: Job Evaluation by salary band: 1 April 2020 to 31 March 2021
Salary band Number of Number % of posts Posts upgraded Posts downgraded
posts on of jobs evaluated
approved evaluated by salary Number % of posts Number % of posts
establishment bands evaluated evaluated
Lower Skilled
(Level 1-2) 17 232 0 0 0%
Skilled (Level 3-5) 28 860 0 0% 0 0 0 0%
Highly skilled
production (Level 6-8) 19 827 0 0% 0 0% 0 0%
Highly skilled
supervision (Level 9-12) 14 725 0 0% 0 0% 0 0%
Senior Management
Service Band A 101 0 0% 0 0% 0 0%
Senior Management
Service Band B 31 0 0% 0 0% 0 0%
Senior Management
Service Band C 5 0 0% 0 0% 0 0%
Senior Management
Service Band D 2 0 0% 0 0% 0 0%
Contract (Level 1-2) 1 231 0 0% 0 0% 0 0%
Contract (Level 3-5) 2 820 0 0% 0 0% 0 0%
Contract (Level 6-8) 1 977 0 0% 0 0% 0 0%
Contract (Level 9-12) 3 943 0 0% 0 0% 0 0%
Salary band Number of Number % of posts Posts upgraded Posts downgraded

posts on of jobs evaluated
approved evaluated by salary Number % of posts Number % of posts
establishment bands evaluated evaluated
Contract Band A 8 0 0% 0 0% 0 0%
Contract Band B 8 0 0% 0 0% 0 0%
Contract Band C 3 0 0% 0 0% 0 0%
Contract Band D 0 0 0% 0 0% 0 0%
Total 90 773 0 0
Table 2.4.2: Profile of employees whose positions were upgraded due to their posts being upgraded: 1 April
2020 to 31 March 2021
Gender African Asian Coloured White Total
Female 0 0 0 0 0
Male 0 0 0 0 0
Total 0 0 0 0 0
Employees with a disability 0
Table 2.4.3: Employees with salary levels higher than those determined by job evaluation by occupation:
1 April 2020 to 31 March 2021
Occupation Number of Job evaluation level Remuneration level Reason for
employees deviation
None 0
Total number of employees whose salaries exceeded the level determined by job evaluation
Percentage of total employed 0,0000%
Table 2.4.4: Profile of employees whose salary levels were higher than those determined by job evaluation:
1 April 2020 to 31 March 2021
Gender African Asian Coloured White Total
Female 0% 0% 0% 0% 0%
Male 0% 0% 0% 0% 0%
Total 0% 0% 0% 0% 0%
0% 0% 0% 0% 0%
Employees with a disability
Table 2.5.1: Annual turnover rates by salary band: 1 April 2020 to 31 March 2021
Salary band Number of Appointments Terminations Turnover rate
employees at and transfers and transfers
beginning of into the out of the
period department department
- 01 April 2020
Lower skilled ( Levels 1-2) 22744 12079 14805 65,09%
Skilled (Levels 3-5) 22399 1903 881 3,93%
Highly skilled production (Levels 6-8) 16449 770 1111 6,75%
Highly skilled supervision (Levels 9-12) 12848 914 1160 9,03%
Senior Management Service Bands A 72 3 7 9,72%
Senior Management Service Bands B 17 1 5,88%
Senior Management Service Bands C 2 0 0,00%
Senior Management Service Bands D 1 1 100,00%
Contracts 4514 8661 3219 71,31%
Total 79046 24330 21185 26,80%
* The net headcount not always aligned, due to the nature of appointments in the Gauteng Department of Health,
eg: Abnormal appointments.
Table 2.5.2: Annual turnover rates by critical occupation: 1 April 2020 to 31 March 2021
Critical occupation Number of Appointments and Terminations and Turnover rate
employees at transfers into the transfers out of
beginning of department the department
period-April 2020
01. Medical Practitioner 2608 1581 1166 43,90%
02. Medical Intern 1178 667 511 50,70%
03. Medical Specialist 2536 551 427 19,40%
04. Dental Practitioner 316 135 115 24,10%
05. Dentists / Specialist 170 40 60 22,10%
06. Emergency Care Practitioner 1965 611 54 3,40%
07. Professional Nurses 15275 2291 1765 9,90%
08. Staff Nurses 7184 1701 507 3,20%
09. Nursing Assistant 6461 1284 328 3,10%
10. Student Nurses 1764 40 336 3,90%
11. Pharmacist 542 194 131 24,90%
12. Pharmacist intern 62 65 65 101,60%
GRAND TOTAL 40 061 9 160 5 465 11,10%
* Headcount - excludes Administration, support and other allieds.
Table 2.5.3: Reasons why staff left the Department: 1 April 2020 to 31 March 2021
Termination type Number % of total resignations
Death 464 2.19%
Resignation 3 279 15.48%
Expiry of contract 16 115 76.07%
Dismissal – operational changes 0.00%
Dismissal – misconduct 97 0.46%
Dismissal – incapacity 1 0.00%
Dismissal – inefficiency 0.00%
Discharged due to ill-health 51 0.24%
Retirement 1 178 5.56%
Transfer to other Public Service
Departments 0.00%
Other 0.00%
Total 21 185 100.00%
Total number of employees who
left as a % of total employment 25.85%
Table 2.5.4: Promotions by critical occupation: 1 April 2020 to 31 March 2021

Occupation Number of Promotions to Salary level Progressions Notch
Employees 1 another salary promotions to another progression
April 2020 level as a % of notch within a as a % of
employees salary level employees by
occupation
Dental Practitioner 316 9 2,85% 9 2,85%
Dental Specialist 170 10 5,88% 2 1,18%
Medical Practitioner 2608 67 2,57% 58 2,22%
Medical Intern 1178 0,00% 0,00%
Medical Specialist 2542 100 3,93% 30 1,18%
Emergency Care Practitioner 1965 109 5,55% 36 1,83%
Pharmacist 542 22 4,06% 17 3,14%
Pharmacist (Intern ) 62 0,00% 0 0,00%
Professional Nurses 15275 1105 7,23% 663 4,34%
Staff Nurses 7184 452 6,29% 441 6,14%
Nursing Assistant 6461 360 5,57% 360 5,57%
Professional Nurse (Student) 1764 0,00% 0,00%
Total 40 067 2 234 5,58% 1 616 4,03%
Table 2.5.5: Promotions by salary band: 1 April 2020 to 31 March 2021

Salary Band Number Number of promotions to Progressions Notch
Employees employees 1 another salary to another progression as
1 April 2020 April 2020 level notch within a a % of
salary level employees by
salary bands
Lower skilled (Levels 1-2) 23383 4 0,02% 0,00%
Skilled (Levels3-5) 22405 626 2,79% 392 1,75%
7,66% 5,78%
(Levels 6-8) 17038 1305 984
5,70% 2,70%
(Levels 9-12) 16105 918 435
Senior Management (Level
6,96% 0,00%
13-16) 115 8
Total 79046 2861 3,62% 1811 2,29%
Table 2.6.1: Total number of employees (including employees with disabilities) in occupational categories as at
31 March 2021
Occupational category Male Female Total
African Coloured Indian White African Coloured Indian White
Legislators, senior
officials and
managers 69 2 2 3 62 2 6 4 150
Professionals 2057 81 473 738 2527 129 577 997 7579
Technicians
and associate
professionals 2851 49 64 115 17820 458 375 860 22592
Clerks 2649 44 17 37 6366 87 15 203 9418
Service and sales
workers 754 10 7418 88 5 8275
Skilled agriculture
and fishery workers 0
Craft and related
trades workers 3183 25 21 52 16008 89 14 106 19498
Plant and machine
operators and
assemblers 402 6 1 7 36 452
Elementary
occupations 4312 78 7 50 7845 168 1 57 12518
Total 16277 295 585 1002 58082 1021 988 2232 80482
Employees with
disabilities 307 9 4 32 995 27 12 78 1464
Table 2.6.2: Total number of employees (including employees with disabilities) in occupational bands as at 31
March 2021
Top Management 3 3 6
Senior Management 46 2 2 3 40 1 2 4 100
Professionally
qualified and
experienced
specialists and mid-
management 2966 108 479 719 9907 346 740 1400 16665
Skilled technical
and academically
qualified workers,
junior management,
supervisors, foreman
and superintendents 2966 44 29 94 14731 284 181 609 18938

Semi-skilled and
discretionary decision
making 5750 64 17 56 17893 136 10 88 24014
Unskilled and defined
decision making 4546 77 58 130 15508 254 55 131 20759
Total 16277 295 585 1002 58082 1021 988 2232 80482
Employees with
disabilities 307 9 4 32 995 27 12 78 1464
Table 2.6.3: Recruitment: 1 April 2020 to 31 March 2021

Occupational band Male Female Total
Top Management 1 1
Senior Management 6 1 2 9
Professionally
qualified and
experienced
specialists and
mid-management 671 33 155 243 1 349 89 215 472 3 227
Skilled technical
and academically
qualified workers,
junior management,
supervisors, foremen
and superintendents 422 12 7 12 2 051 47 74 182 2 807
Semi-skilled and
discretionary
decision-making 954 8 6 3 3 779 15 1 14 4 780
Unskilled and
defined decision-
making 2 210 40 33 71 10 861 160 44 75 13 494
Total 4 264 93 202 329 18 042 311 334 743 24 318
Employees with
disabilities 2 1 9 12
Table 2.6.4: Promotions: 1 April 2020 to 31 March 2021

Top Management 0
Senior Management 4 4 8
Professionally
qualified and
experienced
specialists and
mid-management 150 4 11 15 654 22 16 46 918
Skilled technical
and academically
qualified workers,
junior management,
supervisors, foremen
and superintendents 196 1 2 2 1 078 9 7 10 1 305
Semi-skilled and
discretionary
decision-making 145 2 1 471 5 2 626
Unskilled and
defined decision-
making 1 3 4
Total 496 7 14 17 2 210 36 23 58 2 861
Employees with
disabilities 3 2 33 1 1 1 41
Table 2.6.5: Terminations: 1 April 2020 to 31 March 2021

Top Management 1 1 2
Senior Management 13 1 2 16
Professionally qualified and
experienced specialists and
mid-management 434 21 106 242 1291 81 162 458 2795
Skilled technical and
academically qualified
workers, junior management,
supervisors, foreman and
superintendents 282 9 6 17 1279 53 53 195 1894
Semi-skilled and
discretionary decision
making 280 2 5 776 13 2 10 1088
Unskilled and defined
decision making 2499 28 50 87 12162 165 47 79 15117
Total 3509 60 163 351 15511 312 264 742 20912
Employees with Disabilities 32 1 1 4 225 4 0 6 273
Table 2.6.6: Disciplinary action for the period 1 April 2020 to 31 March 2021
Disciplinary action Male Female Total
407 4 3 3 438 11 9 22 897
NOTES:
Total Disciplinary cases reported:1040
10 of 1040 were reported and no officials identified
Table 2.6.7 Skills Development for the period 01 April 2020 - 31 March 2021
Occupational Male Female Total
Category African Coloured Indian Total White African Coloured Indian Total White
Black Black
1. Legislators,
Senior Officials
and Managers 35 6 6 47 4 32 2 3 37 4 92
2. Professionals 1 544 96 255 1 895 216 1 055 215 97 1 367 88 3 566
3. Technicians
and Associate
Professionals 1 991 81 102 2 174 344 3 078 97 516 3 691 845 7 054
4. Clerks 1 099 41 22 1 162 69 1 199 91 41 1 331 166 2 728
5. Service
Workers and
Shop and Market
Sales Workers 111 16 13 140 49 369 17 11 397 15 601
7. Craft and
Related Trades
Workers 2 0 0 2 0 0 0 0 0 0 2
8. Plant and
Machine
Operators and
Assemblers 1 0 0 1 0 0 0 0 0 0 1
9. Elementary
Occupations 498 51 9 558 49 1 691 189 61 1 941 50 2 598
Total 5 281 291 407 5 979 731 7 424 611 729 8 764 1 168 16 642
Employees with
disabilities 6 1 0 7 0 1 0 0 1 0 8
Notes: a. Data Supplied by Human Resource Development : Skills Development

b. Classification legend:
▪ Legislators, Officials responsible for determining and formulating policy and strategy, planning, directing and
Senior Officials and coordinating the policies and activities of the organisation e.g CEOs, Senior Managers, College
Managers: Principals, etc.
▪ Professionals: Include officials whose main task require a high level of professional knowledge e.g. Clinical
Psychologists,
Medical & Dental Practitioners, etc
▪ Technicians This group includes occupations whose main tasks require technical knowledge and experience
and Associate e.g. Clinical
Professionals: Technologists, Industrial Technicians, Environmental Health Officers, Professional Nurses, etc.
▪ Clerks This group includes occupations whose tasks require the knowledge and experience necessary
to organise,
store, compute and retrieve information e.g. Acounting Clerks, Stores Officers, Administration
Clerks
▪ Service Workers This group includes occpations whose main tasks require the knowledge and experience
and Shop and Market necessary to
Sales Workers: provide personal and protective services e.g. Auxilairy Services Officers (ward attendants),
Emergency Care Practitioners, Firefighters, Food Services Aids, etc.
▪ Craft and Related This group includes occupations whose main tasks require the knowledge and experience of
Trades Workers: skilled trades and
handicrafts e.g. Clinical Photogrpahers, plumbers, electricians, etc.
▪ Plant and Machine The main tasks of this occupational grouping involve the use of automated industrial machinery
Operators and and equipment
Assemblers: e.g. Drivers, Tradesmans Aids, etc.
▪ Elementary This group covers occupations which require relatively low / elementary levels of knowledge and
Occupations: experience
necessary to perform mostly simple and routine tasks, involving the use of hand held tools and in
some cases considerable physical effort, and, with few exceptions, limited personal initiative and
judgement e.g. Cleaners, Groundsmen, etc.
Table 2.7.1 Signing of Performance Agreements by SMS members as on 31 March 2021

SMS Level Total number Total number of Total number Signed Reason for not
of funded SMS SMS members of signed performance having concluded
posts performance agreements as % performance
agreements of total number of agreement
SMS members
Director-
General/ Head of 1 0
Department
Salary Level 16 1 1 0
One on
Salary Level 15 8 5 6 86% Precautionery
suspension
Precautionery
suspension,
dispute with the
Salary Level 14 39 28 21 84%
supervisor and
some did not
provide reasons
Two have
grievances with
Salary Level 13 109 82 67 82% supervisor and rest
did not provide
reasons
Total 158 116 94 82%
Table 2.7.2 Reason for not having concluded Performance Agreements for all SMS members as on 31 March
2021
Reasons
One level 15 and two on 14 on precautionery suspension
One level 14 is having a grievance
One level 13 on precautionery suspension and twelve did not provide reasons
Two level 13 are having grievances with their supervisors
Table 2.7.3 Disciplinary steps taken against SMS members for not having concluded Performance agreements
Reasons
Follow ups made with all senior managers who have their performance agreement outstanding
Table 2.8.1 Performance Rewards by race and gender:2020/2021

Beneficiary Profile Cost
Race and Gender Number of Number of % of total within Cost (R’000) Average cost per
beneficiaries employees group employee
African
Male 2952 13570 22% R 25 427 934,80 R 8 613,80
Female 15104 45171 33% R 104 844 787,20 R 6 941,52
Asian
Male 50 482 10% R 444 835,60 R 8 896,71
Female 154 879 18% R 1 328 718,80 R 8 628,04
Coloured
Male 55 241 23% R 481 518,00 R 8 754,87
Female 248 903 27% R 2 173 107,60 R 8 762,53
White
Male 78 928 8% R 641 412,40 R 8 223,24
Female 381 2216 17% R 3 046 556,00 R 7 996,21
Total 19022 64390 R 138 388 870,40
Table 2.8.2 Performance Rewards by salary band for personnel below Senior Management Service:2020/2021
Beneficiary Profile Cost Total cost as a
Salary band Number of Number of % of total Total Cost Average cost per % of the total
beneficiaries employees within (R’000) employee personnel
salary expenditure
bands
Lower Skilled
(Levels 1-2) 2260 8025 28% R 19 753 568,00 R 8 740,52 0,20%
Skilled (level 3-5)
6043 22366 27% R 51 502 458,40 R 8 522,66 0,55%
Highly skilled
production
(level 6-8)
4711 17113 28% R 39 009 282,40 R 8 280,47 0,40%
Highly skilled
supervision
(level 9-12) 3454 16232 21% R 28 123 561,60 R 8 142,32 0,31%
Periodic
remuneration N/A N/A N/A N/A N/A N/A
Abnormal
appointment N/A N/A N/A N/A N/A N/A
Total 16468 63736 R 138 388 870,40 R 8 403,50 1,47%
Table 2.8.3 Performance Rewards by critical occupation:2020/2021

Salary Band Number of Total % of total within Total Cost Average cost
beneficiaries employment occupation (R’000) per Beneficiary
Nursing 8405 34171 25% R 72 137 186,40 R 8 582,65

Medical 418 6904 6% R 3 690 168,80 R 8 828,16
Pharmacists 176 632 28% R 1 566 624,80 R 8 901,28
Allied 867 867 100% R 7 461 533,60 R 8 606,15
Total 9866 42574 23% R 84 855 513,60 R 8 600,80
Table 2.8.4 Performance related rewards (cash bonus), by salary band for Senior Management
Service:2020/2021
Beneficiary Profile Cost Total cost as a
Salary band Number of Number of % of total Total Cost Average cost % of the total
beneficiaries beneficiaries within salary (R’000) per employee personnel
bands expenditure
Band A No performance bonus paid to members of Senior Management Service

Band B
Band C
Band D
Total
Table 2.9.1 Foreign workers by salary band: 1 April 2020 to 31 March 2021
Salary band 01-Apr-20 31-Mar-21 Change
Number % of total Number % of total Number % change
Lower skilled
(Level 1-5) 68 8.88% 61 7.56% -7 -1.32%
Highly skilled
production
(Level 6-8) 51 6.66% 56 6.94% 5 0.28%
Highly skilled
supervision
(Level 9-12) 472 61.62% 468 57.99% -4 -3.63%
Contract
(Level 9-12) 175 22.85% 222 27.51% 47 4.66%
Contract
(Level 13-16) 0 0.00% 0 0.00% 0 0.00%
GRAND TOTAL 766 100.00% 807 100.00% 41 0.00%
Table 2.9.2 Foreign workers by salary band: 1 April 2020 to 31 March 2021
Major occupation 01-Apr-20 31-Mar-21 Change
Number % of total Number % of total Number % change
1. Professionals 608 79.37% 632 78.31% 24 -1.06%
2. Technicians and Associate
Professionals 133 17.36% 153 18.96% 20 1.60%
3. Clerks 7 0.91% 5 0.62% -2 -0.29%
4. Service Workers 3 0.39% 3 0.37% 0 -0.02%
5. Service Workers and Shop
and Market Sales Workers 8 1.04% 8 0.99% 0 -0.05%
6. Plant and Machine Operators
and Assemblers 1 0.13% 1 0.12% 0 -0.01%
7. Elementary Occupations 6 0.78% 5 0.62% -1 -0.16%
GRAND TOTAL 766 100.00% 807 100.00% 41 0.00%
Table 2.10.1 Sick leave: 1 January 2020 to 31 December 2020

Salary band Total days % days with Number of % of total Average Estimated
medical employees employees days per cost (R’000)
certification using sick using sick employee
leave leave
Contract (Level 1-2) 270 89.6 94 0.2 3 145
Contract (Level 3-5) 1 032 89.8 333 0.6 3 861
Contract (Level 6-8) 3 293 79.1 774 1.5 4 4 353
Contract (Level 9-12) 6 673 80.2 1 307 2.5 5 17 229
Contract (Level 13-16) 57 89.5 7 0 8 313
Contract Other 352 94 110 0.2 3 144
Lower skilled (Level 1-2) 54 225 90.1 8 049 15.7 7 31 032
Skilled (Level 3-5) 126 137 88 17 122 33.4 7 109 581
(Level 6-8) 106 768 87.2 14 052 27.4 8 148 012
(Level 9-12) 73 453 86.5 9 406 18.3 8 204 227
Senior Management
(Level 13-16) 342 85.1 53 0.1 6 1 509
Other 3 66.7 1 0 3 4
TOTAL 372 605 87.6 51 308 100 7 517 410
Information Source: Vulindlela
Table 2.10.2 Disability leave (temporary and permanent): 1 January 2020 to 31 December 2020
Salary band Total days % days with Number of % of total Average days Estimated
medical employees employees per employee cost (R’000)
certification using using
disability disability
leave leave
Contract (Level 3-5) 10 100 3 0.2 3 8
Contract (Level 6-8) 80 100 4 0.2 20 99
Contract (Level 9-12) 681 100 20 1.2 34 1 428
Lower skilled (Level 1-2) 6 385 100 217 13.4 29 3 809
Skilled (Level 3-5) 13 999 100 549 34 25 12 174
(Level 6-8) 14 596 100 474 29.3 31 20 606
(Level 9-12) 10 243 100 349 21.6 29 29 975
Total 45 994 700 1 616 100 17 68 099
Table 2.10.3 Annual leave: 1 January 2020 to 31 December 2020

Number of employees
Salary band Total days taken Average per employee
using annual leave
Contract (Level 1-2) 694 168 4
Contract (Level 3-5) 2 036 450 5
Contract (Level 6-8) 11 405 939 12
Contract (Level 9-12) 45 801 3 205 14
Contract (Level 13-16) 267 20 13
Contract Other 2 998 266 11
Lower skilled (Level 1-2) 195 277 12 475 16
Skilled (Level 3-5) 477 441 22 321 21
Highly skilled production (Level 6-8) 391 378 17 810 22
Highly skilled supervision (Level 9-12) 287 406 13 134 22
Senior Management (Level 13-16) 1 841 93 20
Other 59 3 20
TOTAL 1 416 602 70 884 20
Table 2.10.4 Capped leave: 1 January 2020 to 31 December 2020

Salary band Total days of Average Average Number of Total number Number of
capped leave number capped employees of capped employees
taken of days leave per who took leave as at end of
taken per employee capped leave available at period
employee as at end of end of period
period
Contract (Level 1-2) 0 0 0 0 0 0
Contract (Level 3-5) 0 0 0 0 0 0
Contract (Level 6-8) 0 0 2 0 3.13 2
Contract (Level 9-12) 0 0 16 0 31.61 2
Contract (Level 13-16) 0 0 25 0 49.14 2
Contract Other 0 0 0 0 0 0
Lower skilled (Level 1-2) 2 2 19 1 356.06 19
Skilled (Level 3-5) 239.5 3 21 80 51 897.63 2 436
409.5 3 28 134 73 127.42 2 637
(Level 6-8)
550 4 31 126 79 756.93
(Level 9-12) 2 590
Senior Management
0 0 53 0 1 691.97 32
(Level 13-16)
Other 0 0 0 0 0 0
Total 1 201 4 27 341 206 913.89 7 720
Table 2.10.5 Leave pay-outs (estimated) 1 January 2020 to 31 December 2020

Reason Total Estimated Number of Estimated
Amount (R’000) Employees Average per
Employee (R)
Annual - Discounting With Resignation (Work Days) 23 887,00 914,00 26 135,00
Annual - Discounting: Unused Vacation Credits (Work
Days) 84,00 2,00 42 000,00
Annual - Gratuity: Death/Retirement/Medical
Retirement(Work) 45 294,00 1 185,00 38 223,00
Annual - Head of Departments (Gratuity) (Work Days) 11,00 1,00 11 000,00
Capped - Gratuity: Death/Retirement/Medical
Retirement(Work 40 661,00 781,00 52 063,00
Capped - Head Of Departments (Gratuity) (Work Days) 1,00 1,00 1 000,00
Total 109 938,00 - -
Table 2.11.1 Steps taken to reduce the risk of occupational exposure

Units/categories of employees identified to be at high risk of contracting
Key steps taken to reduce the risk
HIV & related diseases (if any)
Health care Professionals- Doctors and Nurses - Biological Exposure through Policy, Protocols & PPE,
cuts, Splashes, bites, Nasocomial Infection (NSI), Needle stick Injuries -teaching of segregation of waste,
- proper waste disposal
Cleaners ( Needle stick injuries) -Policy, Protocols & PPE
Table 2.11.2 Details of Health Promotion and HIV/AIDS Programmes

Question Yes No Details, if yes
1. Has the department Yes Dr S Senabe
designated a member of the Chief Director: HRD& EHWP (Director Post Vacant)
SMS to implement the provisions
contained in Part VI E of
Chapter 1 of the Public Service
Regulations, 2001? If so, provide
her/his name and position.
2. Does the department have a Yes No. of staff: 26 (including x 2 Interns)
dedicated unit or has it designated 2 - DD Occupational Health & Wellness Management ( (x1
specific staff members to promote vacant)
the health and well-being of 6 - AD Occupational Health Nurses x 3, Occupational
your employees? If so, indicate Theraphy x1 Social Worker X 2
the number of employees who
13 - X 11 Administrators - X 2 Interns
are involved in this task and the
annual budget that is available for 4 Clinic Staff (x2 Retired Prof Nurses, x 2 COVID19 Nurses (x
this purpose. 1 Vacant Occu Medical Practitioner Post)
1 Social Worker (Level 7)
3. Has the department introduced Yes HIV, TB & STI - workplace
an Employee Assistance or Health Prevention programme
Promotion Programme for your
• Peer education programme
employees? If so, indicate the
key elements/services of this • Capacity building (training)
Programme. • Condom education and distribution
• HIV Testing Services
Treatment care and support
• Support group programme
• Adherence and psychosocial counselling on ART
Employee Assistance Programme
• Telephone and face to face counselling
• Debriefing
• Organizational Wellness
• physical and Individual Wellness
Occupational Health & Wellness clinic
• COIDA - management of work injuries and diseases /
Emergency Care
• Medical Surveillance
• Primary Health Care & Family Planning
4. Has the department established Yes • The department has a Provincial Occupational Health &
(a) committee(s) as contemplated Safety Committee. (Dr S Senabe & Ms R Bodibe)
in Part VI E.5 (e) of Chapter 1 of • Each Institution has an Occupational Health & Safety
the Public Service Regulations, Committee.
2001? If so, please provide the • Provincial Wellness Committee. (Ms Ntombi Mdumbe)
names of the members of the
• Provincial HIV, TB & STI Committee (Ms Palesa Koetsi)
committee and the stakeholder(s)

that they represent.
5. Has the department reviewed SHERQ Policy , Health & Productivity Policy,
its employment policies and Draft HIV, TB & STI Policy
practices to ensure that these
Wellness Management Policy
do not unfairly discriminate
against employees on the basis Medical Surveillance Policy, GDOH Biological Exposure
of their HIV status? If so, list the Protocols Occupational Health
employment policies/practices so Policy Guidelines and Protocols
reviewed. for TB, HIV and Hepatitis B
Question Yes No Details, if yes

6. Has the department introduced • Peer education programme
measures to protect HIV- • Capacity building on management of disclosure
positive employees or those
• HIV Testing Services (HCT)
perceived to be HIV-positive from
discrimination? If so, list the key • Support group programme
elements of these measures. • Adherence and psychosocial counselling and support on
ART
7. Does the department Yes HCT & Counselling is conducted on every employee
encourage its employees to participating in the Medical Surveillance Programme,
undergo Voluntary Counselling Occupational Health & Wellness Staff Clinics conduct HCT and
and Testing? If so, list the results provide Primary Health Care Services
that you have you achieved. Health Calendar activities eg. (STI & Condom week, World TB
day, Men’s Health awareness day, World Aids Day)

8. Has the department developed Yes Operational Plan & APP INDICATORS
measures/indicators to monitor & DPSA Quarterly, & Annual reports and the DPSA SMT Annual
evaluate the impact of its health Monitoring Tool & Audit
promotion programme? If so, list Departmental Monthly, Quarterly report, Annual reports
these measures/indicators.
Table 2.12.1 Collective agreements for the period 1 April 2020 to 31 March 2021
Subject matter Date
1. PHSDSBC Resolution 1 of 2020, Framework agreement on the appointment of a Gauteng 19/05/2020
Department of Health Occupational Health and Safety Committee (OHSC) on Covid -19
2 PSCBC Resolution 1 of 2020, Agreement on the amendment of PSCBC Resolution 5 of 25/06/2020
2001 annual leave.
Table 2.12.2 Misconduct and disciplinary hearings finalised for the period 1 April 2020 to 31 March 2021
Outcomes of disciplinary hearings Number % of total
Correctional counselling 8 1%
Verbal warning 35 6%
Written warning 235 37%
Final written warning 232 36%
Suspended without pay 39 6%
Fine 0 0%
Demotion 0 0,00%
Dismissal 59 9%
Not guilty 2 0.3%
Case withdrawn 16 3%
Total 626 100%
NOTES:
Total numer of cases finalised:714
61 of 714 were closed due i.e lack of eveidance
presented,cautioned, Service termination, no grounds to
charge and deceased
5 of 714 employee were cautioned
23 of 714 were Absconded in terms of the Public Service Act
Table 2.12.3 Types of misconduct addressed at disciplinary hearings for the period 1 April 2020 to 31 March
2021
Type of misconduct Number % of total
Absenteeim 147 16%
Assault 4 0%
Derelication of duties 11 1%
Desertion of post 32 4%
Fraud and corruption 42 5%
Jnsurbordination 91 10%
misuse of state vehicle 7 1%
Money lending 3 0%
Negligency 58 6%
Poor performance 13 1%
Theft 97 11%
Unlawful industrail action 73 8%
While on duty conduct himself in an improper, disgraceful and unacceptable manner 82 9%
Others include:fail to comply with an Act, RWOPS, late coming,fail to comply with an
253 28%
Act
Total 913 100%
Table 2.12.4 Grievances logged for the period 1 April 2020 to 31 March 2021
Grievances Number % of Total
Number of grievances resolved 402 51%
Number of grievances not resolved 212 49%
Total number of grievances lodged 614 100%
NOTES:
321 of 402 where resolved within the 30 days
81 of 402 where resolved outside the 30 days
NATURE OF GRIEVANCES LODGED

Unfair treatment
Filling of post
Salary problem
Unfair labour practice
Performance assessment
Disciplinary matter
Application for approval
Undermining authority
Table 2.12.5 Disputes logged with Councils for the period 1 April 2020 to 31 March 2021
Disputes Number % of Total
Number of disputes finalised 36 36%
Number of disputes pending 63 53%
Total number of disputes lodged 98 100%
NOTES: Finalised- 47 cases
13 of 36 in favour of the Department
4 of 36 in favour of applicant
7 of 36 is settled
12 of 36 is withdrawn
NOTES: Pending - 62 cases

62 Arbitration in progress
Table 2.12.6 Strike action for the period 1 April 2020 to 31 March 2021
Total number of persons working days lost 1191
Total costs working days lost R1 507
Amount recovered as a result of no work no pay (R’000) No work no pay
outstanding
Table 2.12.7 Precautionary suspensions for the period 1 April 2020 to 31 March 2021
Number of people suspended 26
Number of people who’s suspension exceeded 30 days 20
Average number of days suspended 112 days
Cost of suspension(R’000) R 130 817 404
Table 2.13.1 Training needs identified for the period 01 April 2020 - 31 March 2021
Occupational Gender Number of Learnerships Training needs at the start of the
Categories employees reporting period
as at 1 April Skills Other forms Total
2020 of
training
1. Legislators, Senior
Officials and Managers Female 0 60 60
Male 0 40 40
2. Professionals Female 0 5000 5 000
Male 0 2500 2 500
Professionals Female 900 8000 0 8 900
Male 600 3500 0 4 100
4. Clerks Female 0 6000 6 000
Male 0 3000 3 000
5. Service Workers and
Shop and Market Sales
Workers Female 0 200 200
Male 0 100 100
7. Craft and Related Trades
Workers Female 0 0 0
Male 0 5 5
8. Plant and Machine
Operators and Assemblers Female 0 0 0
Male 0 5 5
9. Elementary Occupations Female 0 3000 3 000
Male 0 2000 2 000
Total 0 1 500 33 410 0 34 910
NB: Bursaries are recorded

under “Other forms of training”
Notes:
a. Data provided by the Directorate Human Resource

Development:Skills Development
. Number of employees is as at the beginning of the reporting period (i.e. April
2016) as required by the reporting guideline.
b. Learnerships, Skills Programmes and other forms of training are trainining
needs identified as per Workplace Skills Plan of 2016/2017
d. Classification legend:
▪ Legislators, Senior Officials
Officials responsible for determining and formulating policy and strategy,
and Managers:
planning, directing and coordinating the policies and activities of the
organisation e.g CEOs, Senior Managers, College Principals, etc.
▪ Professionals: Include officials whose main task require a high level of professional
knowledge e.g. Clinical Psychologists,
Medical & Dental Practitioners, etc
▪ Technicians and Associate This group includes occupations whose main tasks require technical
Professionals: knowledge and experience e.g. Clinical
Technologists, Industrial Technicians, Environmental Health Officers,
Professional Nurses, etc.
▪ Clerks: This group includes occupations whose tasks require the knowledge and
experience necessary to organise,
store, compute and retrieve information e.g. Acounting Clerks, Stores
Officers, Administration Clerks
▪ Service Workers and Shop and This group includes occpations whose main tasks require the knowledge
Market Sales Workers: and experience necessary to
provide personal and protective services e.g. Auxilairy Services Officers
(ward attendants), Emergency Care Practitioners, Firefighters, Food
Services Aids, etc.
▪ Craft and Related Trades This group includes occupations whose main tasks require the knowledge
Workers: and experience of skilled trades and
handicrafts e.g. Clinical Photogrpahers, plumbers, electricians, etc.
▪ Plant and Machine Operators The main tasks of this occupational grouping involve the use of
and Assemblers: automated industrial machinery and equipment
e.g. Drivers, Tradesmans Aids, etc.
▪ Elementary Occupations: This group covers occupations which require relatively low / elementary
levels of knowledge and experience
necessary to perform mostly simple and routine tasks, involving the
use of hand held tools and in some cases considerable physical effort,
and, with few exceptions, limited personal initiative and judgement e.g.
Cleaners, Groundsmen, etc.
Table 2.13.2 Training provided for the period 01 April 2020 - 31 March 2021
Occupational Gender Number of Training provided within the
2020 of
training
1. Legislators, Senior Officials
and Managers Female 0 41 0 41
Male 0 51 0 51
2. Professionals Female 0 1455 0 1 455
Male 0 2111 0 2 111
Professionals Female 30 4506 0 4 536
Male 15 2503 0 2 518
4. Clerks Female 715 782 0 1 497
Male 552 679 0 1 231
5. Service Workers and Shop
and Market Sales Workers Female 0 412 0 412
189 Male 0 189 0 189
7. Craft and Related Trades
Workers Female 0 0 0 0
Male 0 2 0 2
Occupational Gender Number of Training provided within the

2020 of
training
8. Plant and Machine
Operators and Assemblers Female 0 0 0 0
Male 0 1 0 1
9. Elementary Occupations Female 0 1991 0 1 991
Male 0 607 0 607
Total 0 1 312 15 330 0 16 642

NB: Bursaries are recorded
under “Other forms of training”
Notes:
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 2016) as required by the reporting guideline.
c. Learnerships, Skills Programmes and other forms of training is trainining
provided as per Annual Training Report of 2016/2017
d. Classification legend:
▪ Legislators, Senior Officials Officials responsible for determining and formulating policy and strategy, planning,
and Managers: directing and coordinating the policies and activities of the organisation e.g CEOs,
Senior Managers, College Principals, etc.
▪ Professionals: Include officials whose main task require a high level of professional knowledge e.g.
Clinical Psychologists, Medical & Dental Practitioners, etc
▪ Technicians and Associate This group includes occupations whose main tasks require technical knowledge and
Professionals: experience e.g. Clinical Technologists, Industrial Technicians, Environmental Health
Officers, Professional Nurses, etc.
▪ Clerks: This group includes occupations whose tasks require the knowledge and experience
necessary to organise, store, compute and retrieve information e.g. Acounting Clerks,
Stores Officers, Administration Clerks
▪ Service Workers and Shop and This group includes occpations whose main tasks require the knowledge and
Market Sales Workers: experience necessary to provide personal and protective services e.g. Auxilairy
Services Officers (ward attendants), Emergency Care Practitioners, Firefighters, Food
Services Aids, etc.
▪ Craft and Related Trades This group includes occupations whose main tasks require the knowledge and
Workers: experience of skilled trades and handicrafts e.g. Clinical Photographers, plumbers,
electricians, etc.
▪ Plant and Machine Operators The main tasks of this occupational grouping involve the use of automated industrial
and Assemblers: machinery and equipment
e.g. Drivers, Tradesmans Aids, etc.
▪ Elementary Occupations: This group covers occupations which require relatively low / elementary levels of
knowledge and experience necessary to perform mostly simple and routine tasks,
involving the use of hand held tools and in some cases considerable physical effort,
and, with few exceptions, limited personal initiative and judgement e.g. Cleaners,
Groundsmen, etc.
Significant
improvements
in the quality of
financial statements
submitted to AGSA
Audit.
PART E
PART A:
FINANCIAL
INFORMATION
Audit General Report

Report of the Auditor-General to Gauteng Provincial Legislature on Vote
no. 4: Gauteng Department of Health
Report on the audit of the financial statements
Opinion
1. I have audited the financial statements of the Gauteng Department of Health set out on pages
218 to 319, which comprise the appropriation statement, the statement of financial position as at
31 March 2021, the statement of financial performance, statement of changes in net assets and
cash flow statement for the year then ended, as well as the notes to the financial statements,
including a summary of significant accounting policies.
2. In my opinion, the financial statements present fairly, in all material respects, the financial position
of the Gauteng Department of Health as at 31 March 2021, and its financial performance and cash
flows for the year then ended in accordance with the Modified Cash Standard (MCS) prescribed by
the National Treasury and the requirements of the Public Finance Management Act of South Africa
Act 1 of 1999 (PFMA) and the Division of Revenue Act of South Africa 4 of 2020 (Dora).
Basis for opinion
3. I conducted my audit in accordance with the International Standards on Auditing (ISAs). My

responsibilities under those standards are further described in the auditor-general’s responsibilities
for the audit of the financial statements section of my report.
4. I am independent of the department in accordance with the International Ethics Standards Board
for Accountants’ International code of ethics for professional accountants (including International
Independence Standards) (IESBA code) as well as other ethical requirements that are relevant to
my audit in South Africa. I have fulfilled my other ethical responsibilities in accordance with these
requirements and the IESBA code.
5. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis
for my opinion.
Emphasis of matters
6. I draw attention to the matters below. My opinion is not modified in respect of these matters.
Material uncertainties
7. With reference to note 19 to the financial statements, the department is the defendant in various
lawsuits. The ultimate outcome of the matters cannot presently be determined and no provision
for any liability that may result has been made in the financial statements.
Payables which exceeded voted funds to be surrendered
8. As disclosed in note 21.2 to the financial statements, payables of R1 899 257 000 exceeded the
payment term of 30 days, as required by treasury regulation 8.2.3. This amount, in turn, exceeded
the R1 139 525 000 of voted funds to be surrendered by R759 732 000 as per the statement of
financial performance. Therefore, the amount of R759 732 000 would have constituted unauthorised
expenditure had the amounts due been paid on time.
REPORT OF THE AUDITOR GENERAL

to the Gauteng Provincial Legislature on Vote no. 4: Gauteng Department of Health
Subsequent events
9. I draw attention to note 33 to the financial statements, which deals with subsequent events and,
specifically, the possible effects of the future implications of a fire incident that took place at the
Charlotte Maxeke Hospital, which caused substantial damage to assets and inventory and will
have an impact in the next financial year. My opinion is not modified in respect of this matter.
Other matter
10. I draw attention to the matter below. My opinion is not modified in respect of this matter.
Unaudited supplementary schedules
11. The supplementary information set out on pages 320 to 330 does not form part of the financial
statements and is presented as additional information. I have not audited these schedules and,
accordingly, I do not express an opinion on them.
Responsibilities of the accounting officer for the financial statements
12. The accounting officer is responsible for the preparation and fair presentation of the financial
statements in accordance with the MCS prescribed by the National Treasury and the requirements
of the PFMA and Dora, and for such internal control as the accounting officer determines is necessary
to enable the preparation of financial statements that are free from material misstatement, whether
due to fraud or error.
13. In preparing the financial statements, the accounting officer is responsible for assessing the
department’s ability to continue as a going concern, disclosing, as applicable, matters relating to
going concern and using the going concern basis of accounting unless the appropriate governance
structure either intends to liquidate the department or to cease operations, or has no realistic
alternative but to do so.
Auditor-general’s responsibilities for the audit of the financial statements
14. My objectives are to obtain reasonable assurance about whether the financial statements as a
whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s
report that includes my opinion. Reasonable assurance is a high level of assurance but is not
a guarantee that an audit conducted in accordance with the ISAs will always detect a material
misstatement when it exists. Misstatements can arise from fraud or error and are considered
material if, individually or in aggregate, they could reasonably be expected to influence the
economic decisions of users taken on the basis of these financial statements.
15. A further description of my responsibilities for the audit of the financial statements is included in
the annexure to this auditor’s report.

Report on the audit of the annual performance report
Introduction and scope
16. In accordance with the Public Audit Act 25 of 2004 (PAA) and the general notice issued in terms
thereof, I have a responsibility to report on the usefulness and reliability of the reported performance
information against predetermined objectives for the selected programme presented in the annual
performance report. I performed procedures to identify material findings but not to gather evidence
to express assurance.
17. My procedures address the usefulness and reliability of the reported performance information,
which must be based on the department’s approved performance planning documents. I have not
evaluated the completeness and appropriateness of the performance indicators included in the
planning documents. My procedures do not examine whether the actions taken by the department
enabled service delivery. My procedures do not extend to any disclosures or assertions relating to
the extent of achievements in the current year or planned performance strategies and information
in respect of future periods that may be included as part of the reported performance information.
Accordingly, my findings do not extend to these matters.
18. I evaluated the usefulness and reliability of the reported performance information in accordance
with the criteria developed from the performance management and reporting framework, as
defined in the general notice, for the following selected programme presented in the department’s
annual performance report for the year ended 31 March 2021:
Programmes Pages in the annual

performance report
Programme 2 – district health services 39 – 75
19. I performed procedures to determine whether the reported performance information was properly
presented and whether performance 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.
20. The material findings on the usefulness and reliability of the performance information of the
selected programme are as follows:
Programme 2 – district health services
Various indicators
21. The achievements below were reported in the annual performance report for the listed indicators.
However, supporting evidence provided differed materially from the reported achievement, while
in other instances I was unable to obtain sufficient appropriate audit evidence. This was due to
the lack of accurate and complete records. I was unable to confirm the reported achievements
by alternative means. Consequently, I was unable to determine whether any further adjustments
were required to these reported achievements.

No Performance indicator Reported achievement

1 Couple year protection rate 45,30%
2 Antenatal 1st visit before 20 weeks rate 63,30%
3 Maternal Mortality in facility Ratio 118,7
4 Mother postnatal visit within 6 days rate 75%
5 Immunisation under 1 year coverage 85%
6 Child under 5 years diarrhoea case fatality rate 2,70%
7 Severe acute malnutrition death under 5 years rate 9,20%
8 TB Rifampicin Resistant/MDR/pre-XDR treatment success rate 60,20%
9 Number of people tested for HIV 4 355 221
10 School Grade 1 learners screened (Quintile 1-5 public primary schools) 17 922
11 School Grade 8 learners screened (Quintile 1-5 public primary schools) 4944
12 Child under 5 years diarrhoea case fatality rate (District Hospitals) 2%
13 Child under 5 years pneumonia case fatality rate (District Hospitals) 1,80%
14 Severe acute malnutrition death under 5 years rate (District Hospitals) 22%
15 Death in facility under 5 years against live birth rate (District Hospitals) 0,74%
16 Neonatal (<28 days) death in facility rate 13,2
17 Maternal Mortality in facility ratio 69,8
18 ART adult remain on ART end of period 1115574
19 ART child under 15 remain in care rate end of period 21088
20 Infant PCR test positive around 10 weeks rate 0,69%
21 Measles 2nd dose coverage 77,80%
Various indicators
22. I was unable to obtain sufficient appropriate audit evidence that systems and processes were
established to enable consistent measurement and reliable reporting of performance against
the predetermined indicator definitions for the indicators listed below. This was due to limitations
placed on the scope of my work. I was unable to validate the existence of systems and processes
by alternative means.
No. Performance indicator Planned target Reported achievement

1 Ideal clinic status obtained rate 84,7% 89%
2 Ideal hospital status obtained 0% 16,7%
Various indicators
23. The achievements reported in the annual performance report differed materially from the supporting
evidence provided for the indicators listed below:
No. Performance indicator Reported achievement

1 All DS-TB Client Treatment Success Rate 83,50%
2 All DS-TB client Death Rate 7,40%
3 All DS-TB client LTF rate 8,70%

Other matters
24. I draw attention to the matters below.
Achievement of planned targets
25. Refer to the annual performance report on pages 39 to 75 for information on the achievement of
planned targets for the year and management’s explanations provided for the underachievement
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 21 to 23 of this
report.
Adjustment of material misstatements
26. I identified material misstatements in the annual performance report submitted for auditing. As
management subsequently corrected only some of the misstatements, I raised material findings
on the usefulness and reliability of the reported performance information. Those that were not
corrected are reported above.
Report on the audit of compliance with legislation
27. In accordance with the PAA and the general notice issued in terms thereof, I have a responsibility
to report material findings on the department’s compliance with specific matters in key legislation.
I performed procedures to identify findings but not to gather evidence to express assurance.
28. The material findings on compliance with specific matters in key legislation are as follows:
Procurement and contract management
29. Some of the goods and services of a transaction value above R500 000 were procured without
inviting competitive bids and deviations were approved by the accounting officer although it was
practical to invite competitive bids, as required by treasury regulations 16A6.1 and 16A6.4. Similar
non-compliance was also reported in the prior year.
30. Some of the contracts were awarded to bidders who did not submit a declaration on whether they
are employed by the state or connected to any person employed by the state, which is prescribed
in order to comply with treasury regulations 16A6.3(a). Similar non-compliance was also reported
in the prior year.
31. Some of the contracts were awarded to suppliers whose tax matters had not been declared by the
South African Revenue Service to be in order as required by treasury regulation 16A9.1(d).
32. The specifications of personal protective equipment (PPE) items procured did not comply with the
specifications prescribed by the Department of Health, as required by paragraph 3.7.6 of National
Treasury Instruction Note 8 of 2019/20.

33. The covid-19 PPE items procured through quotations were not in accordance with the specifications
of the national Department of Health and World Health Organisation, as required by paragraph 6.4
of National Treasury Instruction Note 3 of 2020/21.
34. The covid-19 PPE items procured through quotations were not in accordance with the specifications
of the national Department of Health and the World Health Organization, as required by paragraph
4.6 of National Treasury Instruction Note 5 of 2020/21.
35. The prices of COVID-19 PPE items were higher than the prescribed prices in annexure A of
national Treasury Instruction Note 8 of 2019/20, in contravention of paragraph 3.7.6 of same
instruction note.
36. The prices of covid-19 PPE items were higher than prescribed prices in annexure A of National
Treasury Instruction Note 3 of 2020/21, in contravention of paragraph 6.4 of same instruction note.
37. The prices of covid-19 PPE items were higher than the prescribed prices in annexure A of National
Treasury Instruction Note 5 of 2020/21, in contravention of paragraph 4.3 of same instruction note.
38. The COVID 19 PPE items through quotations were in excess of price prescribed on Annexure A as
required by paragraph 4.6 of National Treasury Instruction note No 5 of 2020/21.
39. The suppliers of PPE items were not listed on the central supplier database, as required by
paragraph 3.7.6 of National Treasury Instruction Note 8 of 2019/20.
40. The suppliers of covid-19 PPE items procured through the quotations were not registered on the
central supplier database as required by paragraph 6.4 of instruction note 3 of 2020/21.
41. The suppliers of covid-19 PPE items procured through the quotations were not registered on the
central supplier database as required by paragraph 4.6 of Instruction Note 5 of 2020/21.
42. The existing contracts for covid-19 PPE items were not honoured and the reason for not utilising
the contract was not justifiable in terms of paragraph 3.7.2 of National Treasury Instruction Note
8 of 2019/20.
43. In some instances the suppliers of COVID 19 PPE items were not registered with the Department
of Small Business Development as required by paragraph 4.6 (d) of National Treasury instruction
note 5 of 2020/21.
Expenditure management
44. Effective and appropriate steps were not taken to prevent irregular expenditure amounting to
R3 921 794 000, as disclosed in note 25.1 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 irregular expenditure
disclosed in the financial statements was caused by non-compliance with Treasury Regulations on
competitive bidding as well as procurement irregularities on the procurement of PPE.
45. Effective steps were not taken to prevent fruitless and wasteful expenditure amounting to R224
598 000, as disclosed in note 26.1 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 overcharging on the procurement of PPE.

46. Payments were not made within 30 days or an agreed period after receipt of an invoice, as required
by TR 8.2.3.
Consequence management
47. Disciplinary steps were not taken against the officials who had incurred and permitted irregular
expenditure, as required by section 38(1)(h)(iii) of the PFMA.
Strategic planning and performance management
48. Specific information systems were not implemented to enable the monitoring of progress made
towards achieving targets, core objectives and service delivery as required by public service
regulation 25(1)(e)(i) and (iii).
Other information
49. 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
programme presented in the annual performance report that have been specifically reported in
this auditor’s report
50. 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 on it.
51. 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 programme presented in the annual performance report, or my knowledge obtained
in the audit, or otherwise appears to be materially misstated.
52. When I do receive and read the other information, if I conclude that there is a material misstatement
therein, we are required to communicate the matter to those charged with governance and request
that the other information be corrected. If the other information is not corrected, I have to retract
the auditor’s report and re-issue an amended report as appropriate. However, if it is corrected this
will not be necessary.
Internal control deficiencies
53. 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.
54. 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
performance report. This resulted in non-compliance with key legislation and material findings on
the annual financial statements and annual performance report.

55. Senior management did not implement sufficient controls with regard to the preparation of an
accurate and complete annual performance report that is supported by reliable information. This
resulted in material findings on the annual performance report. Furthermore, there was a lack of
monitoring of controls to ensure compliance with laws and regulations, including procurement and
contract management and expenditure management.
Material irregularities
56. In accordance with the PAA and the Material Irregularity Regulations, I have a responsibility
to report on material irregularities identified during the audit and on the status of the material
irregularities reported in the previous year’s auditor’s report.
Material irregularities in progress
57. I identified a material irregularity during the audit and notified the accounting officer, as required
by material irregularity regulation 3(2). By the date of this auditor’s report, the response of the
accounting officer was not yet due. This material irregularity will be included in the next year’s
auditor’s report.
Status of previously reported material irregularities
Procurement of V-blocks IT infrastructure without inviting competitive bids
58. The R538 718 000 contract for V-blocks IT infrastructure was awarded during March 2015 without
inviting competitive bids, as required by treasury regulation 16A6.1.
59. An investigation that 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.
60. The accounting officer was notified of the material irregularity on 24 June 2019.
61. The following actions have been taken by the accounting officer to resolve the material irregularity,
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.
• Took disciplinary actions against two out of the three implicated officials on 3 April 2020 and
19 June 2020, where the officials were cautioned and given verbal warnings. The action
against the third official had not yet been finalised as the official did not agree with the
outcome of the initial process and requested a formal hearing in the presence of his attorney.
The formal hearing was subsequently held on 17 August 2021 and the matter is expected to
be finalised by 31 October 2021.
62. I will follow up on the finalisation of the formal disciplinary process for the remaining employee and
the progress of referrals by the accounting officer during my next audit.

Other reports
63. In addition to the investigations relating to material irregularities, I draw attention to the following
engagements conducted by various parties which 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.
64. 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 had been finalised while others were still in progress at the date of this auditor’s
report.
Johannesburg
31 August 2021
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 programme and on the department’s
compliance with respect to the selected subject matters.
Financial statements
65. 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 relating to events or conditions that
may cast significant doubt on the ability of the Gauteng Department of Health 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 my 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 operating as a going concern
• evaluate the overall presentation, structure and content of the financial statements, including
the disclosures, and determine whether the financial statements represent the underlying
transactions and events in a manner that achieves fair presentation.
Communication with those charged with governance
66. 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.
67. I also provide the accounting officer with a statement that I have complied with relevant ethical
requirements regarding independence, and to communicate with them all relationships and other
matters that may reasonably be thought to bear on my independence and, where applicable,
actions taken to eliminate threats or safeguards applied.
APPROPRIATION STATEMENT
218
for the year ended 31 March 2021

Appropriation per programme
2020/21 2019/20
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 2 405 845 - 1 292 000 3 697 845 3 695 016 2 829 99.9% 1 482 145 1 481 446
2 DISTRICT HEALTH SERVICES 18 896 930 - -530 319 18 366 611 17 959 247 407 364 97.8% 16 557 681 15 895 452
3 EMERGENCY MEDICAL SERVICES 1 586 670 - 94 700 1 681 370 1 680 801 569 100.0% 1 541 714 1 539 781
4 PROVINCIAL HOSPITAL SERVICES 9 945 440 - -3 161 9 942 279 9 905 850 36 429 99.6% 9 274 405 9 224 458
5 CENTRAL HOSPITAL SERVICES 19 676 222 - -63 589 19 612 633 19 254 052 358 581 98.2% 19 111 200 19 064 441
6 HEALTH SCIENCES AND TRAINING 979 639 - -78 371 901 268 787 210 114 058 87.3% 1 151 743 1 045 256
7 HEALTH CARE SUPPORT SERVICES 385 264 - 6 000 391 264 388 844 2 420 99.4% 369 788 368 944
8 HEALTH FACILITIES MANAGEMENT 4 959 493 - -717 260 4 242 233 4 041 357 200 876 95.3% 2 090 143 2 053 885
Programme sub total 58 835 503 - - 58 835 503 57 712 377 1 123 126 98.1% 51 578 819 50 673 663
TOTAL 58 835 503 - - 58 835 503 57 712 377 1 123 126 98.1% 51 578 819 50 673 663
Reconciliation with Statement of Financial Performance
Add:
Departmental receipts 513 787 728 245
Actual amounts per Statement of Financial Performance (Total 59 349 290 52 307 064
Actual amounts per Statement of Financial Performance
Revenue) 57 712 377 50 673 663
Expenditure
Appropriation per economic classification

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Current payments 52 072 208 491 689 - 552 511 52 011 386 51 575 685 435 701 99,2% 50 092 738 49 790 416
Compensation of employees 31 776 201 10 011 - 219 068 31 567 144 31 474 850 92 294 99,7% 32 207 011 31 816 217
Salaries and wages 27 208 328 10 011 - 194 068 27 024 271 27 754 918 - 730 647 102,7% 28 107 978 28 062 007
Social contributions 4 567 873 - - 25 000 4 542 873 3 719 932 822 941 81,9% 4 099 033 3 754 210
Goods and services 20 296 007 480 094 - 333 443 20 442 658 20 099 251 343 407 98,3% 17 884 363 17 971 818
Administrative fees 11 382 - - 11 382 11 945 - 563 104,9% 7 472 10 317
Advertising 32 706 - - 32 706 13 771 18 935 42,1% 7 181 4 112
Minor assets 89 702 - 242 - 89 460 39 640 49 820 44,3% 79 754 26 356
Audit costs: External 26 415 - - 26 415 25 489 926 96,5% 55 038 60 270
Bursaries: Employees 10 960 - - 10 960 8 992 1 968 82,0% 9 651 1 479
Catering: Departmental activities 21 879 - - 21 879 11 473 10 406 52,4% 6 393 5 840
Communication (G&S) 94 621 - 53 - 94 568 71 889 22 679 76,0% 103 702 60 021
Computer services 372 946 - - 372 946 271 752 101 194 72,9% 259 296 284 524
Consultants: Business and advisory services 503 352 - 1 591 - 501 761 352 948 148 813 70,3% 391 061 371 922
Infrastructure and planning services 654 199 - - 654 199 - - - - - -
Laboratory services 3 290 382 31 662 - 94 202 3 227 842 2 874 613 353 229 89,1% 2 732 387 2 683 236
Legal services 18 011 - 130 000 148 011 173 340 - 25 329 117,1% 17 072 135 885
Contractors 370 362 - 39 000 - 331 362 302 338 29 024 91,2% 353 914 314 434
Agency and support / outsourced services 275 179 - - 275 179 294 125 - 18 946 106,9% 278 561 316 757
Fleet services (including government motor transport) 207 563 - - 207 563 181 897 25 666 87,6% 269 175 175 594
Inventory: Clothing material and accessories - - - - 11 217 - 11 217 - - 1 566
Inventory: Food and food supplies 414 502 - - 414 502 317 673 96 829 76,6% 487 978 387 378
Inventory: Fuel, oil and gas 313 992 - - 313 992 278 186 35 806 88,6% 394 107 414 232
Inventory: Learner and teacher support material 1 732 - - 1 732 1 041 691 60,1% 1 833 3 544
Inventory: Materials and supplies 62 572 - 131 - 62 441 43 543 18 898 69,7% 49 798 30 167
Inventory: Medical supplies 3 524 539 20 242 95 000 3 639 781 4 365 954 - 726 173 120,0% 3 992 427 4 153 251
Inventory: Medicine 4 502 904 17 138 - 185 647 4 334 395 4 381 043 - 46 648 101,1% 4 576 641 4 467 735
Inventory: Other supplies 124 557 - - 124 557 112 084 12 473 90,0% 147 292 104 123
Consumable supplies 2 179 100 - 2 010 375 605 2 552 695 2 493 708 58 987 97,7% 502 722 461 165
Consumable: Stationery, printing and office supplies 205 549 - 160 - 205 389 141 840 63 549 69,1% 221 615 202 694
Operating leases 330 870 70 961 - 401 831 439 940 - 38 109 109,5% 297 403 293 080
Property payments 2 513 318 383 297 - 2 896 615 2 822 398 74 217 97,4% 2 523 913 2 952 774
Transport provided: Departmental activity 12 455 - - 12 455 437 12 018 3,5% 9 545 922
Travel and subsistence 57 980 - - 57 980 14 884 43 096 25,7% 42 470 25 848
Training and development 44 076 - 19 - 44 057 12 659 31 398 28,7% 45 559 12 909
Operating payments 19 303 - - 19 303 11 646 7 657 60,3% 11 015 4 411
Venues and facilities 6 164 - - 6 164 786 5 378 12,8% 8 054 3 887
Rental and hiring 2 735 - - 2 735 15 968 - 13 233 583,8% 1 334 1 385
219
220
Appropriation per economic classification

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Current payments 52 072 208 491 689 - 552 511 52 011 386 51 575 685 435 701 99,2% 50 092 738 49 790 416
Interest and rent on land
Compensation of employees 31 776 201
- 1 584
10 011 - 219 068
- 1 584
31 567 144
1 584
31 474 850
-
92 294
100,0%
99,7%
1 364
32 207 011
2 381
31 816 217
Salaries and wages
Interest (Incl. interest on unitary payments (PPP)) 27 208 328- 10 011- - 194 068- 27 024 271- 27 754 918- - 730 647
- 102,7%- 28 107 978
1 364 28 062 007
2 381
Social
Rent oncontributions
land 4 567 873- 1 584- - 25 000- 4 542 873
1 584 3 719 932
1 584 822 941
- 81,9%
100,0% 4 099 033- 3 754 210-
Goods and services 20 296 007 480 094 - 333 443 20 442 658 20 099 251 343 407 98,3% 17 884 363 17 971 818
Transfers and subsidies
Administrative fees 1 635
11 229
382 -- 169 872- 1 805
11 101
382 1 787
11 316
945 - 17 785
563 99,0%
104,9% 2 2727 605
472 2 319
10 190
317
Advertising
Provinces and municipalities 520 706
32 489 -- -- 520 706
32 489 520 771
13 489 18 935
- 42,1%
100,0% 181
7067 220 112
7054 394
Minor assets 89 702 - 242 - 89 460 39 640 49 820 44,3% 79 754 26 356
Municipalities
Audit costs: External
520 489
26 415
-- -- 520 489
26 415
520 489
25 489
-
926
100,0%
96,5%
706 220
55 038
705 394
60 270
Bursaries:
MunicipalEmployees
bank accounts 520 960
10 489 -- -- 520 960
10 489 992
5208 489 1 968
- 82,0%
100,0% 651
7069 220 479
7051 394
Catering: Departmental
Departmental agencies and activities
accounts 23 879
21 352 -- -- 23 879
21 352 23 473
11 352 10 406
- 52,4%
100,0% 393
226 135 840
225 135
Communication (G&S) 94 621 - 53 - 94 568 71 889 22 679 76,0% 103 702 60 021
Departmental
Computer services agencies 23 352
372 946 -- -- 23 352
372 946 23 352
271 752 -
101 194 100,0%
72,9% 22 135
259 296 22 135
284 524
Consultants:
Higher education Business and advisory services
institutions 503 352
15 459 - 1 591- -- 501 761
15 459 352 948
12 871 148 813
2 588 70,3%
83,3% 391 061
1 488 371 922
1 488
Non-profit institutions
Laboratory services
723 627
3 290 382 31 662
- -- 66 757
94 202
656 870
3 227 842
602 710
2 874 613
54 160
353 229
91,8%
89,1%
672 443
2 732 387
672 308
2 683 236
Legal services
Households 352 011
18 302 -- 236 000
130 629 588 011
148 931 627 340
173 894 -- 38 329
25 963 117,1%
106,6% 870 072
17 319 917 885
135 865
Contractors
Social benefits 370 362
99 157 - 39 000- -- 331 362
99 157 302 338
114 262 - 29 024
15 105 91,2%
115,2% 353 914
138 477 314 434
121 402
Agency and support / outsourced services 275 179 - - 275 179 294 125 - 18 946 106,9% 278 561 316 757
Other
Fleet transfers
services to households
(including government motor transport) 253
207 145
563 -- 236 629- 489
207 774
563 513
181 632
897 - 23
25 858
666 104,9%
87,6% 731
269 842
175 796
175 463
594
Inventory:
Payments for capital material and accessories
Clothingassets 5 128 066- - 491 715- 382 639- 5 018 990- 4 349 217
11 350 - 669 217
11 640 86,7%- 2 839 765- 566
2 0841 816
Inventory: Food and food supplies 414 502 - - 414 502 317 673 96 829 76,6% 487 978 387 378
Buildings and other fixed structures
Inventory: Fuel, oil and gas
3 119 183
313 992
- 455 053- - 63 061- 2 601 069
313 992
2 351 646
278 186
249 423
35 806
90,4%
88,6%
883 592
394 107
451 786
414 232
Inventory:
BuildingsLearner and teacher support material 732
3 1191 183 - 455 053- - 63 061- 732
2 6011 069 041
2 3511 646 691
249 423 60,1%
90,4% 833
8831 592 544
4513 786
Machinery
Inventory:and Materials and supplies
equipment 2 008 572
62 883 -- 131
36 662 445 700- 2 417 441
62 921 1 997 543
43 704 420 898
18 217 69,7%
82,6% 1 956 798
49 173 1 633 167
30 030
Inventory: Medical supplies 3 524 539 20 242 95 000 3 639 781 4 365 954 - 726 173 120,0% 3 992 427 4 153 251
Inventory: equipment
TransportMedicine 4 267
502 828
904 17 138- - 94 700
185 647 4 362
334 528
395 4 550
381 014
043 -- 187
46 486
648 151,7%
101,1% 4 265
576 976
641 4 362
467 012
735
Inventory: Other supplies
Other machinery and equipment 1 741 557
124 055 - 36 662- 351 000- 2 055 557
124 393 1 447 084
112 690 607 473
12 703 90,0%
70,4% 1 690 292
147 197 1 271 123
104 018
Consumable supplies 2 179 100 - 2 010 375 605 2 552 695 2 493 708 58 987 97,7% 502 722 461 165
Payment for financial assets
Consumable: Stationery, printing and office supplies 205 549
- -
26
160
-- 26
205 389
26
141 840
-
63 549
100,0%
69,1%
4 378
221 615
4 378
202 694
Operating leases 58 835 870
330 503 70 961- -- 58 835 831
401 503 57 712 940
439 377 - 1 123 109
38 126 109,5%
98,1% 55 209 403
297 486 54 198 080
293 800
Property payments 2 513 318 383 297 - 2 896 615 2 822 398 74 217 97,4% 2 523 913 2 952 774
Transport provided: Departmental activity 12 455 - - 12 455 437 12 018 3,5% 9 545 922
Travel and subsistence 57 980 - - 57 980 14 884 43 096 25,7% 42 470 25 848
Training and development 44 076 - 19 - 44 057 12 659 31 398 28,7% 45 559 12 909
Operating payments 19 303 - - 19 303 11 646 7 657 60,3% 11 015 4 411

Venues and facilities 6 164 - - 6 164 786 5 378 12,8% 8 054 3 887
Rental and hiring 2 735 - - 2 735 15 968 - 13 233 583,8% 1 334 1 385
Programme 1: ADMINISTRATION
2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 OFF OF THE MEC 24 043 - - 24 043 16 068 7 975 66.8% 19 789 17 051
2 MANAGEMENT 2 381 802 - 1 292 000 3 673 802 3 678 948 -5 146 100.1% 1 462 356 1 464 395
2 405 845 - 1 292 000 3 697 845 3 695 016 2 829 99.9% 1 482 145 1 481 446
Economic classification
Current payments 2 394 491 -7 650 000 3 044 484 2 940 737 103 747 96.6% 953 307 997 922
Compensation of employees 466 972 - - 466 972 442 839 24 133 94.8% 460 525 429 366
Salaries and wages 409 517 - - 409 517 385 885 23 632 94.2% 410 713 376 603
Social contributions 57 455 - - 57 455 56 954 501 99.1% 49 812 52 763
Goods and services 1 927 519 -1 591 650 000 2 575 928 2 496 314 79 614 96.9% 492 782 567 539
Administrative fees 4 617 - - 4 617 5 648 -1 031 122.3% 1 624 4 746
Advertising 14 200 - - 14 200 13 124 1 076 92.4% 2 749 2 391
Minor assets 811 - - 811 4 831 -4 020 595.7% 235 585
Audit costs: External 26 415 - - 26 415 25 462 953 96.4% 55 038 60 058
Bursaries: Employees - - - - 42 -42 - - -2
Catering: Departmental activities 4 750 - - 4 750 5 902 -1 152 124.3% 904 424
Communication (G&S) 28 684 - - 28 684 36 526 -7 842 127.3% 17 670 23 184
Computer services 342 590 - - 342 590 254 918 87 672 74.4% 229 334 269 495
Consultants: Business and advisory services 122 163 -1 591 - 120 572 40 322 80 250 33.4% 130 266 46 339
Laboratory services - - - - -525 525 - - -
Legal services 18 011 - 130 000 148 011 155 357 -7 346 105.0% 17 072 119 825
Contractors 3 150 - - 3 150 14 3 136 0.4% 397 40
Agency and support / outsourced services 1 500 - - 1 500 24 923 -23 423 1661.5% - 52
Entertainment - - - - - - - - -
Fleet services (including government motor transport) 2 910 - - 2 910 3 701 -791 127.2% 2 862 3 426
221
222
Programme 1: ADMINISTRATION
2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Inventory: Clothing material and accessories
Sub programme - - - - 8 708 -8 708 - - -
1 OFF Inventory:
OF THE MECFood and food supplies 24 043
33 - - 24 043
33 16 068
3 7 975
30 66.8%
9.1% 19 789
31 17 051
16
2 MANAGEMENT 2 381 802- - 1 292 000- 3 673 802- 3 678 948
48 -5 146
-48 100.1%
- 1 462 356- 1 464 395-
Inventory: Materials and supplies 20
2 405 845 -- 1 292 000- 20
3 697 845 36
3 695 016 -16
2 829 180.0%
99.9% 42
1 482 145 6
1 481 446
Inventory: Medical supplies 94 130 - 121 000 215 130 219 234 -4 104 101.9% - -392
Inventory: Medicine - - - - - - - 4 595 4 610
Economic classification - - - - 10 905 -10 905 - - 22
Consumable
Current supplies
payments 2
1 394 664
229 491 -7- 650
399 000 3
1 044 664
628 484 2
1 940 902
628 737 103-238
747 100.0%
96.6% 953 772
307 997 601
922
Compensation
Consumable: of employees
Stationery, printing and office supplies 466 972
3 336 - - 466 972
3 336 442 839
1 827 241 133
509 94.8%
54.8% 460 525
3 793 429 366
1 891
Salaries leases
Operatingand wages 16 893
409 517 - - 16 893
409 517 25 380
385 885 23 487
-8 632 150.2%
94.2% 7 566
410 713 18 499
376 603
Property
Social payments
contributions 895
576 455 - - 895
576 455 518
12 954
56 -5 623
501 181.6%
99.1% 536
496 812 056
527 763
Transport
Goods provided: Departmental activity
and services 1 927 519- -1 591- 650 000- 2 575 928- 2 496 314- 79 614- -
96.9% 2
492 782 567 539-
Travel and subsistence
Administrative fees 787
5 617
4 - - 4 787
5 617 476
2 648
5 -1 311
3 031 42.8%
122.3% 977
6 624
1 4 207
3 746
Training and development
Advertising 14 200- - - 14 200- 230
13 124 1 -230
076 -
92.4% 209
1 749
2 16
2 391
Operating
Minor payments
assets 811- - - 811- 107
4 831 -4 -107
020 -
595.7% 235- 40
585
Venues
Audit and facilities
costs: External 690
26 415 - - 690
26 415 25 462- 690
953 -
96.4% 804
552 038 180
601 058
hiring
Rental and Employees
Bursaries: 270- - - 270- 15 695
42 -15 425
-42 5813.0%
- 304- 224
-2
Interest
Catering:
andDepartmental
rent on land activities 4 750- 1 584- - 584
1 750
4 584
1 902
5 -1 152- 100.0%
124.3% 904- 1 017
424
Interest (Incl. interest
Communication (G&S)on unitary payments (PPP)) 28 684- - - 28 684- 36 526- -7 842- -
127.3% 17 670- 017
231 184
Rent on land
Computer services 342 590- 1 584- - 1 584
342 590 1 584
254 918 87 672- 100.0%
74.4% 229 334- 269 495-
Consultants:
Transfers Business and advisory services
and subsidies 122 163
2 729 -1 591- 291 000- 120
293 572
729 40 322
395 238 80 250
-101 509 33.4%
134.6% 130
512 266
587 46 339
470 415
Households
Laboratory services 2 729- - 291 000- 293 729- 238
395-525 509
-101 525 134.6%
- 512 587- 470 415-
Social
Legal benefits
services 196
181 011 - 130 000- 1 196
148 011 3 477
155 357 281
-2 346
-7 290.7%
105.0% 489
28 072
17 7 551
119 825
Other transfers to households
Contractors 533
1 150
3 - 291 000- 292 533
3 150 391 761
14 -993 228
136 133.9%
0.4% 098
484 397 462 864
40
Payments
Agencyfor capital
and supportassets
/ outsourced services 8 500
1 625 - 351 000- 359 625
1 500 359 034
24 923 591
-23 423 99.8%
1661.5% 16 144- 13 002
52
Machinery and equipment
Entertainment 8 625- - 351 000- 359 625- 359 034- 591- 99.8%
- 16 144- 13 002-
Transport
Fleet equipment
services (including government motor transport) 2 910- - - 2 910- 3 701- -791- -
127.2% 28
2 862 3 426-
Other machinery and equipment 8 625 - 351 000 359 625 359 034 591 99.8% 16 116 13 002
Payment for financial assets - 7 - 7 7 - 100.0% 107 107
2 405 845 - 1 292 000 3 697 845 3 695 016 2 829 99.9% 1 482 145 1 481 446
Subprogramme: 1.1: OFF OF THE MEC

2020/21 2019/20
appropriation
Economic classification R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Current payments 23 843 - - 23 843 15 317 8 526 64.2% 19 631 13 763
Salaries and wages 16 785 16 785 10 636 6 149 63.4% 13 173 9 317
Social contributions 1 104 1 104 1 325 -221 120.0% 784 1 045
Goods and services 5 954 - - 5 954 3 356 2 598 56.4% 5 674 3 401
Administrative fees 50 50 1 49 2.0% 114 16
Advertising - - 1 -1 - - -
Minor assets 100 100 2 98 2.0% 35 428
Catering: Departmental activities 250 250 30 220 12.0% 206 204
Communication (G&S) 380 380 87 293 22.9% 320 318
Contractors - - 11 -11 - - -
Fleet services (including government motor transport) 350 350 260 90 74.3% 435 363
Inventory: Food and food supplies 33 33 3 30 9.1% 31 7
Inventory: Materials and supplies - - - - - - 1
Inventory: Medical supplies - - 11 -11 - - -
Inventory: Medicine - - - - - - 15
Medsas inventory interface - - - - - - -
Inventory: Other supplies - - - - - - 3
Consumable supplies 75 75 9 66 12.0% 71 62
Consumable: Stationery, printing and office supplies 50 50 109 -59 218.0% 534 27
Operating leases 1 988 1 988 1 928 60 97.0% 1 042 1 721
Property payments - - 855 -855 - - 4
Transport provided: Departmental activity - - - - - - -
Travel and subsistence 2 468 2 468 49 2 419 2.0% 2 687 231
Venues and facilities 190 190 - 190 - 180 3
Rental and hiring 20 20 - 20 - 19 -
Transfers and subsidies - - - - 697 -697 - - 3 108
Households - - - - 697 -697 - - 3 108
Social benefits - 697 -697 - - 3 104
Other transfers to households - - - - 4
Payments for capital assets 200 - - 200 54 146 27.0% 158 180
Machinery and equipment 200 - - 200 54 146 27.0% 158 180
Transport equipment - - - - - - - -
Other machinery and equipment 200 200 54 146 27.0% 158 180
Total 24 043 - - 24 043 16 068 7 975 66.8% 19 789 17 051
223
224
Subprogramme: 1.2: MANAGEMENT

2020/21 2019/20
appropriation
Current payments 2 370 648 -7 650 000 3 020 641 2 925 420 95 221 96.8% 933 676 984 159
Social contributions 56 351 56 351 55 629 722 98.7% 49 028 51 718
Goods and services 1 921 565 -1 591 650 000 2 569 974 2 492 958 77 016 97.0% 487 108 564 138
Administrative fees 4 567 4 567 5 647 -1 080 123.6% 1 510 4 730
Advertising 14 200 14 200 13 123 1 077 92.4% 2 749 2 391
Minor assets 711 711 4 829 -4 118 679.2% 200 157
Audit costs: External 26 415 26 415 25 462 953 96.4% 55 038 60 058
Bursaries: Employees - - 42 -42 - - -
Catering: Departmental activities 4 500 4 500 5 872 -1 372 130.5% 698 220
Communication (G&S) 28 304 28 304 36 439 -8 135 128.7% 17 350 22 866
Computer services 342 590 342 590 254 918 87 672 74.4% 229 334 269 495
Consultants: Business and advisory services 122 163 -1 591 120 572 40 322 80 250 33.4% 130 266 46 339
Laboratory services - - -525 525 - - -
Scientific and technological services - - - - - - -
Legal services 18 011 130 000 148 011 155 357 -7 346 105.0% 17 072 119 825
Contractors 3 150 3 150 3 3 147 0.1% 397 40
Agency and support / outsourced services 1 500 1 500 24 923 -23 423 1661.5% - 52
Entertainment - - - - - - -
Fleet services (including government motor transport) 2 560 2 560 3 441 -881 134.4% 2 427 3 063
Subprogramme: 1.2: MANAGEMENT

2020/21 2019/20
appropriation
Current payments
Inventory: Clothing material and accessories 2 370 648- -7 650 000 3 020 641- 2 925 420
8 708 95 221
-8 708 96.8%
- 933 676- 984 159-
Compensation
Inventory: Food employees
of and food supplies 449 083- - - 449 083- 430 878- 18 205- 95.9%
- 446 568- 419 004
9
Salaries and
Inventory: wages
Fuel, oil and gas 392 732- 392 732- 375 249
48 17 483
-48 95.5%
- 397 540- 367 286-
Social contributions
Inventory: Materials and supplies 56 351
20 56 351
20 55 629
36 722
-16 98.7%
180.0% 49 028
42 51 718
5
Goods and services
Inventory: Medical supplies 1 921 565
94 130 -1 591 121
650 000 2 215 974
569 130 2 219 958
492 223 77 016
-4 093 97.0%
101.9% 487 108- 138
564-392
Administrative
Inventory: fees
Medicine 4 567- 4 567- 5 647- -1 080- 123.6%
- 4 510
1 595 730
4 595
Advertising
Medsas inventory interface 14 200- 14 200- 13 123- 1 077- 92.4%
- 2 749- 2 391-
Minor assets
Inventory: Other supplies 711- 711- 10 829
4 905 -10 118
-4 905 679.2%
- 200- 157
19
Audit costs: External
Consumable supplies 1 229 415
26 589 399 000 1 628 415
26 589 1 628 462
25 893 953
-304 96.4%
100.0% 038
55 701 058
60 539
Bursaries: Employees
Consumable: Stationery, printing and office supplies 3 286- 3 286- 42
1 718 -42
1 568 -
52.3% 3 259- 1 864-
Operating leases activities 14 500
4 905 14 500
4 905 23 872
5 452 -8 372
-1 547 130.5%
157.3% 698
6 524 220
16 778
Communication
Property payments(G&S) 28 304
6 895 28 304
6 895 11 439
36 663 -4 135
-8 768 128.7%
169.2% 17 350
6 536 22 866
7 052
Transport
Computer provided:
services Departmental activity 342 590- 342 590- 254 918- 87 672- 74.4%
- 229 334
2 269 495-
Consultants:
Travel Business and advisory services
and subsistence 122 163
3 319 -1 591 120 572
3 319 40 322
2 427 250
80 892 33.4%
73.1% 130 266
4 290 46 339
2 976
Laboratory
Training andservices
development - - -525
230 525
-230 - 1 209- 16-
Scientific and
Operating technological services
payments - - 107- -107- - - 40-
Legal services
Venues and facilities 011
18 500 130 000 011
148 500 155 357- 346
-7 500 105.0%
- 17 072
2 624 119 825
1 177
Contractors
Rental and hiring 150
3 250 150
3 250 3
15 695 -15 147
3 445 0.1%
6278.0% 397
285 40
224
Interest
Agencyand support
andrent / outsourced services
on land 1 500- 1 584 - 500
1 584 24 923
1 584 -23 423- 1661.5%
100.0% - 52
1 017
Entertainment
Interest (Incl. interest on unitary payments (PPP)) - - - - - - 1 017-
Rent services
Fleet on land (including government motor transport) 2 560 1 584 1 560
2 584 1 441
3 584 -881- 134.4%
100.0% 2 427- 3 063
Transfers and subsidies 2 729 - 291 000 293 729 394 541 -100 812 134.3% 512 587 467 307
Households 2 729 - 291 000 293 729 394 541 -100 812 134.3% 512 587 467 307
Social benefits 1 196 1 196 2 780 -1 584 232.4% 28 489 4 447
Other transfers to households 1 533 291 000 292 533 391 761 -99 228 133.9% 484 098 462 860
Payments for capital assets 8 425 - 351 000 359 425 358 980 445 99.9% 15 986 12 822
Machinery and equipment 8 425 - 351 000 359 425 358 980 445 99.9% 15 986 12 822
Transport equipment - - - 28 -
Other machinery and equipment 8 425 351 000 359 425 358 980 445 99.9% 15 958 12 822
Payment for financial assets 7 - 7 7 - 100.0% 107 107
Total 2 381 802 - 1 292 000 3 673 802 3 678 948 -5 146 100.1% 1 462 356 1 464 395
225
226
Programme 2: DISTRICT HEALTH SERVICES

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 DISTRICT MANAGEMENT 741 510 - - 741 510 826 373 - 84 863 111,4% 3 630 667 3 525 137
2 COMMUNITY HEALTH CLINICS 2 755 945 - - 136 130 2 619 815 2 475 289 144 526 94,5% 690 759 676 273
3 COMMUNITY HEALTH CENTRES 2 383 319 - - 193 818 2 189 501 2 064 122 125 379 94,3% 2 502 946 2 365 449
4 COMMUNITY BASED SERVICES 2 379 878 - - 2 379 878 2 445 328 - 65 450 102,8% 2 118 456 1 970 765
5 HIV/AIDS 6 167 521 - - 6 167 521 5 986 583 180 938 97,1% 2 310 909 2 191 503
6 NUTRITION 65 115 - - 60 524 4 591 4 591 - 100,0% 4 984 690 4 862 623
7 CORONER SERVICES 283 549 - - 18 000 265 549 263 857 1 692 99,4% 58 627 58 586
8 DISTRICT HOSPITALS 4 120 093 - - 121 847 3 998 246 3 893 104 105 142 97,4% 260 627 245 116
18 896 930 - - 530 319 18 366 611 17 959 247 407 364 97,8% 16 557 681 15 895 452
2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
5 L{ ÇwL/ Ç
1 Current a ! b ! D9 a 9 b Ç
payments 17 727 510
741 507 -16- -463 562- 17 263 510
741 929 16 896 373
826 832 -84 863
367 097 111.4%
97.9% 183 986 667
630 980 183 425 137
525 937
2 / h Compensation
a a Üb LÇò I 9 !of[ ÇI / [ Lb L/ {
employees 102 300 945
755 342 -3 989- -195 130
-136 068 102 101 815
619 285 102 019 289
475 369 144 526
81 916 94.5%
99.2% 11 646 759
690 704 11 402 273
676 148
3 / h aSalaries
a Üb LÇòand
I 9!wages
[ ÇI / 9b Çw9{ 82 764 319
383 170 -3 989- -174 818
-193 068 82 586 501
189 113 82 744 122
064 767 -158 379
125 654 94.3%
101.8% 102 130 946
502 400 92 969 449
365 741
4 / h aSocial
a Üb LÇcontributions
ò . ! { 95 { 9wëL/ 9{ 12 536 878
379 172 - -21 000- 12 515 878
379 172 12 274 328
445 602 -65 450
240 570 102.8%
84.1% 12 516 456
118 304 1 432 765
970 407
Goods
5 I Lë4! L5{ and services 76 427 521
167 165 3 973- -268 494- 76 162 521
167 644 65 877 583
986 463 285 938
180 181 97.1%
96.0% 72 340 909
310 276 72 023 503
191 789
6 b ÜÇAdministrative
wLÇLh b fees 65 115
1 708 - -60 524- 591
14 708 591
14 207 501- 100.0%
70.7% 4 984 690
1 951 4 862 623
1 371
Advertising
7 / h wh b 9w{ 9wëL/ 9{ 283 549
15 730 - -18 000- 265 549
15 730 857
263 198 692
151 532 99.4%
1.3% 58 627
1 006 58 586
674
8 5L{ ÇMinor
wL/ ÇI assets
h { t LÇ! [ { 4 120 093
30 734 - -121 847
- 3 998 246
30 734 3 893 104
10 508 105 142
20 226 97.4%
34.2% 260 627
42 047 245 116
9 198
Catering: Departmental activities 16 236
18 896 930 -- -
-530 319 16 236
18 366 611 5 035
17 959 247 11 201
407 364 31.0%
97.8% 4 792
16 557 681 5 079
15 895 452
Communication (G&S) 28 895 -53 - 28 842 13 173 15 669 45.7% 49 526 17 253
Computer services 50 - - 50 721 -671 1442.0% 350 348
Consultants: Business and advisory services 5 601 - - 5 601 10 631 -5 030 189.8% 41 017 3 095
Infrastructure and planning services - - - - - - - - -
Laboratory services 1 737 150 - -94 202 1 642 948 1 631 763 11 185 99.3% 1 356 762 1 537 055
Scientific and technological services - - - - - - - - -
Legal services - - - - 1 283 -1 283 - - 4 198
Contractors 79 662 - - 79 662 82 960 -3 298 104.1% 104 078 62 693
Agency and support / outsourced services 53 695 - - 53 695 32 247 21 448 60.1% 76 775 60 746
Fleet services (including government motor transport) 50 880 - - 50 880 31 064 19 816 61.1% 63 432 37 798
Inventory: Clothing material and accessories - - - - 1 342 -1 342 - - 1 469
Inventory: Food and food supplies 74 089 - - 74 089 48 481 25 608 65.4% 134 555 94 851
Inventory: Fuel, oil and gas 94 197 - - 94 197 67 382 26 815 71.5% 141 099 160 914
Inventory: Learner and teacher support material - - - - - - - - 2 448
Inventory: Materials and supplies 24 782 -131 - 24 651 12 725 11 926 51.6% 30 264 8 982
Inventory: Medical supplies 645 946 - -26 000 619 946 533 617 86 329 86.1% 743 402 661 500
Inventory: Medicine 3 183 771 5 138 -118 897 3 070 012 3 329 445 -259 433 108.5% 3 373 534 3 325 775
227
228

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme 30 075 - - 30 075 24 249 5 826 80.6% 61 092 29 581
Consumable
1 5 L{ ÇwL supplies
/ Ç a ! b ! D9 a 9bÇ 741 465
492 510 -10
- -29 395- 741 060
463 510 826 838
363 373 -84 222
99 863 78.6%
111.4% 3 630 885
171 667 3 525 347
151 137
2 / h a Consumable:
a Üb LÇò I 9 ! Stationery,
[ ÇI / [ Lb L/ printing
{ and office supplies 85 416
2 755 945 -160- -136 130- 85 256
2 619 815 49 415
2 475 289 35 841
144 526 58.0%
94.5% 690 685
122 759 99 843
676 273
3 / h a Operating
a Üb LÇò I leases
9! [ ÇI / 9b Çw9{ 80 026
2 383 319 -795- -193 818- 79 231
2 189 501 70 888
2 064 122 8 343
125 379 89.5%
94.3% 81 482
2 502 946 93 844
2 365 449
4 / h a Property
a Üb LÇòpayments
. ! { 95 { 9wëL/ 9{ 2 379 093
616 878 - - 2 379 093
616 878 2 445 189
536 328 -65 904
79 450 87.0%
102.8% 2 118 126
686 456 1 970 016
636 765
5 I Lë4Transport
! L5{ provided: Departmental activity 5 740
6 167 521 - - 5 740
6 167 521 264
5 986 583 5 476
180 938 4.6%
97.1% 4 409
2 310 909 604
2 191 503
Travel
6 b ÜÇwL ÇLh band subsistence 65 364
37 115 - -60 524- 37
4 364
591 4 540
6 591 30 824- 17.5%
100.0% 16 047
4 984 690 5 703
4 862 623
Training
7 / h wh b 9w{ 9wëL
and /development
9{ 20 537
283 549 -16
- -18 000- 20 521
265 549 7 121
263 857 13
1 400
692 34.7%
99.4% 58 893
23 627 590
588 586
Operating
8 5L{ ÇwL/ ÇI h { t payments
LÇ! [ { 10 244
4 120 093 - -121 847- 10 244
3 998 246 4 310
3 893 104 5 934
105 142 42.1%
97.4% 3 427
260 627 245 444
116
Venues and facilities 4 114
18 896 930 -- -530 319- 4 114
18 366 611 17 959 786
247 3 328
407 364 19.1%
97.8% 4 590
16 557 681 2 361
15 895 452
Rental and hiring 1 965 - - 1 965 81 1 884 4.1% 50 9
Transfers and subsidies 881 756 - -66 757 814 999 760 127 54 872 93.3% 816 246 816 396
Provinces and municipalities 445 569 - - 445 569 445 569 - 100.0% 405 085 404 259
Provinces 445 569 - - 445 569 445 569 - 100.0% - -
Provincial Revenue Funds 92 000 - - 92 000 92 000 - 100.0% - -
Provincial agencies and funds 353 569 - - 353 569 353 569 - 100.0% - -
Municipalities - - - - - - - 405 085 404 259
Municipal bank accounts - - - - - - - 405 085 404 259
Non-profit institutions 406 627 - -66 757 339 870 285 710 54 160 84.1% 372 443 372 308
Households 29 560 - - 29 560 28 848 712 97.6% 38 718 39 829
Social benefits 29 560 - - 29 560 28 834 726 97.5% 38 718 39 187
Other transfers to households - - - - 14 -14 - - 642
Payments for capital assets 287 667 - - 287 667 302 272 -14 605 105.1% 383 399 176 533
Machinery and equipment 287 667 - - 287 667 302 272 -14 605 105.1% 383 399 176 533
Transport equipment 50 814 - - 50 814 56 748 -5 934 111.7% 68 017 60 091
Other machinery and equipment 236 853 - - 236 853 245 524 -8 671 103.7% 315 382 116 442
Payment for financial assets - 16 - 16 16 - 100.0% 1 723 1 723
18 896 930 - -530 319 18 366 611 17 959 247 407 364 97.8% 20 188 348 19 420 589
Subprogramme: 2.1: DISTRICT MANAGEMENT

2020/21 2019/20
appropriation
Current payments 687 482 -16 - 687 466 767 125 -79 659 111.6% 3 560 045 3 467 126
Compensation of employees 519 131 - - 519 131 617 022 -97 891 118.9% 2 599 136 2 613 141
Salaries and wages 471 243 471 243 560 671 -89 428 119.0% 2 232 977 2 264 960
Social contributions 47 888 47 888 56 351 -8 463 117.7% 366 159 348 181
Goods and services 168 351 -16 - 168 335 150 103 18 232 89.2% 960 909 853 985
Advertising 200 200 50 150 25.0% 331 5
Minor assets 2 091 2 091 848 1 243 40.6% 10 833 2 509
Catering: Departmental activities 1 180 1 180 2 687 -1 507 227.7% 300 4
Communication (G&S) 6 321 6 321 2 862 3 459 45.3% 9 998 3 538
Computer services - - 721 -721 - - -
Consultants: Business and advisory services 185 185 4 181 2.2% 221 216
Infrastructure and planning services - - - - - - -
Laboratory services 100 100 - 100 - 120 622 120 396
Legal services - - - - - - 2 021
Contractors 1 459 1 459 1 133 326 77.7% 24 791 11 896
Agency and support / outsourced services 40 40 95 -55 237.5% 26 980 24 337
Fleet services (including government motor transport) 22 535 22 535 13 939 8 596 61.9% 14 905 4 852
Housing - - - - - - -
Inventory: Clothing material and accessories - - 226 -226 - - 654
Inventory: Farming supplies - - - - - - -
Inventory: Food and food supplies 1 327 1 327 1 269 58 95.6% 56 118 40 217
229
230
Subprogramme: 2.1: DISTRICT MANAGEMENT

2020/21 2019/20
appropriation
Inventory:
Current Fuel, oil and gas
payments 4 350
687 482 -16 - 4 350
687 466 4 855
767 125 -79-505
659 111.6%
111.6% 55 261
3 560 045 68 238
3 467 126
Inventory: Learner
Compensation and teacher support material
of employees 519 131- - - 519 131- 617 022- -97 891- -
118.9% 2 599 136- 1 224
2 613 141
Inventory: Materials
Salaries and wages and supplies 7 035
471 243 7 035
471 243 3 384
560 671 3 651
-89 428 48.1%
119.0% 10 279
2 232 977 2 914
2 264 960
Inventory: Medical supplies
Social contributions 15
47 732
888 15
47 732
888 32
56 229
351 -16
-8 497
463 204.9%
117.7% 214
366 682
159 202
348 323
181
Inventory:
Goods Medicine
and services 5
168 351 -16 - 5
168 335 -28
150 103 33
18 232 (560.0%)
89.2% 118
960 951
909 115
853 849
985
Medsas inventory
Administrative feesinterface 335- 335- 49- 286- -
14.6% 752- 591-
Inventory:
AdvertisingOther supplies 4 624
200 4 624
200 3 808
50 816
150 82.4%
25.0% 25 430
331 11 008
5
Consumable
Minor assets supplies 16
2 519
091 16
2 519
091 8 314
848 8
1 205
243 50.3%
40.6% 58
10 678
833 58
2 179
509
Consumable:
Catering: Departmental printing and office supplies
Stationery,activities 14
1 078
180 14
1 078
180 16
2 658
687 -2
-1 580
507 118.3%
227.7% 27 193
300 19 792
4
Operating
Communication
leases(G&S) 26
6 860
321 26
6 860
321 27
2 865
862 -1
3 005
459 103.7%
45.3% 19
9 782
998 22
3 493
538
Property
Computerpayments
services 28 957- 28 957- 25 645
721 312
3-721 88.6%
- 157 128- 139 996-
Transport provided:
Consultants: Departmental
Business activity
and advisory services 250
185 250
185 4- 250
181 -
2.2% 1 731
221 18
216
Infrastructure and planning services 12 913- 12 913- 3 098- 9 815- 24.0%
- 2 453- 336-
Training
Laboratory development
andservices 1 205
100 -16 1 189
100 366- 823
100 30.8%
- 2 083
120 622 120 227
396
Operating payments
Legal services - - 1- -1- - 1 407- 2 152
021
Rental and hiring
Contractors 50
1 459 50
1 459 25
1 133 25
326 50.0%
77.7% 24 791- 11 896-
Transfers
Agencyand subsidies
and support / outsourced services 2 944
40 - - 2 944
40 3 214
95 -270
-55 109.2%
237.5% 8 992
26 980 8 364
24 337
Entertainment - - - - - - 16-
Households
Fleet services (including government motor transport) 2 944
22 535 - - 2 944
22 535 3 214
13 939 8-270
596 109.2%
61.9% 8 992
14 905 8
4 348
852
Social benefits
Housing 2 944- 2 944- 3 214- -270- 109.2%
- 8 992- 8 348-
Other transfers
Inventory: Clothing households
tomaterial and accessories - - 226 -226- - - 654
Payments
Inventory: capital assets
for Farming supplies 51 084- - - 51 084- 56 018- -4 934- 109.7%
- 61 250- 49 267-
Machinery
Inventory:and equipment
Food and food supplies 51
1 084
327 - - 51
1 084
327 56
1 018
269 -4 934
58 109.7%
95.6% 61
56 250
118 49
40 267
217
Transport equipment 40 229 40 229 49 237 -9 008 122.4% 7 200 7 129
Other machinery and equipment 10 855 10 855 6 781 4 074 62.5% 54 050 42 138
Payment for financial assets 16 16 16 - 100.0% 380 380
Total 741 510 - - 741 510 826 373 -84 863 111.4% 3 630 667 3 525 137
Subprogramme: 2.2: COMMUNITY HEALTH CLINICS

2020/21 2019/20
appropriation
Current payments 2 364 729 - -129 897 2 234 832 2 099 990 134 842 94.0% 635 175 633 631
Compensation of employees 1 393 029 - -50 000 1 343 029 1 352 785 -9 756 100.7% 506 796 481 555
Salaries and wages 1 166 012 -30 000 1 136 012 1 148 471 -12 459 101.1% 462 484 425 204
Social contributions 227 017 -20 000 207 017 204 314 2 703 98.7% 44 312 56 351
Goods and services 971 700 - -79 897 891 803 747 205 144 598 83.8% 128 379 152 076
Administrative fees - - - - - 130 7
Advertising - - - - - 250 81
Minor assets 3 252 3 252 2 127 1 125 65.4% 2 263 347
Catering: Departmental activities - - - - - 700 91
Consultants: Business and advisory services - - - - - - 22
Laboratory services 172 583 172 583 168 351 4 232 97.5% - -
Legal services - - 287 -287 - - -
Contractors 2 413 2 413 1 278 1 135 53.0% 2 605 24
Agency and support / outsourced services 8 080 8 080 1 325 6 755 16.4% 135 74
Fleet services (including government motor transport) 840 840 4 836 0.5% 14 550 16 475
Inventory: Fuel, oil and gas 4 262 4 262 1 946 2 316 45.7% 2 200 3 082
Inventory: Learner and teacher support material - - - - - - -
Inventory: Materials and supplies 4 884 4 884 1 705 3 179 34.9% 1 426 650
Inventory: Medical supplies 51 621 51 621 18 673 32 948 36.2% 15 594 28 504
Inventory: Medicine 492 731 -79 897 412 834 352 294 60 540 85.3% - -
Inventory: Other supplies 2 899 2 899 1 491 1 408 51.4% 2 100 4 177
231
232
Subprogramme: 2.2: COMMUNITY HEALTH CLINICS

2020/21 2019/20
appropriation
Consumable
Current supplies
payments 2 364 692
13 729 - -129 897 2 234 692
13 832 2 099 997
11 990 134 695
1 842 87.6%
94.0% 635 424
8 175 633 837
6 631
Compensation Stationery,
Consumable: of employeesprinting and office supplies 1 393 008
8 029 - -50 000 1 343 008
8 029 1 352 422
4 785 -9 586
3 756 55.2%
100.7% 506 723
15 796 481 436
22 555
Salaries leases
Operatingand wages 1 166 465
1 012 -30 000 1 136 465
1 012 1 148 471 994
-12 459 32.2%
101.1% 462 292
29 484 425 575
27 204
Property
Social payments
contributions 227 051
198 017 -20 000 207 051
198 017 204 101
178 314 19 950
2 703 89.9%
98.7% 44 048
22 312 56 099
37 351
Transport
Goods provided: Departmental activity
and services 971 700- - -79 897 891 803- 747 205- 144 598- -
83.8% 250
128 379 16
152 076
Administrative fees 465- 465- 32- 433- 6.9%
- 945
2 130 1 299
7
Advertising 190- 190- - 190- - 292
1 250 117
81
Operating
Minor payments
assets 3 252- 3 252- 2 127- 1 125- -
65.4% 50
2 263 347-
Venues and
facilities activities - - - - - 700- 1
91
Communication (G&S) 373 412
6 154 - -6 233 367 179
6 154 367 150
2 531 29
3 623 100.0%
41.1% 5 100
2 573 369
2 933
Provinces and municipalities
Consultants: Business and advisory services 353 569- - - 353 569- 353 569- - 100.0%
- - 22-
Laboratory
Provincesservices 172 569
353 583 - - 172 569
353 583 168 569
353 351 4 232- 100.0%
97.5% - -
LegalProvincial
services Revenue Funds - - 287 -287- - - -
Provincial agencies and funds
Contractors 353 569
2 413 353 569
2 413 353 569
1 278 1 135- 100.0%
53.0% 2 605- 24
Non-profit
Agency andinstitutions
support / outsourced services 14 826
8 080 -6 233 593
8 080 1 593
8 325 6 755- 100.0%
16.4% 135 74
Households
Fleet services (including government motor transport) 017
5 840 - - 017
5 840 4 988
4 29
836 99.4%
0.5% 14 100
2 550 16 369
2 475
Social benefits
Inventory: Clothing material and accessories 5 017- 5 017- 4 988
80 29
-80 99.4%
- 2 100- 2 218
3
Other transfers
Inventory: Farming households
tosupplies - - - - - - 151-
Payments
Inventory: capital
for Food andassets
food supplies 804
17 110 - - 110
17 804 90
8 149 20
9 655 81.8%
45.8% 829
53 276 226
40 065
Machinery
Fuel, oil and gas 17
4 804
262 - - 17
4 804
262 8
1 149
946 9
2 655
316 45.8%
45.7% 53
2 276
200 40
3 065
082
TransportLearner and teacher support material 1 700- 1 700- 443- 1 257- 26.1%
- 38 382- 35 342-
Other machinery
Inventory: Materialsand
andequipment
supplies 16
4 104
884 16
4 104
884 7
1 706
705 8
3 398
179 47.9%
34.9% 14
1 894
426 4 723
650
Inventory:
Payment Medical supplies
for financial assets 51 621 51 621- 18 673 32 948- 36.2%
- 15 594
208 28 504
208
Total
Inventory: Medicine 2 755 731
492 945 - -136 897
-79 130 2 619 834
412 815 2 475 294
352 289 144 540
60 526 85.3%
94.5% 690 759- 676 273-
Inventory: Other supplies 2 899 2 899 1 491 1 408 51.4% 2 100 4 177
Subprogramme: 2.3: COMMUNITY HEALTH CENTRES

2020/21 2019/20
appropriation
Current payments 2 349 577 - -193 818 2 155 759 2 034 309 121 450 94.4% 2 119 496 1 996 990
Compensation of employees 1 705 416 - -193 818 1 511 598 1 506 540 5 058 99.7% 1 355 381 1 310 440
Salaries and wages 1 483 315 -193 818 1 289 497 1 288 720 777 99.9% 1 161 676 1 117 528
Social contributions 222 101 222 101 217 820 4 281 98.1% 193 705 192 912
Administrative fees 30 30 2 28 6.7% - 9
Minor assets 4 274 4 274 1 653 2 621 38.7% 8 057 1 534
Laboratory services 84 247 84 247 66 536 17 711 79.0% 106 500 127 112
Legal services - - 161 -161 - - 156
Contractors 5 037 5 037 2 000 3 037 39.7% 4 734 1 094
Agency and support / outsourced services 6 778 6 778 2 810 3 968 41.5% 8 266 4 319
Fleet services (including government motor transport) 9 950 9 950 5 805 4 145 58.3% 500 550
Housing - - - - - - -
Inventory: Food and food supplies 3 164 3 164 446 2 718 14.1% - 14
Inventory: Materials and supplies 3 109 3 109 1 025 2 084 33.0% 4 850 1 171
Inventory: Medicine 229 023 229 023 230 849 -1 826 100.8% 354 614 350 925
233
234
Subprogramme: 2.3: COMMUNITY HEALTH CENTRES

2020/21 2019/20
appropriation
Current payments
Inventory: Other supplies 2 349
3 577
393 - -193 818 2 155
3 759
393 2 034
2 309
039 121
1 450
354 94.4%
60.1% 2 119
1 496
579 1 996
2 990
302
Compensation of employees
Consumable supplies 1 705
19 416
608 - -193 818 1 511
19 598
608 1 506
9 540
999 5
9 058
609 99.7%
51.0% 1 355
14 381
200 1 310
7 440
886
Salaries and wages
9 315
851 -193 818 1 289
9 497
851 1 288
5 720
138 4 777
713 99.9%
52.2% 1 161
7 676
628 1 117
3 528
386
Operating leases 222
24 101
673 222
24 101
673 217
23 820
077 4
1 281
596 98.1%
93.5% 193 705
800 192 912
603
Goods
Property services
andpayments 644
172 161
170 - - 644
172 161
170 527
137 769
429 116
34 392
741 81.9%
79.8% 764
181 115
955 686
163 550
470
Administrative
Transport provided:
fees Departmental activity 30
75 30
75 2- 28
75 6.7%
- - 9-
Minor
Travel assets
199 4 274
199 1 653
168 2 621
31 38.7%
84.4% 8 057
300 1 534
29
Communication (G&S)
Training and development 6 873- 6 873- 2 873- 4 000- 41.8%
- 10 704- 3 460-
Laboratory services
Operating payments 84
5 247
672 84
5 247
672 66 536
48 17
5 711
624 79.0%
0.8% 106 500
150 127 112-
Scientific
Rental andand technological services
hiring -- -- -- -- -- -- 9-
Legal services
Rent on land - -- 161 -161- -- -- 156
Contractors
Transfers and subsidies 5
9 037
050 - - 5
9 037
050 2
6 000
930 3
2 037
120 39.7%
76.6% 4 734
353 539 355 094
1 029
Agency and
Provinces and support / outsourced services
municipalities 6 778- - - 6 778- 2 810- 3 968- 41.5%
- 8 266
334 186 334 319
4 186
Fleet services (including government motor transport)
Municipalities 9 950- - - 9 950- 5 805- 4 145- 58.3%
- 500
334 186 550
334 186
Housing
Municipal bank accounts - -- - -- -- 334 186- 334 186-
Non-profit Clothing material and accessories
Inventory:institutions - -- 40 -40- -- 14 053- 121
14 053
Inventory: Farming supplies
Households 9 050- - - 9 050- 6 930- 2 120- -
76.6% 5 300- 6 790-
Inventory: Food and food supplies
Social benefits 3
9 164
050 3
9 164
050 6 446
916 2
2 718
134 14.1%
76.4% 5 300- 14
6 790
Inventory:
Other transfers
Fuel, oiltoand gas
households 19 190- 19 190- 12 218
14 6 972
-14 63.7%
- 4 302- 1 405
Inventory:
Payments for Learner
capital and teacher support material
assets 24 692- - - 24 692- 22 883- 1 809- -
92.7% 29 664- 13 183-
Inventory:
Buildings Materials
and other fixed supplies
andstructures 3 109- - - 3 109- 1 025- 2 084- 33.0%
- 4 850- 1 171-
Inventory:
BuildingsMedical supplies 36 845 36 845- 23 453- 13 392- 63.7%
- 54 976 16 995
Inventory: Medicine
Other fixed structures 229 023 229 023- 230 849 -1 826- 100.8%
- 354 614- 350 925
Machinery and equipment 24 692 - - 24 692 22 883 1 809 92.7% 29 664 13 183
Transport equipment 4 187 4 187 - 4 187 - 3 850 1 060
Other machinery and equipment 20 505 20 505 22 883 -2 378 111.6% 25 814 12 123
Payment for financial assets - - - 247 247
Total 2 383 319 - -193 818 2 189 501 2 064 122 125 379 94.3% 2 502 946 2 365 449
Subprogramme: 2.4: COMMUNITY BASED SERVICES

2020/21 2019/20
appropriation
Current payments 2 146 474 - - 2 146 474 2 250 852 -104 378 104.9% 2 083 728 1 956 068
Compensation of employees 1 586 027 - - 1 586 027 1 489 033 96 994 93.9% 1 535 452 1 460 396
Salaries and wages 1 405 386 1 405 386 1 351 066 54 320 96.1% 1 332 746 1 255 165
Goods and services 560 447 - - 560 447 761 819 -201 372 135.9% 548 276 495 672
Advertising 450 450 146 304 32.4% - -
Minor assets 3 480 3 480 557 2 923 16.0% 6 836 1 298
Catering: Departmental activities 1 102 1 102 839 263 76.1% - 1
Communication (G&S) 3 146 3 146 390 2 756 12.4% 8 397 3 267
Legal services - - - - - - -
Contractors 2 660 2 660 448 2 212 16.8% 6 913 1 929
Fleet services (including government motor transport) 1 645 1 645 9 1 636 0.5% 7 200 6 418
Inventory: Food and food supplies 16 234 16 234 9 807 6 427 60.4% 4 737 271
Inventory: Materials and supplies 1 015 1 015 311 704 30.6% 2 458 515
Inventory: Other supplies 936 936 561 375 59.9% 2 750 1 768
Consumable supplies 9 906 9 906 6 701 3 205 67.6% 14 699 8 522
Consumable: Stationery, printing and office supplies 4 549 4 549 2 909 1 640 63.9% 10 598 5 751
Operating leases 976 976 103 873 10.6% 10 640 17 984
235
236
Subprogramme: 2.4: COMMUNITY BASED SERVICES

2020/21 2019/20
appropriation
Current payments
Property payments 2 146
17 474
210 - - 2 146
17 474
210 2 250
12 852
640 -104
4 378
570 104.9%
73.4% 2 083
143 728
070 1 956
134 068
111
Transport provided: Departmental activity 1 586 027
700 - - 1 586 027
700 1 489 033
30 96 994
670 93.9%
4.3% 1 535 452- 1 460 396-
Salaries and
Travel and wages
subsistence 1 405
3 386
038 1 405
3 386
038 1 351
2 066
229 54 320
809 96.1%
73.4% 1 332 746
350 1 255 165
167
Social
Trainingcontributions
and development 180
4 641
424 180
4 641
424 137
1 967
432 42
2 674
992 76.4%
32.4% 202
3 706
104 205 231-
Goods and services
Operating payments 560 447
315 - - 560 447
315 761 819
7 -201 372
308 135.9%
2.2% 548 276
33 495 6721
Administrative fees
Venues and facilities 283- 283- 103- 180- 36.4%
- 15- 48-
Advertising
Rental and hiring 450
14 450
14 146- 304
14 32.4%
- -- --
Transfers assets
Minor and subsidies 3 480
224 892 - - 3 480
224 892 188 557
376 2 923
36 516 16.0%
83.8% 6
9 836
431 1
7 298
492
Non-profit Departmental activities
Catering:institutions 1 102
222 686 1 102
222 686 186 839
164 36 263
522 76.1%
83.6% - 1
Communication (G&S)
Households 3
2 146
206 - - 3
2 146
206 2 390
212 2 756
-6 12.4%
100.3% 8
9 397
431 3
7 267
492
Laboratory services
Social benefits 12
2 531
206 12
2 531
206 10
2 212
212 2 319
-6 81.5%
100.3% 54
9 212
431 60
7 200
492
Scientific and technological
Other transfers services
to households - -- - -- -- -- -
Legal services
Payments for capital assets 8 512- - - 8 512- 6 100- 2 412- -
71.7% 25 101- 7 009-
Contractors
Machinery and equipment 2
8 660
512 - - 2
8 660
512 6 448
100 2
2 212
412 16.8%
71.7% 6 913
25 101 1
7 929
009
Agency
Transport support / outsourced services
andequipment 2 432- 2 432- 1 116- 1 316- 45.9%
- 7
2 559
400 4 625
Fleet services
Other (including
machinery government motor transport)
and equipment 1
8 645
512 1
8 645
512 9
6 100 1
2 636
412 0.5%
71.7% 7 200
22 701 6
7 418
009
Inventory:
Payment Clothing material
for financial assets and accessories - -- 6 -6- -- 196- 33
196
Total 2 379 878- - - 2 379 878- 2 445 328- -65 450- -
102.8% 2 118 456- 1 970 765-
Inventory: Food and food supplies 16 234 16 234 9 807 6 427 60.4% 4 737 271
Inventory: Materials and supplies 1 015 1 015 311 704 30.6% 2 458 515
Inventory: Other supplies 936 936 561 375 59.9% 2 750 1 768
Consumable: Stationery, printing and office supplies 4 549 4 549 2 909 1 640 63.9% 10 598 5 751
Operating leases 976 976 103 873 10.6% 10 640 17 984
Subprogramme: 2.5: HIV/AIDS

2020/21 2019/20
Adjuste d Shifting of Virement Final Actual Variance Expe nditure Final Actual
Appropriation Funds Appropriation Expe nditure as % of final Appropriation Expe nditure
appropriation
Curre nt payme nts 5 843 249 - - 5 843 249 5 676 858 166 391 97.2% 2 076 120 1 969 596
Compensation of employees 2 012 238 -3 989 - 2 008 249 1 947 702 60 547 97.0% 1 461 714 1 376 592
Salaries and wages 1 607 794 -3 989 1 603 805 1 686 007 -82 202 105.1% 1 300 403 1 251 265
Goods and services 3 831 011 3 989 - 3 835 000 3 729 156 105 844 97.2% 614 406 593 004
Administrative fees 130 130 - 130 - 260 35
Advertising 14 924 14 924 - 14 924 - - -
Minor assets 10 498 10 498 377 10 121 3.6% 2 474 712
Audit costs: External - - - - - - -
Bursaries: Employees - - - - - - -
Catering: Departmental activities 13 834 13 834 1 493 12 341 10.8% 1 223 273
Communication (G&S) 482 -53 429 6 423 1.4% 3 178 264
Computer services 50 50 - 50 - - -
Consultants: Business and advisory services 4 500 4 500 10 441 -5 941 232.0% - -
Laboratory services 1 209 448 1 209 448 1 224 348 -14 900 101.2% 6 981 10 076
Contractors 43 362 43 362 63 438 -20 076 146.3% 2 818 708
Agency and support / outsourced services 6 000 6 000 220 5 780 3.7% 1 603 1 635
Fleet services (including government motor transport) 175 175 31 144 17.7% 1 427 786
Housing - - - - - - -
Inventory: Food and food supplies 32 32 884 -852 2762.5% 10 582 8 225
Inventory: Fuel, oil and gas - - - - - 3 150 2 022
Inventory: Materials and supplies 563 -131 432 18 414 4.2% 821 391
Inventory: Medicine 1 935 172 5 138 1 940 310 1 999 021 -58 711 103.0% 459 675 457 699
237
238
Subprogramme: 2.5: HIV/AIDS

2020/21 2019/20
appropriation
Medsas
Curre inventory
nt payme nts interface 5 843 249- - - 5 843 249- 5 676 858- 166 391- -
97.2% 2 076 120- 1 969 596-
Inventory: Other
Compensation supplies
of employees 2 012 238- -3 989 - 2 008 249- 10
1 947 702 -10
60 547 -
97.0% 3 750
1 461 714 1 376-684
592
Consumable
Salaries and supplies
wages 1 339
607 279
794 -10
-3 989 1 339
603 269
805 1 269
686 333
007 69 936
-82 202 79.4%
105.1% 7 061
1 300 403 4 333
1 251 265
Consumable: Stationery, printing and office supplies
Social contributions 18 053
404 444 -160 17 893
404 444 3 232
261 695 14 661
142 749 18.1%
64.7% 4 825
161 311 2 738
125 327
Operating
Goods leases
and services 1 680
3 831 011 3-795
989 - 3 835 885
000 75
3 729 156 105 810
844 8.5%
97.2% 1 186
614 406 2 651
593 004
Property payments
Administrative fees 2 270
130 2 270
130 566- 1 704
130 24.9%
- 9 439
260 9 934
35
Transport
Advertisingprovided: Departmental activity 4 250
14 924 4 250
14 924 155- 4 095
14 924 3.6%
- 697- 295-
Minor assets 19
10 279
498 19
10 279
498 665
377 18
10 614
121 3.4%
3.6% 4
2 108
474 2 229
712
Audit costs: External 12 766- 12 766- 5 302- 7 464- 41.5%
- 2 509- 92-
Operating
Bursaries: payments
Employees - - - - - 307- 51-
Venues
Catering:and
Departmental
facilities activities 3 224
13 834 3 224
13 834 1 225
493 2 999
12 341 7.0%
10.8% 1 223- 273-
Rental
Communication
and hiring(G&S) 1 901
482 -53 1 901
429 14
6 1 887
423 0.7%
1.4% 50
3 178 264-
Interest
Computer rent on land
and services 50- - - 50- - 50- - - -
Interest
Consultants:
(Incl. Business unitary
interest onand payments
advisory (PPP))
services 4 500 4 500- 10 441 -5 941- -
232.0% - -
Rent
Infrastructure
on land and planning services - - - - - - -
Laboratory services 1 197
209 700
448 - - 1 197
209 700
448 1 180
224 593
348 17 107
-14 900 91.3%
101.2% 216
6 133
981 217
10 230
076
Provinces
Scientificand
andmunicipalities
technological services 92 000- - - 92 000- 92 000- - 100.0%
- - -
Provinces
Legal services 92 000- - - 92 000- 92 000- - 100.0%
- - -
Provincial Revenue Funds
Contractors 92
43 000
362 92
43 000
362 92
63 000
438 -20 076- 100.0%
146.3% 2 818- 708
Non-profit
Agency andinstitutions
support / outsourced services 104
6 000 104
6 000 86 362
220 17
5 638
780 83.0%
3.7% 213
1 935
603 213
1 893
635
Households
Entertainment 1 700- - - 1 700- 2 231- -531- 131.2%
- 2 198- 3 337-
Social
Fleet benefits
services (including government motor transport) 1 700
175 1 700
175 2 231
31 -531
144 131.2%
17.7% 2
1 198
427 2 846
786
Housing - - - - - - 491-
Payments
Inventory: capital assets
for Clothing material and accessories 126 572- - - 126 572- 129 132
537 560
-2-537 102.0%
- 18 557- 4 578
2
Buildings and
Inventory: other fixed
Farming structures
supplies - - - - - - - - -
Inventory:
BuildingsFood and food supplies 32 32- 884 -852- -
2762.5% 10 582- 8 225
Other fixed
Inventory: structures
Fuel, oil and gas - - - - - 3 150 2 022
Machinery
Learner and teacher support material 126 572- - - 126 572- 129 132- -2 560- 102.0%
- 18 557- 4 578-
TransportMaterials and supplies 563- -131 432- 18 414- -
4.2% 4 054
821 900
391
Other machinery
Inventory: and equipment
Medical supplies 126
189 572
139 126
189 572
139 129
148 132
765 -2 560
40 374 102.0%
78.7% 14
86 503
282 3 678
88 537
Payment for financial

Inventory: Medicine assets 1 935 172 5 138 1 940 310- 1 999 021 -58 711- -
103.0% 99
459 675 99
457 699
Total 6 167 521 - - 6 167 521 5 986 583 180 938 97.1% 2 310 909 2 191 503
Subprogramme: 2.6: NUTRITION

2020/21 2019/20
appropriation
Current payments - - - - - - - 4 707 527 4 700 518
Compensation of employees - - - - - - - 1 382 872 1 342 090
Salaries and wages - - - 1 223 144 1 209 242
Social contributions - - - 159 728 132 848
Goods and services - - - - - - - 3 324 655 3 358 428
Administrative fees - - - 6 90
Advertising - - - - 553
Minor assets - - - 152 26
Catering: Departmental activities - - - 2 146 4 632
Communication (G&S) - - - 817 17
Consultants: Business and advisory services - - - 40 575 2 641
Infrastructure and planning services - - - - -
Laboratory services - - - 947 198 1 098 761
Contractors - - - 36 259 34 122
Agency and support / outsourced services - - - 3 117 311
Fleet services (including government motor transport) - - - 4 338 -
Housing - - - - -
Inventory: Clothing material and accessories - - - - 2
Inventory: Farming supplies - - - - -
Inventory: Food and food supplies - - - 6 171 5 681
Inventory: Fuel, oil and gas - - - - -
Inventory: Learner and teacher support material - - - - -
239
240
Subprogramme: 2.6: NUTRITION

2020/21 2019/20
appropriation
Current payments
Inventory: Materials and supplies - - - - - - - 4 707 527
1 518
4 700 364
Inventory: Medical supplies - - - - - - - 1 122 872
382 069 1 342 090
96 047
Salaries and
Inventory: wages
Medicine - - - 2
1 105 144
223 896 2
1 074 242
209 432
Medsas inventory interface - - - 159 728- 132 848-
Goods and services
Inventory: Other supplies - - - - - - - 3 324 655- 3 358 428
1
Consumable fees
Administrativesupplies - - - 6
6 571 90
4 156
Consumable:
Advertising Stationery, printing and office supplies - - - 27 769- 553
24 665
Minor assets
Operating leases - - - 152- 26
45
Property Departmental activities
Catering: payments - - - 146
2 119 632
4 804
Communication
Transport (G&S)
provided: Departmental activity - - - 817- 17
257
Consultants:
Travel Business and advisory services
and subsistence - - - 40 575
3 059 1 641
2 226
Infrastructure
Training and planning services
and development - - - 12 345- 7 825-
Operating services
Laboratorypayments - - - 947 198
57 1 098 761
80
Contractors
Venues and facilities - - - 36 259
3 990 34 122
1 690
Rental
Agencyand support / outsourced services
andhiring - - - 3 117- 311-
Interest
Fleet services
and rent(including
on land government motor transport) - - - - - - - 4 338- -
Interest
Housing(Incl. interest on unitary payments (PPP)) - - - - -
Rent on land
Inventory: Clothing material and accessories - - - - 2
Inventory:
Transfers andFarming supplies
subsidies 65 115 - -60 524 4 591- 4 591 - -
100.0% 157 798- 158 574-
Provinces
Inventory:and municipalities
Food and food supplies - - - - - - - 70
6 899
171 70
5 073
681
Municipalities
Inventory: Fuel, oil and gas - - - - - - - 70 899- 70 073-
Municipal
Inventory: bank
Learner accounts
and teacher support material - - - 70 899- 70 073-
Non-profit institutions 65 115 -60 524 4 591 4 591 - 100.0% 85 828 85 744
Households - - - - - - - 1 071 2 757
Social benefits - - - 1 071 2 757
Other transfers to households - - - -
Payments for capital assets - - - - - - - 119 347 3 513
Machinery and equipment - - - - - - - 119 347 3 513
Transport equipment - - - 598
Other machinery and equipment - - - 118 749 3 513

Total 65 115 - -60 524 4 591 4 591 - 100.0% 4 984 690 4 862 623
Subprogramme : 2.7: CORONER SERVICES

2020/21 2019/20
appropriation
Curre nt payme nts 274 336 - -18 000 256 336 252 567 3 769 98.5% - -
Compensation of employees 233 419 - -18 000 215 419 215 037 382 99.8% - -
Salaries and wages 208 671 -17 000 191 671 191 368 303 99.8%
Social contributions 24 748 -1 000 23 748 23 669 79 99.7%
Goods and services 40 917 - - 40 917 37 530 3 387 91.7% - -
Administrative fees 10 10 33 -23 330.0%
Advertising 50 50 - 50 -
Minor assets 300 300 471 -171 157.0%
Audit costs: External - - - - -
Bursaries: Employees - - - - -
Catering: Departmental activities 80 80 16 64 20.0%
Communication (G&S) 600 600 236 364 39.3%
Computer services - - - - -
Consultants: Business and advisory services - - 6 -6 -
Infrastructure and planning services - - - - -
Laboratory services 661 661 128 533 19.4%
Scientific and technological services - - - - -
Legal services - - - - -
Contractors 1 750 1 750 1 602 148 91.5%
Agency and support / outsourced services 1 550 1 550 764 786 49.3%
Entertainment - - - - -
Fleet services (including government motor transport) 6 751 6 751 7 228 -477 107.1%
Housing - - - - -
241
242
Subprogramme : 2.7: CORONER SERVICES

2020/21 2019/20
appropriation
CurreInventory:
nt paymeClothing
nts material and accessories 274 336- - -18 000 256 336- 91
252 567 -91
3 769 -
98.5% - -
Inventory: Fuel,
Compensation oil and gas
of employees 233 419- - -18 000 215 419- 7
215 037 -7
382 -
99.8% - -
Salaries Learner
Inventory:and wagesand teacher support material 208 671- -17 000 191 671- 191 368- 303- -
99.8%
Inventory:
Social Materials and supplies
contributions 100
24 748 -1 000 100
23 748 23
23 669 77
79 23.0%
99.7%
Inventory:
Goods Medical supplies
and services 40 165
8 917 - - 40 165
8 917 37 610
9 530 -1 445
3 387 117.7%
91.7% - -
Inventory: Medicine
10 50
10 169
33 -119
-23 338.0%
330.0%
Medsas inventory interface
Advertising 50- 50- - 50- -
Inventory:
Minor Other supplies
assets 140
300 140
300 90
471 50
-171 64.3%
157.0%
Consumable
Audit supplies
costs: External 4 472- 4 472- 2 178- 2 294- 48.7%
-
Consumable:
Bursaries: Stationery, printing and office supplies
Employees 1 714- 1 714- 1 419- 295- 82.8%
-
Catering: leases
OperatingDepartmental activities 80- 80- 16- 64- -
20.0%
Property payments
Communication (G&S) 167
13 600 167
13 600 648
12 236 519
364 96.1%
39.3%
Transport provided:
Computer services Departmental activity - - - - -
Consultants: Business and advisory services 400- 400- 186
6 214
-6 46.5%
-
Infrastructure and planning services 50- 50- - 50- -
Operating payments
Laboratory services 17
661 17
661 64
128 -47
533 376.5%
19.4%
Venues and
Scientific andfacilities
technological services 890- 890- 561- 329- 63.0%
-
Legal services 783- - - 783- 467- 316- 59.6%
- 58 627 58 586
Contractors 1 750 1 750- 1 602 148- -
91.5% 58 627 58 586
Households
Agency and support / outsourced services 783
1 550 - - 783
1 550 467
764 316
786 59.6%
49.3% - -
Social benefits
Entertainment 783- 783- 467- 316- 59.6%
-
Other
Fleet transfers
(including government motor transport) 6 751 6 751- 7 228 -477- -
107.1% -
Payments
Housingfor capital assets 8 430- - - 8 430- 10 823- -2 393- 128.4%
- - -
Buildings and other fixed structures - - - - - - - - -
Machinery and equipment 8 430 - - 8 430 10 823 -2 393 128.4% - -
Transport equipment 2 605 2 605 5 462 -2 857 209.7%
Other machinery and equipment 5 825 5 825 5 361 464 92.0%
Total 283 549 - -18 000 265 549 263 857 1 692 99.4% 58 627 58 586
Subprogra mme: 2.8: DISTRICT HOSPITALS

2020/21 2019/20
Adjusted Shifting of Virement Fina l Actual Variance Expenditure Fina l Actual
Appropria tion Funds Appropria tion Expenditure as % of final Appropria tion Expenditure
a ppropria tion
Current pa yments 4 061 660 - -121 847 3 939 813 3 815 131 124 682 96.8% 244 844 234 882
Compensation of employees 2 851 082 - 66 750 2 917 832 2 891 250 26 582 99.1% 206 217 204 793
Salaries and wages 2 421 749 66 750 2 488 499 2 518 464 -29 965 101.2% 183 993 181 417
Goods and services 1 210 578 - -188 597 1 021 981 923 881 98 100 90.4% 38 627 30 089
Administrative fees 920 920 1 020 -100 110.9% 36 -
Advertising 106 106 2 104 1.9% 94 30
Minor assets 6 839 6 839 4 475 2 364 65.4% 599 263
Catering: Departmental activities 40 40 - 40 - 123 74
Communication (G&S) 5 319 5 319 4 275 1 044 80.4% 861 236
Computer services - - - - - 350 348
Consultants: Business and advisory services 916 916 180 736 19.7% - -
Laboratory services 257 580 -94 202 163 378 162 188 1 190 99.3% 627 114
Legal services - - 835 -835 - - -
Contractors 22 981 22 981 13 061 9 920 56.8% 1 167 1 024
Housing - - - - - - -
Inventory: Clothing material and accessories - - 362 -362 - - -
Inventory: Food and food supplies 53 222 53 222 35 985 17 237 67.6% - -
Inventory: Fuel, oil and gas 59 725 59 725 46 772 12 953 78.3% - 6
Inventory: Materials and supplies 8 076 8 076 6 259 1 817 77.5% 150 63
243
244
Subprogra mme: 2.8: DISTRICT HOSPITALS

2020/21 2019/20
a ppropria tion
Inventory:
Current Medical supplies
pa yments 4 061 193
252 660 - -121 000
-26 847 3 939 193
226 813 3 815 788
225 131 405
124 682 99.8%
96.8% 244 744
6 844 234 935
6 882
Inventory: Medicine
Compensation of employees 2 851 310
152 082 - -39 000
66 750 2 917 310
113 832 2 891 560
112 250 750
26 582 99.3%
99.1% 40
206 217 17
204 793
Medsas inventory
Salaries and wages interface 2 421 749- 66 750 2 488 499- 2 518 464- -29 965- -
101.2% 183 993- 181 417-
Inventory:
Social Other supplies
18 333 429 083
18 333 372 250
16 786 56 833
1 547 89.9%
86.8% 53
22 224 1
23 376
Consumable
Goods supplies
and services 1 210 989
88 578 - -188 395
-29 597 1 021 594
59 981 923 316
55 881 98 278
4 100 92.8%
90.4% 38 574
3 627 30 255
3 089
Consumable: Stationery,
Administrative fees printing and office supplies 29 163
920 163
29 920 15 637
1 020 526
13-100 53.6%
110.9% 1 756
36 1 283-
Operating leases
Advertising 24 372
106 372
24 106 19 297
2 075
5 104 79.2%
1.9% 94- 30-
Property
Minor payments
assets 184 268
6 839 184
6 268
839 169 160
4 475 15 108
2 364 91.8%
65.4% 13 239
599 10 606
263
Transport
Audit provided:
costs: Departmental activity
External 465- 465- 79- 386- 17.0%
- - -
Bursaries: Employees 1 070- 1 070- 162- 908- 15.1%
- 379- 81-
Training and
Catering: development
Departmental activities 1 902
40 1 902
40 21- 1 881
40 1.1%
- 477
123 102
74
Operating payments
4 319 5 240
4 319 190
4 275 50
1 044 98.8%
80.4% 16
861 8
236
Venues and
Computer facilities
services - - - - - 600
350 670
348
Consultants: Business and advisory services
Rental and hiring 916- 916- 180
42 736
-42 19.7%
- - -
Infrastructure
Transfers and planning services
and subsidies 7 860- - - 7 860- 8 806- -946- -
112.0% 634- 388-
Laboratory services
Households 257
7 580
860 - -94 202- 163
7 378
860 162
8 188
806 190
1-946 99.3%
112.0% 627
634 114
388
Scientific and technological services
Social benefits 7 860- 7 860- 8 806- -946- -
112.0% 634- 388-
Legal
Otherservices
transfers to households - - 835 -835- - - -
Contractors
Payments for capital assets 22
50 981
573 - - 22
50 981
573 13
69 061
167 -18 920
9 594 56.8%
136.8% 14 167
1 954 1
9 024
651
Agency and
Machinery andsupport / outsourced services
equipment 28
50 815
573 - - 28
50 815
573 25
69 917
167 -18 898
2 594 89.9%
136.8% 14 135
2 954 1
9 108
651
Entertainment
Transport equipment 2 093- 2 093- 1 606- 487- -
76.7% 4 333- 8 531-
Fleet
Otherservices (including
machinery government motor transport)
and equipment 8 984
48 480 8 984
48 480 4 048
67 561 -19 936
4 081 45.1%
139.4% 10 607
5 621 3
1 865
120
Housing
Payment for financial assets - - - - - 195- 195-
Total 4 120 093- - -121 847 3 998 246- 362
3 893 104 105-362
142 -
97.4% 260 627- 245 116-
Inventory: Food and food supplies 53 222 53 222 35 985 17 237 67.6% - -
Inventory: Fuel, oil and gas 59 725 59 725 46 772 12 953 78.3% - 6
Programme 3: EMERGENCY MEDICAL SERVICES

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 EMERGENCY TRANSPORT 1 422 713 - 94 700 1 517 413 1 531 680 -14 267 100.9% 1 341 503 1 424 067
2 PLANNED PATIENT TRANSPORT 163 957 - - 163 957 149 121 14 836 91.0% 200 211 115 714
1 586 670 - 94 700 1 681 370 1 680 801 569 100.0% 1 541 714 1 539 781
Current payments 1 001 169 - - 1 001 169 1 006 360 -5 191 100.5% 976 606 845 924
Compensation of employees 714 402 - - 714 402 757 890 -43 488 106.1% 648 787 620 939
Salaries and wages 602 293 - - 602 293 629 238 -26 945 104.5% 554 919 517 054
Social contributions 112 109 - - 112 109 128 652 -16 543 114.8% 93 868 103 885
Administrative fees 3 500 - - 3 500 2 502 998 71.5% 3 500 3 508
Advertising 1 500 - - 1 500 - 1 500 - 2 500 -
Minor assets 7 833 - - 7 833 1 568 6 265 20.0% 8 042 1 701
Catering: Departmental activities 150 - - 150 475 -325 316.7% 250 116
Communication (G&S) 4 834 - - 4 834 3 102 1 732 64.2% 4 934 2 322
Computer services 512 - - 512 - 512 - 512 -
Legal services - - - - - - - - 988
Contractors 6 500 - - 6 500 13 562 -7 062 208.6% 5 134 5 051
Agency and support / outsourced services 520 - - 520 190 330 36.5% 2 028 188
Fleet services (including government motor transport) 130 000 - - 130 000 130 976 -976 100.8% 181 775 117 973
Inventory: Food and food supplies 15 - - 15 6 9 40.0% 15 7
Inventory: Fuel, oil and gas 546 - - 546 1 128 -582 206.6% 1 565 1 741
Inventory: Learner and teacher support material - - - - - - - - -
Inventory: Materials and supplies 5 274 - - 5 274 2 413 2 861 45.8% 446 1 725
Inventory: Medical supplies 28 994 - - 28 994 32 426 -3 432 111.8% 19 471 22 493
Inventory: Medicine 1 150 - - 1 150 516 634 44.9% 1 050 415
Medsas inventory interface - - - - - - - - -
Inventory: Other supplies 1 515 - - 1 515 1 648 -133 108.8% 257 40
Consumable supplies 12 366 - - 12 366 12 095 271 97.8% 15 480 11 978
Consumable: Stationery, printing and office supplies 8 353 - - 8 353 5 236 3 117 62.7% 8 853 4 643
Operating leases 40 294 - - 40 294 22 280 18 014 55.3% 36 904 30 944

Property payments 21 479 - - 21 479 18 117 3 362 84.3% 21 855 17 248
245
246
Programme 3: EMERGENCY MEDICAL SERVICES

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Transport provided: Departmental activity
Sub programme 6 095 - - 6 095 - 6 095 - 4 611 227
1 EMERGENCY
Travel and TRANSPORT
subsistence 1 422 713
787 - 94 700- 1 517 413
787 1 531 680
83 -14 267
704 100.9%
10.5% 1 341 503
926 1 424 067
287
2 PLANNED PATIENT
Training TRANSPORT
and development 163 957
3 690 - - 163 957
3 690 121
149 147 143 836
543 91.0%
4.0% 200 211
5 687 115 714
26
Operating payments - - - - - - - - -
Venues and facilities 860 - - 860 - 860 - 660 -
Rental and hiring 1 586 670- -- 94 700- 1 681 370- 1 680 801- 569- -
100.0% 1 541 714- 1 539 781-
Interest and rent on land - - - - - - - 1 364 1 364
Interest (Incl. interest on unitary payments (PPP)) - - - - - - - 1 364 1 364
Rent on land - - - - - - - - -
Transfers and subsidies 75 875 - - 75 875 76 019 -144 100.2% 303 990 303 244
Provinces and municipalities 74 920 - - 74 920 74 920 - 100.0% 301 135 301 135
Provinces - - - - - - - - -
Provincial Revenue Funds - - - - - - - - -
Provincial agencies and funds - - - - - - - - -
Municipalities 74 920 - - 74 920 74 920 - 100.0% 301 135 301 135
Municipal bank accounts 74 920 - - 74 920 74 920 - 100.0% 301 135 301 135
Households 955 - - 955 1 099 -144 115.1% 2 855 2 109
Social benefits 955 - - 955 1 099 -144 115.1% 2 855 1 524
Other transfers to households - - - - - - - - 585
Payments for capital assets 509 626 - 94 700 604 326 598 422 5 904 99.0% 261 045 390 540
Buildings and other fixed structures - - - - 478 -478 - - -
Buildings - - - - 478 -478 - - -
Machinery and equipment 509 626 - 94 700 604 326 597 944 6 382 98.9% 261 045 390 540
Transport equipment 203 799 - 94 700 298 499 488 120 -189 621 163.5% 190 784 297 309
Other machinery and equipment 305 827 - - 305 827 109 824 196 003 35.9% 70 261 93 231
Payment for financial assets - - - - - - - 73 73
1 586 670 - 94 700 1 681 370 1 680 801 569 100.0% 1 541 714 1 539 781
Subprogramme: 3.1: EMERGENCY TRANSPORT

2020/21 2019/20
appropriation
Current payments 837 427 - - 837 427 857 451 -20 024 102.4% 777 210 730 408
Salaries and wages 530 432 530 432 568 862 -38 430 107.2% 471 776 462 860
Administrative fees 3 500 3 500 2 502 998 71.5% 3 500 3 508
Advertising 1 500 1 500 - 1 500 - 2 500 -
Minor assets 7 833 7 833 1 568 6 265 20.0% 8 042 1 701
Catering: Departmental activities 150 150 475 -325 316.7% 250 116
Computer services 512 512 - 512 - 512 -
Legal services - - - - - - 988
Contractors 6 500 6 500 13 562 -7 062 208.6% 5 134 5 051
Agency and support / outsourced services 520 520 190 330 36.5% 2 028 188
Inventory: Fuel, oil and gas 546 546 1 128 -582 206.6% 1 565 1 741
Inventory: Materials and supplies 5 274 5 274 2 413 2 861 45.8% 446 1 725
Inventory: Medical supplies 28 994 28 994 32 426 -3 432 111.8% 19 471 22 493
Inventory: Medicine 1 150 1 150 516 634 44.9% 1 050 415
Inventory: Other supplies 1 515 1 515 1 648 -133 108.8% 257 40
Consumable supplies 12 366 12 366 12 095 271 97.8% 15 480 11 978
247
248
Subprogramme: 3.1: EMERGENCY TRANSPORT

2020/21 2019/20
appropriation
Consumable:
Current paymentsStationery, printing and office supplies 837 353
8 427 - - 837 353
8 427 857 236
5 451 -20 117
3 024 62.7%
102.4% 777 853
8 210 730 643
4 408
Operating leases
Compensation of employees 625
40 294 - - 625
40 294 685 280
22 262 -59 014
18 968 55.3%
109.6% 552 904
36 975 556 944
30 013
Salaries payments
Property and wages 530 479
21 432 530 479
21 432 568 782
17 862 -38 697
3 430 82.8%
107.2% 471 855
21 776 462 248
17 860
Transport
Social provided: Departmental activity
contributions 94 862- 94 862- 116 400- -21 538- -
122.7% 81 199- 67
93 153
Goods
Traveland subsistence
andservices 787
212 133 - - 787
212 133 83
172 189 704
39 944 10.5%
81.2% 926
223 305 287
173 465
3 500 690
3 500 147
2 502 543
3 998 4.0%
71.5% 3 687
5 500 26
3 508
Operating payments
Advertising 1 500- 1 500- - 1 500- - 2 500- -
Venues
Minor and facilities
assets 860
7 833 860
7 833 1 568- 860
6 265 -
20.0% 660
8 042 1 701-
Catering: hiring
Rental andDepartmental activities 150- 150- 475- -325- -
316.7% 250- 116-
Interest and rent on
Communication land
(G&S) 4 834- - - 4 834- 3 102- 1 732- -
64.2% 930
4 934 930
2 322
Interest (Incl.
Computer interest on unitary payments (PPP))
services 512 512- - 512- - 930
512 930-
Rent on
Legal land
services - - - - - - 988
Contractors
Transfers and subsidies 6 500
75 660 - - 6 500
75 660 13
75 562
807 062
-7-147 208.6%
100.2% 5 134
303 175 5 051
303 046
Provinces
Agency and municipalities
and support / outsourced services 920
74 520 - - 920
74 520 920
74 190 330- 100.0%
36.5% 301 135
2 028 135
301 188
Provinces
FleetProvincial Revenue Funds
services (including government motor transport) 61 461 61 461- 55 030 6 431- -
89.5% 83 236- 67 977
Provincial
Inventory: Foodagencies
and food and funds
supplies 15 15- 6 9- -
40.0% 15- 7
Municipalities 74 546
920 - - 74 546
920 1 128
74 920 -582- 206.6%
100.0% 1 565
301 135 1 741
301 135
Inventory: Learner
Municipal bankand teacher support material
accounts 74 920- 74 920- 74 920- - -
100.0% 301 135- 301 135-
Inventory: Materials and supplies
Households 5 274
740 - - 5 274
740 2 413
887 861
2-147 45.8%
119.9% 2 446
040 1 725
911
Inventory: Medical supplies
Social benefits 28 994
740 28 994
740 32 426
887 432
-3-147 111.8%
119.9% 19
2 471
040 22
1 493
326
Inventory: Medicine
Other transfers to households 1 150- 1 150- 516 634- 44.9%
- 1 050- 415
585
Payments
Medsasforinventory
capital interface
assets 509 626- - 94 700 604 326- 598 422- 5 904- -
99.0% 261 045- 390 540-
Inventory:
Buildings Other
and supplies
other fixed structures 1 515- - - 1 515- 1 648
478 -133
-478 108.8%
- 257- 40-
Consumable
Buildings supplies 12 366 12 366- 12 095
478 271
-478 97.8%
- 15 480- 11 978
Other fixed structures - - - -
Machinery and equipment 509 626 - 94 700 604 326 597 944 6 382 98.9% 261 045 390 540
Transport equipment 203 799 94 700 298 499 488 120 -189 621 163.5% 190 784 297 309
Other machinery and equipment 305 827 305 827 109 824 196 003 35.9% 70 261 93 231
Total 1 422 713 - 94 700 1 517 413 1 531 680 -14 267 100.9% 1 341 503 1 424 067

2020/21 2019/20
a ppropria tion
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub progra mme
1 GENERAL HOSPITALS 7 279 341 - - 7 279 341 7 414 991 -135 650 101.9% 6 768 628 6 735 022
2 TUBERCULOSIS HOSPITALS 333 806 - - 333 806 305 465 28 341 91.5% 325 754 310 335
3 PSYCHIATRIC/MENTAL HOSPITALS 1 585 024 - - 1 585 024 1 523 443 61 581 96.1% 1 461 226 1 531 428
4 DENTAL TRAINING HOSPITALS 636 628 - -3 161 633 467 563 679 69 788 89.0% 622 249 551 622
5 OTHER SPECIALISED HOSPITALS 110 641 - - 110 641 98 272 12 369 88.8% 96 548 96 051
9 945 440 - -3 161 9 942 279 9 905 850 36 429 99.6% 9 274 405 9 224 458
Current payments 9 756 346 - - 9 756 346 9 719 813 36 533 99.6% 9 095 972 9 067 916
Compensation of employees 7 140 609 - - 7 140 609 7 125 491 15 118 99.8% 6 854 378 6 792 486
Salaries and wages 6 216 467 - - 6 216 467 6 280 802 -64 335 101.0% 5 960 640 5 990 948
Social contributions 924 142 - - 924 142 844 689 79 453 91.4% 893 738 801 538
Goods and services 2 615 737 - - 2 615 737 2 594 322 21 415 99.2% 2 241 594 2 275 430
Administrative fees 925 - - 925 1 002 -77 108.3% 157 161
Advertising 10 - - 10 1 9 10.0% - 58
Minor assets 14 302 - - 14 302 8 261 6 041 57.8% 11 016 4 260
Audit costs: External - - - - - - - - -
Bursaries: Employees - - - - 1 -1 - - -
Catering: Departmental activities 130 - - 130 10 120 7.7% 145 74
Computer services 694 - - 694 802 -108 115.6% - 28
Consultants: Business and advisory services 374 422 - - 374 422 301 225 73 197 80.5% 218 867 322 322
Laboratory services 339 532 - - 339 532 337 959 1 573 99.5% 167 364 163 245
Legal services - - - - 7 335 -7 335 - - 4 780
Contractors 38 008 - - 38 008 48 681 -10 673 128.1% 35 243 39 836
Agency and support / outsourced services 75 123 - - 75 123 83 902 -8 779 111.7% 71 750 92 906
Fleet services (including government motor transport) 8 892 - - 8 892 6 316 2 576 71.0% 9 368 4 946
Housing - - - - - - - - -
Inventory: Clothing material and accessories - - - - 637 -637 - - 32
249
250

2020/21 2019/20
a ppropria tion
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub progra mme - - - - - - - - -
1 GENERAL HOSPITALS
Inventory: Food and food supplies 7 279
148 341
440 - - 7 279
148 341
440 7 414
118 991
355 -135 650
30 085 101.9%
79.7% 6 768
180 628
901 6 735
124 022
828
2 TUBERCULOSIS HOSPITALS
Inventory: Fuel, oil and gas 333 806
65 296 - - 333 806
65 296 305 465
73 649 28
-8 341
353 91.5%
112.8% 325 754
89 872 310
118 335
909
Inventory: Learner and
3 PSYCHIATRIC/MENTAL teacher support material
HOSPITALS 1 585 024- - - 1 585 024- 1 523 443- 61 581- 96.1%
- 1 461 226
15 1 531 428-
Inventory:
4 DENTAL Materials
TRAINING and supplies
HOSPITALS 636 628
18 130 - -3 161- 633 467
18 130 563 679
12 431 695 788
699 89.0%
68.6% 622 249
5 557 551 622
5 959
Inventory:
5 OTHER Medical
SPECIALISED supplies
HOSPITALS 110
711 641
835 - - 110
711 641
835 98 272
810 885 12 369
-99 050 88.8%
113.9% 96 548
689 943 96 051
632 106
Inventory: Medicine 9 945 147
335 440 - -3 161- 9 942 147
335 279 9 905 288
287 850 47
36 859
429 85.7%
99.6% 9 274 612
272 405 9 224 874
272 458
Inventory: Other supplies 26 107 - - 26 107 29 540 -3 433 113.1% 34 131 30 686
Consumable supplies 112 486 - - 112 486 97 125 15 361 86.3% 99 272 80 409
Consumable: Stationery, printing and office supplies 23 999 - - 23 999 20 411 3 588 85.0% 20 670 23 353
Operating leases 37 368 - - 37 368 38 602 -1 234 103.3% 33 083 26 701
Property payments 267 037 - - 267 037 300 273 -33 236 112.4% 283 844 318 660
Transport provided: Departmental activity 328 - - 328 171 157 52.1% 203 88
Travel and subsistence 1 169 - - 1 169 3 594 -2 425 307.4% 1 193 630
Training and development 4 163 - - 4 163 1 134 3 029 27.2% 4 132 1 945
Operating payments 1 604 - - 1 604 469 1 135 29.2% 1 449 207
Venues and facilities - - - - - - - - -
Rental and hiring 500 - - 500 192 308 38.4% 980 1 152
Transfers and subsidies 16 123 - - 16 123 25 768 -9 645 159.8% 15 725 24 267
Households 16 123 - - 16 123 25 768 -9 645 159.8% 15 725 24 267
Social benefits 16 123 - - 16 123 25 768 -9 645 159.8% 15 725 24 267
Other transfers to households - - - - - - - - -
Payments for capital assets 172 971 - -3 161 169 810 160 269 9 541 94.4% 162 141 131 708
Machinery and equipment 172 971 - -3 161 169 810 160 269 9 541 94.4% 162 141 131 708
Transport equipment 7 329 - - 7 329 2 230 5 099 30.4% 2 296 1 039
Other machinery and equipment 165 642 - -3 161 162 481 158 039 4 442 97.3% 159 845 130 669
9 945 440 - -3 161 9 942 279 9 905 850 36 429 99.6% 9 274 405 9 224 458
Subprogramme: 4.1: GENERAL HOSPITALS

2020/21 2019/20
appropriation
Current payments 7 138 249 - - 7 138 249 7 251 739 -113 490 101.6% 6 621 823 6 600 702
Compensation of employees 5 222 106 - - 5 222 106 5 241 414 -19 308 100.4% 4 967 639 4 950 099
Salaries and wages 4 562 859 4 562 859 4 645 948 -83 089 101.8% 4 346 586 4 386 631
Goods and services 1 916 143 - - 1 916 143 2 010 325 -94 182 104.9% 1 654 184 1 650 603
Administrative fees 774 774 979 -205 126.5% 108 140
Advertising - - 1 -1 - - -
Minor assets 10 304 10 304 6 889 3 415 66.9% 4 859 3 701
Bursaries: Employees - - 1 -1 - - -
Catering: Departmental activities 20 20 9 11 45.0% - 18
Computer services 588 588 696 -108 118.4% - 3
Laboratory services 321 263 321 263 327 167 -5 904 101.8% 153 300 152 631
Legal services - - 7 335 -7 335 - - 4 780
Contractors 32 591 32 591 45 091 -12 500 138.4% 29 216 35 239
Agency and support / outsourced services 73 060 73 060 78 722 -5 662 107.7% 69 422 90 242
251
252
Subprogramme: 4.1: GENERAL HOSPITALS

2020/21 2019/20
appropriation
Entertainment
Current payments 7 138 249- - - 7 138 249- 7 251 739- -113 490- -
101.6% 6 621 823- 6 600 702-
Compensation employees
Fleet servicesof(including government motor transport) 5 222 106
5 877 - - 5 222 106
5 877 5 241 414
4 221 -19 308
1 656 100.4%
71.8% 4 967 639
5 701 4 950 099
2 635
Salaries and wages
Housing 4 562 859- 4 562 859- 4 645 948- -83 089- 101.8%
- 4 346 586- 4 386 631-
Social contributions 659 247- 659 247- 595 368
466 63-368
781 -
90.3% 621 053- 563 468-
Inventory:
Goods Farming supplies
and services 1 916 143- - - 1 916 143- 2 010 325- -94 182- -
104.9% 1 654 184- 1 650 603-
Inventory:
Administrative and food supplies
Foodfees 94 912
774 94 912
774 83 948
979 964
10-205 88.4%
126.5% 89 255
108 83 403
140
Inventory:
AdvertisingFuel, oil and gas 53 155- 53 155- 55 761
1 -2 606
-1 104.9%
- 76 731- 93 573-
Inventory: Learner and teacher support material
Minor assets 10 304- 10 304- 6 889- 3 415- -
66.9% 4 859- 3 701-
Audit costs: Externaland supplies 5 278- 5 278- 7 551- -2 273- 143.1%
- 4 112- 4 796-
Inventory:
Bursaries:Medical supplies
Employees 670 457- 670 457- 777 411
1 -106 954
-1 116.0%
- 634 856- 588 748-
Catering: Medicine
Inventory: Departmental activities 276 296
20 276 296
20 239 190
9 37 106
11 86.6%
45.0% 223 489- 221 426
18
Medsas inventory
Communication interface
(G&S) 7 294- 7 294- 3 051- 4 243- -
41.8% 6 133- 2 652-
Inventory: Other
Computer supplies
services 22 967
588 967
22 588 25 524
696 557
-2-108 111.1%
118.4% 27 060- 24 584
3
Consumable
Consultants: supplies
Business and advisory services 87 342
504 87 342
504 70 425
94 16 917
410 80.6%
18.7% 70 688
468 55 213
171
Consumable: Stationery,
Infrastructure and planningprinting and office supplies
services 18 242- 18 242- 16 165- 2 077- 88.6%
- 14 776- 18 989-
Operating
Laboratoryleases
services 23 577
321 263 321 577
23 263 327 551
21 167 -5 026
2 904 91.4%
101.8% 17 455
153 300 152 364
16 631
Property
Scientific payments
and technological services 206 235- 206 235- 233 197- -26 962- 113.1%
- 221 289- 248 236-
Transport
Legal provided: Departmental activity
services 288- 288- 165
7 335 123
-7 335 57.3%
- 183- 51
4 780
Contractors 613
32 591 613
32 591 45 438
3 091 -2 825
-12 500 560.8%
138.4% 29 494
216 35 362
239
Training development
Agency and support / outsourced services 3 089
73 060 3 089
73 060 78 972
722 2 117
-5 662 31.5%
107.7% 3 363
69 422 1 516
90 242
Operating payments 917 917 211 706 23.0% 246 159
Rental and hiring 500 500 192 308 38.4% 980 971
Households 10 521 - - 10 521 18 213 -7 692 173.1% 10 558 18 199
Social benefits 10 521 10 521 18 213 -7 692 173.1% 10 558 18 199
Payments for capital assets 130 571 - - 130 571 145 039 -14 468 111.1% 135 871 115 745
Transport equipment 3 506 3 506 2 130 1 376 60.8% 1 156 862
Total 7 279 341 - - 7 279 341 7 414 991 -135 650 101.9% 6 768 628 6 735 022
Subprogra mme: 4.2: TUBERCULOSIS HOSPITALS

2020/21 2019/20
a ppropria tion
Current pa yments 331 480 - - 331 480 302 386 29 094 91.2% 323 768 308 010
Advertising - - - - - - -
Minor assets 400 400 149 251 37.3% 1 627 362
Computer services - - - - - - -
Laboratory services 4 000 4 000 3 383 617 84.6% 4 460 2 717
Contractors 1 205 1 205 993 212 82.4% 1 205 625
Agency and support / outsourced services 200 200 122 78 61.0% 627 142
Fleet services (including government motor transport) 350 350 259 91 74.0% 1 119 501
Inventory: Food and food supplies 5 000 5 000 3 216 1 784 64.3% 4 000 3 817
Inventory: Fuel, oil and gas 2 200 2 200 3 029 -829 137.7% 1 119 2 858
253
254
Subprogra mme: 4.2: TUBERCULOSIS HOSPITALS

2020/21 2019/20
a ppropria tion
Inventory:
Current Learner and teacher support material
pa yments 331 480- - - 331 480- 302 386- 29 094- -
91.2% 323 768- 308 010-
Compensation and supplies
of employees 268 350
905 - - 268 350
905 255 218
149 13 132
756 62.3%
94.9% 252 280
718 252 189
657
Inventory: Medical
Salaries and wagessupplies 4 649
231 817 4 649
231 817 4 007
215 845 15 642
972 86.2%
93.1% 5 505
218 439 2 878
215 796
Inventory: Medicine
Social contributions 23
37 188
088 23
37 188
088 18
39 080
304 5 108
-2 216 78.0%
106.0% 25
34 521
279 24
36 287
861
Inventory:
Goods Other supplies
and services 62 839
575 - - 62 839
575 47 418
237 15 421
338 49.8%
75.5% 71 260
050 55 140
353
Consumable
Administrativesupplies
fees 1 215
9 1 215
9 2 193
2 -978
7 180.5%
22.2% 4 794
9 2 626
2
Consumable:
Advertising Stationery, printing and office supplies 1 030- 1 030- 457- 573- 44.4%
- 1 007- 813-
Operating leases
Minor assets 1 783
400 1 783
400 1 386
149 397
251 77.7%
37.3% 1 200
627 1 162
362
Property payments
450 15 671
450 9 214
74 6 457
376 58.8%
16.4% 17 171
783 11 559
425
Transport
Computer provided:
services Departmental activity - - - - - - -
Consultants: Business and advisory services 5
29 5
29 12
21 -7
8 240.0%
72.4% 168
56 18
22
Infrastructure and planning services - - - - - 82- 24-
Operating
Laboratorypayments
services 2
4 000 2
4 000 4
3 383 -2
617 200.0%
84.6% 57
4 460 5
2 717
Contractors
Transfers and subsidies 205
1 441 - - 205
1 441 993
1 124 212
-683 82.4%
254.9% 205
1 671 625
766
Households
Agency and support / outsourced services 441
200 - - 441
200 1 124
122 -683
78 254.9%
61.0% 671
627 766
142
Social benefits
Entertainment 441- 441- 1 124- -683- 254.9%
- 671- 766-
Other
Fleet transfers
(including government motor transport) 350 350- 259 91- -
74.0% 1 119- 501
Inventory:
Payments for Food
capital food supplies
andassets 1 000
5 885 - - 1 000
5 885 1 216
3 955 1 784
-70 64.3%
103.7% 1 000
4 285 1 817
3 529
Machinery
Fuel, oil and gas 1
2 885
200 - - 1
2 885
200 1
3 955
029 -70
-829 103.7%
137.7% 1 285
119 1
2 529
858
Transport equipment - - - - - -
Other machinery and equipment 1 885 1 885 1 955 -70 103.7% 1 285 1 529
Payment for financial assets - - - - 30 30
Total 333 806 - - 333 806 305 465 28 341 91.5% 325 754 310 335
Subprogramme: 4.3: PSYCHIATRIC/MENTAL HOSPITALS

2020/21 2019/20
appropriation
Current payments 1 572 077 - - 1 572 077 1 516 164 55 913 96.4% 1 450 810 1 522 517
Salaries and wages 862 013 862 013 891 377 -29 364 103.4% 858 581 876 143
Advertising 10 10 - 10 - - 58
Minor assets 1 886 1 886 856 1 030 45.4% 3 237 693
Communication (G&S) 1 325 1 325 516 809 38.9% 1 745 718
Computer services 106 106 106 - 100.0% - 25
Consultants: Business and advisory services 373 829 373 829 301 108 72 721 80.5% 218 326 322 116
Contractors 1 137 1 137 462 675 40.6% 838 393
Housing - - - - - - -
Inventory: Fuel, oil and gas 9 723 9 723 14 845 -5 122 152.7% 11 849 22 443
255
256
Subprogramme: 4.3: PSYCHIATRIC/MENTAL HOSPITALS

2020/21 2019/20
appropriation
Inventory:
payments 1 572 077- - - 1 572 077- 1 516 164- 55 913- -
96.4% 1 450 810- 1 522 517-
of employees 1 025 868
1 955 - - 1 025 868
1 955 792
1 038 062 -12 076
1 107 42.4%
101.2% 875
1 016 982 657
1 017 153
Salaries Medical
Inventory:and wagessupplies 862 622
8 013 862 622
8 013 891 541
6 377 -29 081
2 364 75.9%
103.4% 858 651
10 581 876 939
5 143
Inventory:
Social Medicine
27 942 163 613
27 942 146 492
22 685 17 121
5 257 81.5%
89.5% 158 921
19 401 141 476
21 010
Medsas
Goods andinventory
services interface 546 122- - - 546 122- 478 102- 68 020- -
87.5% 433 828- 505 364-
Administrative supplies
Inventory: Otherfees 1 240
49 1 240
49 3 363
9 -2 123
40 271.2%
18.4% 5 900
26 5 160
10
Consumable supplies
Advertising 16 621
10 16 621
10 20 902- -4 281
10 125.8%
- 17 959- 17 221
58
Consumable:
Minor assets Stationery, printing and office supplies 1 015
2 886 1 015
2 886 242
2 856 1-227
030 111.3%
45.4% 3 341
2 237 132
2 693
Operating
Audit leases
costs: External 3 064- 3 064- 7 848- -4 784- 256.1%
- 5 760- 6 602-
Property payments
Bursaries: Employees 38 613- 38 613- 53 946- -15 333- 139.7%
- 39 324- 54 506-
Catering: provided: Departmental
Transport Departmental activities activity 40
110 40
110 6
1 34
109 15.0%
0.9% 20
145 37
56
1 325 467
1 325 144
516 323
809 30.8%
38.9% 492
1 745 244
718
Training and
Computer development
services 352
106 352
106 143
106 209- 40.6%
100.0% 208- 72
25
Operating payments
Consultants: Business and advisory services 250
373 829 250
373 829 2
301 108 248
72 721 0.8%
80.5% 52
218 326 14
322 116
Infrastructure and planning services 3 394- - - 3 394- 3 926- -532- 115.7%
- 2 884- 4 224-
Households
3 327 - - 7 394
3 327 5 926
3 809 1-532
518 115.7%
79.3% 4 884
2 867 224
4 784
Social benefits
Scientific and technological services 3 394- 3 394- 3 926- -532- 115.7%
- 2 884- 4 224-
Legal transfers to households
Otherservices - - - - - - -
Payments for capital assets
Contractors 1 553
9 137 - - 1 553
9 137 353
3 462 6 200
675 35.1%
40.6% 7 416
838 4 571
393
Buildings
Agency and other fixed
support / outsourced
structures services 1 213- - - 1 213- 4 397- -3 184- -
362.5% 1 115- 1 969-
Buildings
Other
Fleet fixed structures
services (including government motor transport) 1 857 1 857- 1 229 628- -
66.2% 1 917- 1 505
Machinery
Housing and equipment 9 553- - - 9 553- 3 353- 6 200- 35.1%
- 7 416- 4 571-
TransportClothing material and accessories 3 823- 3 823- 100
241 723
3-241 2.6%
- 1 140- 177
6
Other machinery
Inventory: Farming and equipment
supplies 5 730- 5 730- 3 253- 2 477- 56.8%
- 6 276- 4 394-
Payment for financial
Inventory: Food andassets
food supplies 46 785 46 785- 30 102 16 683- -
64.3% 116
86 260 116
36 528
Total
Inventory: Fuel, oil and gas 1 585 024
9 723 - - 1 585
9 024
723 1 523
14 443
845 61 581
-5 122 96.1%
152.7% 1 461
11 226
849 1 531
22 428
443
Subprogramme: 4.4: DENTAL TRAINING HOSPITALS

2020/21 2019/20
appropriation
Administrative fees 84 84 7 77 8.3% 10 -
Minor assets 1 425 1 425 272 1 153 19.1% 1 187 -574
Communication (G&S) 925 925 199 726 21.5% 1 056 466
Consultants: Business and advisory services 50 50 2 48 4.0% - -
Contractors 2 925 2 925 2 052 873 70.2% 3 847 3 475
Agency and support / outsourced services 300 300 384 -84 128.0% 400 340
Housing - - - - - - -
Inventory: Food and food supplies 23 23 - 23 - 3 1
Inventory: Fuel, oil and gas 148 148 13 135 8.8% 120 34
Inventory: Medicine 6 850 6 850 6 593 257 96.2% 2 751 4 467
Inventory: Other supplies 709 709 183 526 25.8% 572 438
257
258
Subprogramme: 4.4: DENTAL TRAINING HOSPITALS

2020/21 2019/20
appropriation
Current payments
Consumable supplies 607
6 160
075 - - 607
6 160
075 553
2 181
786 53
3 979
289 91.1%
45.9% 604
4 618
956 541
4 679
561
Compensation
Consumable: of employees
Stationery, printing and office supplies 531
1 564
976 - - 531
1 564
976 505
1 044
288 26 520
688 95.0%
65.2% 533
2 709
193 489 110
958
Salaries
Operatingand wages
leases 480
8 404
444 480
8 404
444 455
7 193
205 25
1 211
239 94.8%
85.3% 465
8 589
285 441
2 796
069
Property payments 51
2 160
171 51
2 160
171 49 851
319 1 309
852 97.4%
14.7% 68
2 120
260 47 314
864
Goods and services
Transport provided: Departmental activity 75 596- - - 75 596- 48 137- 27 459- 63.7%
- 70 909- 52 569-
Administrative fees
Travel and subsistence 84
10 84
10 7- 77
10 8.3%
- 10
39 6-
Minor assets
Training and development 1 425
335 1 425
335 272
19 1 153
316 19.1%
5.7% 1 187
215 -574
69
Communication (G&S)
Operating payments 925
435 925
435 199
252 726
183 21.5%
57.9% 1 056
094 466
29
Consultants:
Transfers Business and advisory services
and subsidies 50
1 586 - - 50
1 586 2
2 275 48
-689 4.0%
143.4% 1 440- 943-
Laboratory
Provinces services
and municipalities 6 682- - - 6 682- 1 447- 5 235- 21.7%
- 4 486- 2 905-
Contractors
Households 2
1 925
586 - - 2
1 925
586 2 052
275 873
-689 70.2%
143.4% 3
1 847
440 3 475
943
Agency
Social and support / outsourced services
benefits 1 300
586 1 300
586 2 384
275 -84
-689 128.0%
143.4% 1 400
440 340
943
Entertainment
Payments for capital assets 27 882- - -3 161 24 721- 8 223- 16 498- -
33.3% 16 146- 8 955-
Fleet services
Machinery (including government motor transport)
and equipment 27 576
882 - -3 161 24 576
721 8 549
223 27
16 498 95.3%
33.3% 16 500
146 8 152
955
Housing
Transport equipment - -- - -- -- -- --
Inventory:
Other machinery material
Clothing and and accessories
equipment 27 882- -3 161 24 721- 1
8 223 -1
16 498 -
33.3% 16 146- 26
8 955
Inventory:
Payment Farming supplies
for financial assets - -- - -- -- 45- 45-
Total 23
636 628 - -3 161 23
633 467 563 679- 23
69 788 -
89.0% 3
622 249 1
551 622
Inventory: Medicine 6 850 6 850 6 593 257 96.2% 2 751 4 467
Inventory: Other supplies 709 709 183 526 25.8% 572 438
Subprogra mme: 4.5: OTHER SPECIALISED HOSPITALS

2020/21 2019/20
a ppropria tion
Current pa yments 107 380 - - 107 380 96 343 11 037 89.7% 94 953 95 008
Social contributions 12 705 12 705 13 383 -678 105.3% 11 885 12 885
Minor assets 287 287 95 192 33.1% 106 78
Communication (G&S) 96 96 231 -135 240.6% 110 14
Consultants: Business and advisory services 10 10 - 10 - 17 13
Laboratory services 260 260 153 107 58.8% 251 208
Contractors 150 150 83 67 55.3% 137 104
Inventory: Food and food supplies 1 720 1 720 1 089 631 63.3% 1 383 1 079
Inventory: Learner and teacher support material - - - - - 15 -
259
260
Subprogra mme: 4.5: OTHER SPECIALISED HOSPITALS

2020/21 2019/20
a ppropria tion
Current pa yments
50 - - 107 380
50 96 343
98 11 037
-48 89.7%
196.0% 94 953
42 95 008
236
Inventory: Medical supplies 92
3 079
238 - - 92
3 079
238 85
2 822
132 6
1 257
106 93.2%
65.8% 83
2 330
244 83
2 467
339
Salaries
Inventory:and wages
Medicine 79
1 374
200 79
1 374
200 72 439
933 6 935
267 91.3%
77.8% 71 445
930 70
1 582
218
Social
Medsascontributions
inventory interface 12 705- 12 705- 13 383- -678- 105.3%
- 11 885- 12 885-
Goods and services
Inventory: Other supplies 15 301
352 - - 15 301
352 10 521
52 4 780
300 68.8%
14.8% 11 623
339 11 541
364
Administrative fees
Consumable supplies 9
1 233 9
1 233 5
819 4
414 55.6%
66.4% 4
875 9
788
Minor
Consumable:
assets Stationery, printing and office supplies 287
736 287
736 95
259 192
477 33.1%
35.2% 106
353 78
461
Communication
Operating leases(G&S) 96
500 96
500 231
612 -135
-112 240.6%
122.4% 110
383 14
504
4 347 10
4 347 3 597- 10
750 -
82.7% 17
3 800 13
3 495
Laboratory
Transport provided:
services Departmental activity 260- 260- 153- 107- 58.8%
- 251- 208-
Contractors
Travel and subsistence 150
74 150
74 83- 67
74 55.3%
- 137- 104-
Agency
Training and
and support / outsourced services
development 350
387 350
387 277- 73
387 79.1%
- 186
264 213
264
Entertainment
Transfers and subsidies 181- - - 181- 230- -49- -
127.1% 172- 135-
Households 232
181 - - 232
181 58
230 174
-49 25.0%
127.1% 131
172 153
135
Social benefits 181- 181- 27
230 -27
-49 -
127.1% 172- 135-
Inventory: Food and
Other transfers food supplies
to households 1 720 1 720- 1 089 631- 63.3%
- 1 383- 1 079
Inventory:
Payments for Fuel,
capital and gas
oil assets 70
3 080 - - 70
3 080 1
1 699 69
1 381 1.4%
55.2% 53
1 423 1
908
Machinery Learner
Inventory: and and teacher support material
equipment 3 080- - - 3 080- 1 699- 1 381- -
55.2% 15
1 423 908-
Other machinery and equipment 3 080 3 080 1 699 1 381 55.2% 1 423 908
Total 110 641 - - 110 641 98 272 12 369 88.8% 96 548 96 051
Programme 5: CENTRAL HOSPITAL SERVICES

2020/21 2019/20
a ppropria tion
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub progra mme
1 CENTRAL HOSPITALS 15 014 178 - -31 557 14 982 621 14 208 556 774 065 94.8% 14 810 985 14 603 682
2 PROVINCIAL TERTIARY HOSPITAL SERVICES 4 662 044 - -32 032 4 630 012 5 045 496 -415 484 109.0% 4 300 215 4 460 759
19 676 222 - -63 589 19 612 633 19 254 052 358 581 98.2% 19 111 200 19 064 441
Current pa yments 18 292 118 36 662 -66 750 18 262 030 18 315 272 -53 242 100.3% 17 650 617 17 775 367
Compensation of employees 12 313 797 14 000 - 12 327 797 12 331 230 -3 433 100.0% 11 552 044 11 681 989
Salaries and wages 10 487 331 14 000 - 10 501 331 11 025 105 -523 774 105.0% 10 160 742 10 437 323
Social contributions 1 826 466 - - 1 826 466 1 306 125 520 341 71.5% 1 391 302 1 244 666
Goods and services 5 978 321 22 662 -66 750 5 934 233 5 984 042 -49 809 100.8% 6 098 573 6 093 378
Administrative fees 619 - - 619 1 586 -967 256.2% 161 524
Advertising 704 - - 704 447 257 63.5% 431 622
Minor assets 34 969 -242 - 34 727 12 993 21 734 37.4% 17 053 9 494
Audit costs: External - - - - 27 -27 - - 212
Bursaries: Employees - - - - - - - - -
Computer services 29 100 - - 29 100 15 194 13 906 52.2% 29 100 14 653
Consultants: Business and advisory services 879 - - 879 96 783 10.9% 625 137
Laboratory services 1 213 644 31 662 - 1 245 306 909 932 335 374 73.1% 1 208 205 982 926
Legal services - - - - 9 365 -9 365 - - 6 094
Contractors 235 735 -39 000 - 196 735 150 695 46 040 76.6% 201 894 201 665
Agency and support / outsourced services 144 259 - - 144 259 152 111 -7 852 105.4% 128 000 162 840
261
262
Programme 5: CENTRAL HOSPITAL SERVICES

2020/21 2019/20
a ppropria tion
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub progra mme
1 CENTRAL HOSPITALS
Fleet services (including government motor transport) 15 014 178
7 900 - -31 557- 14 982 621
7 900 14 208 556
3 981 774 065
3 919 94.8%
50.4% 14 810 985
7 200 14 603 682
5 972
2 PROVINCIAL
Housing TERTIARY HOSPITAL SERVICES 4 662 044- - -32 032- 4 630 012- 5 045 496- -415 484
- 109.0%
- 4 300 215- 4 460 759-
Inventory: Clothing material and accessories -
19 676 222 -- -
-63 589 -
19 612 633 19 254 210
052 358-210
581 -
98.2% -
19 111 200 6
19 064 441
Inventory: Farming supplies - - - - - - - - -
Current pa yments
Inventory: Learner and teacher support material 18 292 118- 36 662- -66 750- 18 262 030- 18 315 272- -53 242- 100.3%
- 17 650 617- 17 775 367-
Inventory: Materials and supplies 12 313 797
13 042 14 000- - 12 327 797
13 042 12 331 230
15 116 -2 433
-3 074 100.0%
115.9% 11 552 044
11 877 11 681 989
12 015
Salaries and
Inventory: Medical
wagessupplies 10
2 487
038 331
399 20 000
14 242 - 10
2 501
058 331
641 11
2 025
764 105
621 -705 774
-523 980 105.0%
134.3% 10
2 160
535 742
729 10
2 437
835 323
010
Inventory: Medicine 1 826
982 466
286 12 000- -66 750- 1 826
927 466
536 1 306
763 125
257 164 341
520 279 71.5%
82.3% 1 391
924 302
377 1 244
863 666
424
Goods
Medsasandinventory
servicesinterface 5 978 321- 22 662- -66 750- 5 934 233- 5 984 042- -49 809- 100.8%
- 6 098 573- 6 093 378-
Administrative
Inventory: Otherfees
supplies 619
62 379 - - 619
62 379 586
411 394 20 -967
985 256.2%
66.4% 161
49 931 524
42 410
Consumable
Advertising supplies 261 704
409 -2 000- - 259 704
409 314 447
449 257
-55 040 63.5%
121.2% 154 431
655 155 622
050
Consumable:
Minor assets Stationery, printing and office supplies 80 969
34 487 -242- - 80 727
34 487 62 993
12 297 18 734
21 190 37.4%
77.4% 61 053
17 382 494
699 946
Audit costs:
Operating External
leases 56 296- - - 56 296- 27
43 529 -27
12 767 -
77.3% 37 999- 212
39 677
Property Employees
Bursaries:payments 505 892- - - 505 892- 477 743- 28 149- -
94.4% 441 254- 445 650-
Transport provided: Departmental
activities activity 83
292 - - 83
292 38
2 45
290 45.8%
0.7% 82
320 65
3
Communication
Travel (G&S)
and subsistence 20
2 245
015 - - 20
2 245
015 14
1 353
125 5 892
890 70.9%
55.8% 20
2 056
355 11
1 922
365
Computer
Training services
and development 29
3 100
657 - - 29
3 100
657 15 194
131 13
3 906
526 52.2%
3.6% 29
1 100
812 14 653
585
Consultants:
Operating Business and advisory services
payments 879
5 340 - - 879
5 340 96
4 855 783
485 10.9%
90.9% 625
2 770 137
2 800
Infrastructure
Transfers and planning services
and subsidies 366 215- - - 366 215- 369 149- -2 934- -
100.8% 350 532- 381 490-
Laboratory
Non-profit services
institutions 1 213
317 644
000 31 662- - 1 245
317 306
000 317 932
909 000 335 374- 73.1%
100.0% 1 208
300 205
000 300 926
982 000
Scientific and technological services
Households 49 215- - - 49 215- 52 149- -2 934- -
106.0% 50 532- 81 490-
Legal services
Social benefits 49 215- - - 49 215- 365
519 712 -2 365
-9 497 -
105.1% 50 532- 094
446 490
Contractors
Other transfers to households 235 735
- -39 000- - 196 735
- 695
150 437 040
46 -437 76.6%
- 201 894
- 201 665
37 000
Payments and
Agencyfor support
capital / outsourced services
assets 1 017 259
144 889 -36 662- 3 161- 984 259
144 388 569 111
152 631 -7 852
414 757 105.4%
57.9% 1 108 000
128 858 906 840
162 391
Machinery and equipment 1 017 889 -36 662 3 161 984 388 569 631 414 757 57.9% 1 108 858 906 391
Transport equipment 3 700 - - 3 700 1 544 2 156 41.7% 3 200 2 864
Other machinery and equipment 1 014 189 -36 662 3 161 980 688 568 087 412 601 57.9% 1 105 658 903 527
Payment for financial assets - - - - - - - 1 193 1 193
19 676 222 - -63 589 19 612 633 19 254 052 358 581 98.2% 19 111 200 19 064 441
Subprogra mme: 5.1: CENTRAL HOSPITALS

2020/21 2019/20
a ppropria tion
Current pa yments 13 840 958 14 000 -66 750 13 788 208 13 367 170 421 038 96.9% 13 554 390 13 457 096
Compensation of employees 9 444 178 14 000 - 9 458 178 9 420 167 38 011 99.6% 8 916 832 8 968 734
Salaries and wages 8 051 212 14 000 8 065 212 8 420 823 -355 611 104.4% 7 882 039 8 014 784
Social contributions 1 392 966 1 392 966 999 344 393 622 71.7% 1 034 793 953 950
Goods and services 4 396 780 - -66 750 4 330 030 3 947 003 383 027 91.2% 4 637 558 4 488 362
Advertising 605 605 249 356 41.2% 355 167
Minor assets 24 941 24 941 11 723 13 218 47.0% 9 645 5 613
Audit costs: External - - 27 -27 - - 212
Computer services 29 100 29 100 15 194 13 906 52.2% 29 100 14 017
Laboratory services 902 688 9 000 911 688 602 697 308 991 66.1% 937 440 780 136
Legal services - - 8 946 -8 946 - - 5 938
Contractors 189 618 -39 000 150 618 116 957 33 661 77.7% 167 490 166 079
Inventory: Clothing material and accessories - - - - - - 6
263
264
Subprogra mme: 5.1: CENTRAL HOSPITALS

2020/21 2019/20
a ppropria tion
Inventory:
pa yments 13 840 958- 14 000 -66 750 13 788 208- 13 367 170- 421 038- -
96.9% 13 554 390- 13 457 096-
of employees 9 444 342
9 178 14 000 - 9 458 342
9 178 9 420 454
13 167 38 112
-4 011 144.0%
99.6% 8 916 197
9 832 8 968 989
9 734
Salaries Medical
Inventory:and wagessupplies 8
1 051 515
403 212 14
20 000 8
1 065 515
423 212 8
1 420 917
576 823 -355 402
-153 611 110.8%
104.4% 7
1 882 347
860 039 8
1 014 367
960 784
Inventory:
Social Medicine
contributions 1 392 526
787 966 12 000 -66 750 1 392 776
732 966 999 555
592 344 393 221
140 622 80.9%
71.7% 1 034 770
739 793 953 366
685 950
Inventory:
Goods Other supplies
and services 4 396 000
39 780 - -66 750 4 330 000
39 030 3 947 926
19 003 383 074
19 027 51.1%
91.2% 4 637 600
38 558 4 488 325
34 362
Consumable supplies
183 472 -2 000 377
181 472 883
266 696 506
-85-224 147.1%
147.5% 108 040
59 777
107 288
Consumable: Stationery, printing and office supplies
Advertising 000
48 605 000
48 605 987
35 249 013
12 356 75.0%
41.2% 681
31 355 171
40 167
Operating
Minor leases
assets 24 496
32 941 24 496
32 941 11 115
27 723 13 381
5 218 83.4%
47.0% 26 550
9 645 30 380
5 613
Property
Audit payments
costs: External 400 400- 400 400- 356 028
27 44 372
-27 88.9%
- 347 254- 880
311 212
Transport Departmental activities activity 282
83 282
83 38- 282
45 -
45.8% 280
82 1
65
1 810 17 365
1 810 959
13 869 406
3 941 70.3%
77.9% 16 215
2 900 11 287
1 812
Training and
services 29 190
2 100 29 190
2 100 107
15 194 13 083
2 906 4.9%
52.2% 29 238
1 100 342
14 017
Operating payments 5 190
240 5 190
240 96
4 543 94
697 50.5%
86.7% 2 340
670 2 119
710
Laboratory
Transfers services
and subsidies 902
357 688
335 9 000- - 911
357 688
335 602
360 697
209 308
-2 991
874 66.1%
100.8% 937
340 440
976 780
370 136
588
Legal services
Non-profit institutions 317 000- 317 000- 8 946
317 000 -8 946- -
100.0% 300 000- 5 938
300 000
Contractors
Households 189
40 618
335 -39 000- - 150
40 618
335 116
43 957
209 33
-2 661
874 77.7%
107.1% 167
40 490
976 166
70 079
588
Agency
Social and support / outsourced services
benefits 108
40 650
335 108
40 650
335 120
42 003
772 -11
-2 353
437 110.4%
106.0% 109
40 300
976 142
33 142
588
Fleet
Otherservices (including
transfers government motor transport)
to households 6 200 6 200- 3 307
437 893
2-437 53.3%
- 5 700- 4 898
37 000
Inventory:
Payments for Clothing material and accessories
capital assets 815 885- -14 000 35 193 837 078- 481 177- 355 901- -
57.5% 914 648- 6
775 027
Machinery Food
Inventory: and and food supplies
equipment 116
815 570
885 -14 000 35 193 116
837 570
078 89 753
481 177 26 817
355 901 77.0%
57.5% 105
914 240
648 97 277
775 027
Inventory:
TransportFuel, oil and gas
equipment 87
3 120
500 87
3 120
500 68
1 974
218 18
2 146
282 79.2%
34.8% 88
2 065
500 74
1 998
353
Other machinery and equipment 812 385 -14 000 35 193 833 578 479 959 353 619 57.6% 912 148 773 674
Total 15 014 178 - -31 557 14 982 621 14 208 556 774 065 94.8% 14 810 985 14 603 682
Subprogramme: 5.2: PROVINCIAL TERTIARY HOSPITAL SERVICES

2020/21 2019/20
appropriation
Current payments 4 451 160 22 662 - 4 473 822 4 948 102 -474 280 110.6% 4 096 227 4 318 271
Salaries and wages 2 436 119 2 436 119 2 604 282 -168 163 106.9% 2 278 703 2 422 539
Goods and services 1 581 541 22 662 - 1 604 203 2 037 039 -432 836 127.0% 1 461 015 1 605 016
Advertising 99 99 198 -99 200.0% 76 455
Minor assets 10 028 -242 9 786 1 270 8 516 13.0% 7 408 3 881
Communication (G&S) 2 435 2 435 484 1 951 19.9% 3 156 110
Computer services - - - - - - 636
Consultants: Business and advisory services 689 689 - 689 - 285 18
Laboratory services 310 956 22 662 333 618 307 235 26 383 92.1% 270 765 202 790
Legal services - - 419 -419 - - 156
Contractors 46 117 46 117 33 738 12 379 73.2% 34 404 35 586
265
266
Subprogramme: 5.2: PROVINCIAL TERTIARY HOSPITAL SERVICES

2020/21 2019/20
appropriation
Inventory:
Current Farming supplies
payments 4 451 160- 22 662 - 4 473 822- 4 948 102- -474 280- -
110.6% 4 096 227- 4 318 271-
Inventory: Food and food supplies 2 869
49 619
000 - - 2 869
49 619
000 2 911
36 063
958 -41
12 444
042 101.4%
75.4% 2 635
47 212
000 2 713
43 255
246
Salaries
Inventory:and wages
Fuel, oil and gas 2 436
26 119
000 2 436
26 119
000 2 604
28 282
810 -168
-2 163
810 106.9%
110.8% 2 278
21 703
000 2 422
12 539
790
Inventory: Learner and teacher support material 433 500- 433 500- 306 781- 126 719- 70.8%
- 356 509- 290 716-
Goods and services
3 541
700 22 662 - 1 604
3 203
700 2 037
1 039
662 -432
2 836
038 127.0%
44.9% 1 461
2 015
680 1 605
2 016
026
Administrative
Inventory: Medical
feessupplies 634 147
884 242 635 147
126 890
1 187 704 -552-743
578 605.4%
187.0% 102
675 382 236
874 643
Inventory: Medicine
Advertising 194 760
99 194 760
99 702
170 198 24 058
-99 87.6%
200.0% 184 607
76 058
178 455
Medsas
Minor inventory interface
assets 10 028- -242 9 786- 1 270- 8 516- -
13.0% 7 408- 3 881-
Communication supplies
Inventory: Other (G&S) 23 379
2 435 23 379
2 435 468
21 484 911
1 951 91.8%
19.9% 11 331
3 156 085
8 110
Consumable
Computer supplies
services 78 032- 78 032- 47 566- 30 466- 61.0%
- 46 615- 273
47 636
Consultants: Stationery,
Consumable: Business andprinting
advisory office supplies
andservices 32 487
689 487
32 689 26 310- 177
6 689 81.0%
- 29 701
285 29 775
18
Operating leases
Infrastructure and planning services 23 800- 23 800- 16 414- 7 386- 69.0%
- 11 449- 9 297-
Property payments
105 956 22 662 333 492
105 618 307 715
121 235 -16 223
26 383 115.4%
92.1% 270 000
94 765 202 770
133 790
Scientific provided:
Transport and Departmental
technological activity
services 10- 10- 2- 8- 20.0%
- 40- 2-
Legal and subsistence
Travel services 650- 650- 166
419 484
-419 25.5%
- 140- 78
156
Contractors 46 467
1 117 46 467
1 117 24
33 738 12 443
1 379 1.6%
73.2% 574
34 404 243
35 586
Operating
Agency andpayments
35 609 100
35 609 312
32 108 3-212
501 312.0%
90.2% 100
18 700 90
20 698
Entertainment 8 880- - - 8 880- 8 940- -60- 100.7%
- 9 556- 10 902-
Households
Fleet services (including government motor transport) 1 880
8 700 - - 1 880
8 700 8 940
674 -60
1 026 100.7%
39.6% 9
1 556
500 10
1 902
074
Social benefits
Inventory: Clothing material and accessories 8 880- 8 880- 8 940
210 -60
-210 100.7%
- 9 556- 10 902-
Payments for capital assets 202 004 -22 662 -32 032 147 310 88 454 58 856 60.0% 194 210 131 364
Machinery and equipment 202 004 -22 662 -32 032 147 310 88 454 58 856 60.0% 194 210 131 364
Transport equipment 200 200 326 -126 163.0% 700 1 511
Other machinery and equipment 201 804 -22 662 -32 032 147 110 88 128 58 982 59.9% 193 510 129 853
Total 4 662 044 - -32 032 4 630 012 5 045 496 -415 484 109.0% 4 300 215 4 460 759
Programme 6: HEALTH SCIENCES AND TRAINING

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 NURSE TRAINING COLLEGES 628 619 - -24 000 604 619 556 647 47 972 92.1% 805 951 693 034
2 EMS TRAINING COLLEGES 42 149 - - 42 149 36 495 5 654 86.6% 39 285 29 123
3 BURSARIES 228 319 - -54 371 173 948 129 244 44 704 74.3% 225 665 263 503
4 OTHER TRAINING 80 552 - - 80 552 64 824 15 728 80.5% 80 842 59 596
979 639 - -78 371 901 268 787 210 114 058 87.3% 1 151 743 1 045 256
Current payments 680 069 -3 -24 000 656 066 619 303 36 763 94.4% 870 462 717 915
Compensation of employees 589 899 - -24 000 565 899 556 097 9 802 98.3% 797 613 654 671
Salaries and wages 519 974 - -20 000 499 974 491 551 8 423 98.3% 685 283 575 893
Social contributions 69 925 - -4 000 65 925 64 546 1 379 97.9% 112 330 78 778
Goods and services 90 170 -3 - 90 167 63 206 26 961 70.1% 72 849 63 244
Administrative fees 13 - - 13 - 13 - 79 5
Advertising 62 - - 62 1 61 1.6% 123 37
Minor assets 691 - - 691 1 335 -644 193.2% 510 1 092
Audit costs: External - - - - - - - - -
Bursaries: Employees 10 960 - - 10 960 8 949 2 011 81.7% 9 651 1 481
Communication (G&S) 1 303 - - 1 303 373 930 28.6% 932 723
267
268
2020/21 2019/20
Adjusted Shifting of Virement Virement Actual Variance Expenditure Final Actual

Appropriation Funds Expenditure as % of final Appropriation Expenditure
appropriation
Computer services R’000 - R’000 - R’000 - R’000 - R’000 117 R’000-117 R’000 - R’000 - R’000 -
Consultants: Business and advisory services 287 - - 287 674 -387 234.8% 286 29
Laboratory services 56 - - 56 9 47 16.1% 56 10
Contractors 3 468 - - 3 468 2 393 1 075 69.0% 4 683 1 668
Agency and support / outsourced services -45 - - -45 730 -775 (1622.2%) 5 2
Fleet services (including government motor transport) 2 783 - - 2 783 2 353 430 84.5% 2 041 1 698
Housing - - - - - - - - -
Inventory: Clothing material and accessories - - - - 73 -73 - - 59
Inventory: Food and food supplies 148 - - 148 47 101 31.8% 175 178
Inventory: Fuel, oil and gas 7 - - 7 5 2 71.4% 12 3
Inventory: Learner and teacher support material 1 732 - - 1 732 1 041 691 60.1% 1 818 1 096
Inventory: Materials and supplies 1 171 - - 1 171 768 403 65.6% 1 312 1 012
Inventory: Medical supplies 827 - - 827 1 080 -253 130.6% 1 163 927
Inventory: Medicine 550 - - 550 537 13 97.6% 473 637
Inventory: Other supplies 1 243 - - 1 243 821 422 66.0% 370 460
Consumable supplies 6 916 - - 6 916 4 912 2 004 71.0% 6 375 7 104
Consumable: Stationery, printing and office supplies 3 145 - - 3 145 2 283 862 72.6% 3 322 2 628
Operating leases 8 738 - - 8 738 7 572 1 166 86.7% 5 021 7 998
Property payments 24 754 - - 24 754 22 457 2 297 90.7% 13 342 18 451
Transport provided: Departmental activity - - - - - - - - -
Travel and subsistence 10 282 - - 10 282 757 9 525 7.4% 14 492 14 063
Training and development 10 049 -3 - 10 046 3 893 6 153 38.8% 6 143 1 351
Operating payments 100 - - 100 13 87 13.0% 369 146
Venues and facilities 500 - - 500 - 500 - - 346
Departmental agencies and accounts 23 352 - - 23 352 23 352 - 100.0% 22 135 22 135
Social security funds - - - - - - - - -
Departmental agencies 23 352 - - 23 352 23 352 - 100.0% 22 135 22 135
Higher education institutions 15 459 - - 15 459 12 871 2 588 83.3% 1 488 1 488
Households 253 234 - -54 371 198 863 123 685 75 178 62.2% 249 241 298 308
Social benefits 1 622 - - 1 622 2 265 -643 139.6% 1 497 3 538
251 612 - -54 371 197 241 121 420 75 821 61.6% 247 744 294 770

Payments for capital assets 7 525 - - 7 525 7 996 -471 106.3% 7 733 4 726
Machinery and equipment 7 525 - - 7 525 7 996 -471 106.3% 7 733 4 726
Transport equipment 1 740 - - 1 740 1 372 368 78.9% 1 601 241
Other machinery and equipment 5 785 - - 5 785 6 624 -839 114.5% 6 132 4 485
Payment for financial assets - 3 - 3 3 - 100.0% 684 684
979 639 - -78 371 901 268 787 210 114 058 87.3% 1 151 743 1 045 256
Subprogra mme: 6.1: NURSE TRAINING COLLEGES

2020/21 2019/20
a ppropria tion
Current pa yments 573 835 - -24 000 549 835 540 297 9 538 98.3% 769 398 647 173
Compensation of employees 533 463 - -24 000 509 463 507 704 1 759 99.7% 744 433 610 735
Salaries and wages 469 680 -20 000 449 680 448 578 1 102 99.8% 637 507 536 769
Social contributions 63 783 -4 000 59 783 59 126 657 98.9% 106 926 73 966
Advertising 12 12 1 11 8.3% 41 37
Minor assets 375 375 362 13 96.5% 192 681
Communication (G&S) 1 042 1 042 365 677 35.0% 665 706
Consultants: Business and advisory services 7 7 - 7 - 6 -
Contractors 140 140 29 111 20.7% 183 490
Agency and support / outsourced services -50 -50 - -50 - - -
Fleet services (including government motor transport) 1 012 1 012 548 464 54.2% 1 225 926
Inventory: Learner and teacher support material 1 382 1 382 683 699 49.4% 1 502 850
Inventory: Materials and supplies 571 571 127 444 22.2% 485 328
Inventory: Medical supplies 277 277 75 202 27.1% 415 312
Inventory: Medicine - - 135 -135 - - 38
269
270
Subprogra mme: 6.1: NURSE TRAINING COLLEGES

2020/21 2019/20
a ppropria tion
Medsas
Current inventory interface
pa yments 573 835- - -24 000 549 835- 540 297- 9 538- -
98.3% 769 398- 647 173-
Inventory: Other supplies 463
533 243 - -24 000 463
509 243 704
507 173 1 759
70 99.7%
71.2% 433
744 220 735
610 351
Consumable wages
Salaries and supplies 469 680
4 646 -20 000 449 680
4 646 448 578
2 744 102
1 902 99.8%
59.1% 637 507
4 488 536 769
6 042
1 727 -4 000 59 783
1 727 59 126
1 558 657
169 98.9%
90.2% 106 926
1 877 73 966
2 068
Goods and services
Operating leases 40 372
8 658 - - 40 372
8 658 32 593
7 555 1 779
7 103 80.7%
87.3% 24 965
4 909 36 438
7 947
Advertising
20 003 12
20 003 1
18 169 11
1 834 8.3%
90.8% 41
8 453 37
15 406
Minor assets
Transport provided: Departmental activity 375- 375- 362- 13- 96.5%
- 192- 681-
Communication
Travel (G&S)
6 1 042
6 365
25 677
-19 35.0%
416.7% 665
5 706
10
Consultants:
Training Business and advisory services
and development 7
186 7
186 - 7
186 - 6
120 67-
Contractors
Operating payments 140- 140- 29- 111- 20.7%
- 183
50 490
72
Agency
Transfers and
and support / outsourced services
subsidies -50
50 516 - - -50
50 516 14 093- -50
36 423 -
27.9% 33 205- 42 609-
Entertainment
Higher education institutions 15 459- 15 459- 11 864- 3 595- -
76.7% - 1 412-
Households 35 012
1 057 - - 35 012
1 057 548
2 229 464
32 828 54.2%
6.4% 33 225
1 205 926
41 197
Social benefits 128
1 582 128
1 582 39
2 142 89
-560 30.5%
135.4% 122
1 475 104
2 708
Inventory:
Other transfers
Fuel, oiltoand gas
households 7
33 475 7
33 475 5
87 2
33 388 71.4%
0.3% 7
31 730 3
38 489
Inventory:
Payments for Learner
capital and teacher support material
assets 4 382
1 268 - - 4 382
1 268 683
2 257 699
2 011 49.4%
52.9% 2 502
1 679 850
2 583
Inventory:
Buildings Materials
and other fixed supplies
andstructures 571- - - 571- 127- 444- 22.2%
- 485- 328-
Inventory:
BuildingsMedical supplies 277 277- 75 202- 27.1%
- 415- 312
Inventory: Medicine
Other fixed structures - - 135 -135- - - 38
Machinery and equipment 4 268 - - 4 268 2 257 2 011 52.9% 2 679 2 583
Transport equipment 1 740 1 740 422 1 318 24.3% 550 241
Other machinery and equipment 2 528 2 528 1 835 693 72.6% 2 129 2 342
Total 628 619 - -24 000 604 619 556 647 47 972 92.1% 805 951 693 034
Subprogramme: 6.2: EMS TRAINING COLLEGES

2020/21 2019/20
a ppropria tion
Current pa yments 39 365 -3 - 39 362 30 863 8 499 78.4% 34 707 26 901
Social contributions 3 105 3 105 2 242 863 72.2% 2 525 2 094
Goods and services 16 164 -3 - 16 161 15 657 504 96.9% 14 058 11 119
Administrative fees - - - - - - -
Advertising 50 50 - 50 - 82 -
Minor assets 300 300 241 59 80.3% 302 312
Bursaries: Employees 778 778 778 - 100.0% - 1 217
Computer services - - 117 -117 - - -
Contractors 1 500 1 500 2 364 -864 157.6% 1 500 1 178
Fleet services (including government motor transport) 1 771 1 771 1 805 -34 101.9% 816 772
Housing - - - - - - -
Inventory: Fuel, oil and gas - - - - - 5 -
271
272
Subprogramme: 6.2: EMS TRAINING COLLEGES

2020/21 2019/20
a ppropria tion
Inventory:
pa yments 350
39 365 -3 - 350
39 362 358
30 863 -8
8 499 102.3%
78.4% 316
34 707 246
26 901
600 - - 23 201
600 15 206
641 7 995
-41 65.5%
106.8% 20 649
827 15 782
683
Salaries Medical
Inventory:and wagessupplies 550
20 096 550
20 096 1 005
12 964 7-455
132 182.7%
64.5% 748
18 124 549
13 688
Inventory:
Social Medicine
contributions 550
3 105 550
3 105 402
2 242 148
863 73.1%
72.2% 473
2 525 2 599
094
Medsas
Goods andinventory
services interface 16 164- -3 - 16 161- 15 657- 504- -
96.9% 14 058- 11 119-
Inventory:
Administrative supplies
Otherfees 1 000- 1 000- 647- 353- 64.7%
- 150- 109-
Consumable
Advertising supplies 2 149
50 2 149
50 2 162- -13
50 100.6%
- 1 696
82 1 018-
Consumable:
Minor assets Stationery, printing and office supplies 700
300 700
300 612
241 88
59 87.4%
80.3% 527
302 508
312
Operating
Audit leases
costs: External 80- 80- 17- 63- 21.3%
- 112- 51-
Property payments
Bursaries: Employees 4 751
778 751
4 778 4 288
778 463- 90.3%
100.0% 4 888- 1 045
3 217
Transport Departmental activities activity 100- 100- 3- 97- -
3.0% 52- 8-
100 10
100 63
7 -53
93 630.0%
7.0% 221
106 55
17
Training and
services 700- -3 697- 122
117 575
-117 17.5%
- 860- 602-
Operating payments
Contractors 100
1 500 100
1 500 13
2 364 87
-864 13.0%
157.6% 319
1 500 74
1 178
Transfers
Agencyand
andsubsidies
5 - - 40
5 93
4 -53
1 232.5%
80.0% 22
5 64
2
Households
Entertainment 40- - - 40- 93- -53- 232.5%
- 22- 64-
Social
Fleet benefits
services (including government motor transport) 40
1 771 40
1 771 93
1 805 -53
-34 232.5%
101.9% 22
816 64
772
Housing - - - - - - -
Payments
Inventory: capital
for Food andassets
food supplies 2 744
20 - - 2 744
20 5 536
8 -2 792
12 201.7%
40.0% 4 541
53 2 143
74
Buildings and
Inventory: other
Fuel, oil fixed structures
and gas - - - - - - - 5- -
Buildings - - - -
Other fixed structures - - - -
Transport equipment - 950 -950 - 1 051
Payment for financial assets 3 3 3 - 100.0% 15 15
Total 42 149 - - 42 149 36 495 5 654 86.6% 39 285 29 123
Subprogramme: 6.3: BURSARIES

2020/21 2019/20
appropriation
Compensation of employees - - - - - - - - 36
Salaries and wages - - - - 29
Social contributions - - - - 7
Bursaries: Employees 10 182 10 182 8 171 2 011 80.2% 9 651 264
Travel and subsistence - 28 -28 - - 6 435
Households 218 137 - -54 371 163 766 121 045 42 721 73.9% 216 014 256 768
Social benefits - - - - - - 487
Other transfers to households 218 137 -54 371 163 766 121 045 42 721 73.9% 216 014 256 281
Total 228 319 - -54 371 173 948 129 244 44 704 74.3% 225 665 263 503
273
274
Subprogramme: 6.4: OTHER TRAINING

2020/21 2019/20
appropriation
Compensation of employees 33 235 - - 33 235 33 187 48 99.9% 32 531 28 118
Salaries and wages 30 198 30 198 30 009 189 99.4% 29 652 25 407
Administrative fees 13 13 - 13 - 79 5
Minor assets 16 16 732 -716 4575.0% 16 99
Communication (G&S) 161 161 1 160 0.6% 161 -
Consultants: Business and advisory services 280 280 674 -394 240.7% 280 29
Laboratory services 56 56 9 47 16.1% 56 10
Contractors 1 828 1 828 - 1 828 - 3 000 -
Agency and support / outsourced services - - 726 -726 - - -
Inventory: Materials and supplies - - - - - - 1
Inventory: Medical supplies - - - - - - 66
Consumable supplies 121 121 6 115 5.0% 191 44
Consumable: Stationery, printing and office supplies 718 718 113 605 15.7% 918 52
Property payments - - - - - 1 -
Travel and subsistence 10 266 10 266 641 9 625 6.2% 14 266 7 563
Training and development 9 163 9 163 3 771 5 392 41.2% 5 163 682
Operating payments - - - - - - -
Venues and facilities 500 500 - 500 - - 346
Departmental agencies and accounts 23 352 - - 23 352 23 352 - 100.0% 22 135 22 135
Social security funds - - - - -
Departmental agencies (non-business entities) 23 352 23 352 23 352 - 100.0% 22 135 22 135
Higher education institutions - 1 007 -1 007 - 1 488 76
Households - - - - 318 -318 - - 279
Social benefits - 30 -30 - - 279
Other transfers to households - 288 -288 - - -

Payments for capital assets 513 - - 513 203 310 39.6% 513 -
Machinery and equipment 513 - - 513 203 310 39.6% 513 -
Transport equipment - - - -
Other machinery and equipment 513 513 203 310 39.6% 513
Total 80 552 - - 80 552 64 824 15 728 80.5% 80 842 59 596
Programme 7: HEALTH CARE SUPPORT SERVICES
2020/21 2019/20
a ppropria tion
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Departmental agencies (non-business entities) 23 352 23 352 23 352 - 100.0% 22 135 22 135
Higher education institutions - 1 007 -1 007 - 1 488 76
Households - - - - 318 -318 - - 279
Social benefits - 30 -30 - - 279
Other transfers to households - 288 -288 - - -
Payments for capital assets 513 - - 513 203 310 39.6% 513 -
Machinery and equipment 513 - - 513 203 310 39.6% 513 -
APPROPRIATION
Transport equipment
STATEMENT - - - -
Other machinery and equipment 513 513 203 310 39.6% 513
Total 80 552 - - 80 552 64 824 15 728 80.5% 80 842 59 596
Programme 7: HEALTH CARE SUPPORT SERVICES
2020/21 2019/20
a ppropria tion
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub progra mme
1 LAUNDRIES 281 630 - 6 000 287 630 294 625 -6 995 102.4% 291 993 287 581
2 FOOD SUPPLY SERVICES 103 633 - - 103 633 94 219 9 414 90.9% 77 794 81 363
3 MEDICINE TRADING ACCOUNT 1 - - 1 - 1 - 1 -
385 264 - 6 000 391 264 388 844 2 420 99.4% 369 788 368 944
Current pa yments 381 698 - 6 000 387 698 387 500 198 99.9% 366 295 367 066
Compensation of employees 201 182 - - 201 182 201 582 -400 100.2% 199 694 197 050
Salaries and wages 163 999 - - 163 999 162 430 1 569 99.0% 161 764 161 036
Social contributions 37 183 - - 37 183 39 152 -1 969 105.3% 37 930 36 014
Goods and services 180 516 - 6 000 186 516 185 918 598 99.7% 166 601 170 016
Minor assets 162 - - 162 72 90 44.4% 202 24
Communication (G&S) 450 - - 450 291 159 64.7% 561 342
Contractors 243 - - 243 662 -419 272.4% 298 310
Agency and support / outsourced services 127 - - 127 22 105 17.3% 3 23
275
276
2020/21 2019/20
Adjusted Shifting of Virement Virement Actual Variance Expenditure Final Actual

Appropriation Funds Expenditure as % of final Appropriation Expenditure
appropriation
Entertainment R’000 - R’000 - R’000 - R’000 - R’000 - R’000 - R’000 - R’000 - R’000 -
Fleet services (including government motor transport) 4 098 - - 4 098 3 491 607 85.2% 2 223 3 766
Housing - - - - - - - - -
Inventory: Clothing material and accessories - - - - 247 -247 - - -
Inventory: Farming supplies - - - - - - - - -
Inventory: Learner and teacher support material - - - - - - - - -
Inventory: Materials and supplies 153 - - 153 48 105 31.4% 290 416
Inventory: Medical supplies 4 408 - - 4 408 4 139 269 93.9% 2 719 1 612
Inventory: Medicine - - - - - - - - -
Inventory: Other supplies 3 238 - - 3 238 3 527 -289 108.9% 1 511 913
Consumable supplies 63 294 - 6 000 69 294 72 288 -2 994 104.3% 54 078 54 658
Consumable: Stationery, printing and office supplies 513 - - 513 354 159 69.0% 557 388
Operating leases 6 456 - - 6 456 7 682 -1 226 119.0% 6 532 9 570
Property payments 28 218 - - 28 218 28 855 -637 102.3% 22 859 25 554
Transport provided: Departmental activity - - - - - - - - -
Travel and subsistence 28 - - 28 14 14 50.0% 30 -
Training and development 230 - - 230 3 227 1.3% 183 55
Operating payments 1 865 - - 1 865 1 892 -27 101.4% 2 000 774
Transfers and subsidies 486 - - 486 975 -489 200.6% 468 1 254
Households 486 - - 486 975 -489 200.6% 468 1 254
Social benefits 486 - - 486 975 -489 200.6% 468 652
Other transfers to households - - - - - - - - 602
Payments for capital assets 3 080 - - 3 080 369 2 711 12.0% 2 994 593
Machinery and equipment 3 080 - - 3 080 369 2 711 12.0% 2 994 593
Transport equipment 446 - - 446 - 446 - 50 -
Other machinery and equipment 2 634 - - 2 634 369 2 265 14.0% 2 944 593
385 264 - 6 000 391 264 388 844 2 420 99.4% 369 788 368 944
Subprogramme: 7.1: LAUNDRIES

2020/21 2019/20
appropriation
Current payments 279 144 - 6 000 285 144 293 573 -8 429 103.0% 289 641 285 950
Salaries and wages 139 398 139 398 139 904 -506 100.4% 138 087 138 561
Goods and services 107 161 - 6 000 113 161 119 754 -6 593 105.8% 117 624 116 276
Minor assets 152 152 72 80 47.4% 192 24
Contractors 232 232 662 -430 285.3% 267 -
Agency and support / outsourced services 117 117 21 96 17.9% - 21
Housing - - - - - - -
277
278
Subprogramme: 7.1: LAUNDRIES

2020/21 2019/20
appropriation
Inventory:
payments 279 144- - 6 000 285 144- 293 573- -8 429- -
103.0% 289 641- 285 950-
of employees 151
171 983 - - 151
171 983 45
173 819 106
-1 836 29.8%
101.1% 274
172 017 415
169 674
Salaries Medical
Inventory:and wagessupplies 139 908
2 398 139 908
2 398 139 428
3 904 -520
-506 117.9%
100.4% 138 199
1 087 710
138 561
Inventory:
Social Other supplies
1 585 32 238
1 585 33 575
2 915 337
-1 330 208.0%
104.1% 711
33 930 635
31 113
Consumable
Goods supplies
and services 107 294
47 161 - 6 000 113 294
53 161 119 853
59 754 559
-6 593 112.3%
105.8% 117 578
43 624 116 901
38 276
Consumable:
Minor assets Stationery, printing and office supplies 363
152 363
152 290
72 73
80 79.9%
47.4% 257
192 159
24
Communication
Operating leases(G&S) 6 456
446 456
6 446 7 682
291 -1 226
155 119.0%
65.2% 6 532
557 9 570
340
Property payments
Contractors 23 718
232 23 718
232 23 008
662 710
-430 97.0%
285.3% 17 159
267 20 542-
Travel
Agency and subsistence
and support / outsourced services 25
117 25
117 14
21 11
96 56.0%
17.9% 27- 21-
Entertainment 130- 130- - 130- - 94- -
Operating payments
Fleet services (including government motor transport) 1
4 865
095 1
4 865
095 1
3 892
491 -27
604 101.4%
85.3% 2 000
223 3 774
766
Rent on land
Housing - - - - - - -
Transfers
Inventory: subsidies
andClothing material and accessories 386- - - 386- 893
247 -507
-247 231.3%
- 368- 1 184-
Households
Inventory: Farming supplies 386- - - 386- 893- -507- 231.3%
- 368- 1 184-
Social benefits
Inventory: Food and food supplies 386
61 386
61 893
33 -507
28 231.3%
54.1% 368
60 582
39
Other transfers
Inventory: households
Fuel, oiltoand gas 17 910 17 910- 16 150 1 760- -
90.2% 42 494- 602
40 380
Payments for capital assets 2 100 - - 2 100 159 1 941 7.6% 1 964 427
Machinery and equipment 2 100 - - 2 100 159 1 941 7.6% 1 964 427
Transport equipment 446 446 - 446 - 50 -
Other machinery and equipment 1 654 1 654 159 1 495 9.6% 1 914 427
Total 281 630 - 6 000 287 630 294 625 -6 995 102.4% 291 993 287 581
Subprogramme: 7.2: FOOD SUPPLY SERVICES

2020/21 2019/20
appropriation
Minor assets 10 10 - 10 - 10 -
Communication (G&S) 4 4 - 4 - 4 2
Contractors 10 10 - 10 - 30 310
Fleet services (including government motor transport) 3 3 - 3 - - -
Inventory: Fuel, oil and gas 22 916 22 916 22 112 804 96.5% 10 000 4 422
Inventory: Materials and supplies 2 2 3 -1 150.0% 16 1
Inventory: Medical supplies 1 500 1 500 711 789 47.4% 1 520 902
Inventory: Other supplies 2 000 2 000 952 1 048 47.6% 800 278
Consumable: Stationery, printing and office supplies 150 150 64 86 42.7% 300 229
Operating leases - - - - - - -
Property payments 4 500 4 500 5 847 -1 347 129.9% 5 700 5 012
Travel and subsistence 3 3 - 3 - 3 -
Training and development 100 100 3 97 3.0% 89 55
Transfers and subsidies 100 - - 100 82 18 82.0% 100 70
Households 100 - - 100 82 18 82.0% 100 70
Social benefits 100 100 82 18 82.0% 100 70
Payments for capital assets 980 - - 980 210 770 21.4% 1 030 166
Machinery and equipment 980 - - 980 210 770 21.4% 1 030 166
Other machinery and equipment 980 980 210 770 21.4% 1 030 166
Total 103 633 - - 103 633 94 219 9 414 90.9% 77 794 81 363
279
280
Subprogramme: 7.3: MEDICINE TRADING ACCOUNT

2020/21 2019/20
appropriation
Current payments 1 - - 1 - 1 - 1 -
Goods and services 1 - - 1 - 1 - 1 -
Contractors 1 1 1 - 1
Total 1 - - 1 - 1 - 1 -
Programme 8: HEALTH FACILITIES MANAGEMENT

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 COMMUNITY HEALTH FACILITIES 542 599 67 674 - 610 273 526 523 83 750 86.3% 373 766 421 683
2 EMERGENCY MEDICAL RESCUE SERVICES 22 340 1 362 - 23 702 19 933 3 769 84.1% -3 260 6 813
3 DISTRICT HOSPITAL SERVICES 879 882 -189 738 - 690 144 631 525 58 619 91.5% 157 049 242 631
4 PROVINCIAL HOSPITAL SERVICES 283 146 105 304 - 388 450 353 929 34 521 91.1% 200 733 377 035
5 CENTRAL HOSPITAL SERVICES 1 464 162 39 822 - 1 503 984 1 520 597 -16 613 101.1% 382 434 604 556
6 OTHER FACILITIES 1 767 364 -24 424 -717 260 1 025 680 988 850 36 830 96.4% 979 421 401 167
4 959 493 - -717 260 4 242 233 4 041 357 200 876 95.3% 2 090 143 2 053 885
2020/21 2019/20
appropriation
Current payments 1 - - 1 - 1 - 1 -
Goods and services 1 - - 1 - 1 - 1 -
APPROPRIATION
Contractors
STATEMENT 1 1 1 - 1
Total
for the year ended 31 March 2021 1 - - 1 - 1 - 1 -
Programme 8: HEALTH FACILITIES MANAGEMENT

2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 COMMUNITY HEALTH FACILITIES 542 599 67 674 - 610 273 526 523 83 750 86.3% 373 766 421 683
2 EMERGENCY MEDICAL RESCUE SERVICES 22 340 1 362 - 23 702 19 933 3 769 84.1% -3 260 6 813
3 DISTRICT HOSPITAL SERVICES 879 882 -189 738 - 690 144 631 525 58 619 91.5% 157 049 242 631
4 PROVINCIAL HOSPITAL SERVICES 283 146 105 304 - 388 450 353 929 34 521 91.1% 200 733 377 035
5 CENTRAL HOSPITAL SERVICES 1 464 162 39 822 - 1 503 984 1 520 597 -16 613 101.1% 382 434 604 556
6 OTHER FACILITIES 1 767 364 -24 424 -717 260 1 025 680 988 850 36 830 96.4% 979 421 401 167
4 959 493 - -717 260 4 242 233 4 041 357 200 876 95.3% 2 090 143 2 053 885
281
282
2020/21 2019/20
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Current payments 1 838 810 455 053 - 654 199 1 639 664 1 689 868 - 50 204 103,1% 1 192 499 1 592 369
Compensation of employees 48 998 - - 48 998 40 352 8 646 82,4% 47 266 37 568
Salaries and wages 44 577 - - 44 577 35 140 9 437 78,8% 43 517 33 409
Social contributions 4 421 - - 4 421 5 212 - 791 117,9% 3 749 4 159
Goods and services 1 789 812 455 053 - 654 199 1 590 666 1 649 516 - 58 850 103,7% 1 145 233 1 554 801
Advertising 500 - - 500 - 500 - 372 330
Minor assets 200 - - 200 72 128 36,0% 649 2
Catering: Departmental activities 100 - - 100 - 100 - 124 42
Communication (G&S) 120 - - 120 - 120 - 196 -
Laboratory services - - - - - 4 525 4 525 - - -
Contractors 3 596 - - 3 596 3 371 225 93,7% 2 187 3 171
Fleet services (including government motor transport) 100 - - 100 15 85 15,0% 274 15
Inventory: Food and food supplies - - - - 1 - 1 - - 166
Inventory: Fuel, oil and gas - - - - - 72 72 - - 75
Inventory: Materials and supplies - - - - 6 - 6 - 10 52
Inventory: Medical supplies - - - - - 48 48 - - - 5
Medsas inventory interface - - - - 32 - 32 - - -
Consumable supplies 500 - - 500 99 401 19,8% 205 18
Consumable: Stationery, printing and office supplies 300 - - 300 17 283 5,7% 353 2
Operating leases 84 799 71 756 - 156 555 224 007 - 67 452 143,1% 88 816 65 847
Property payments 1 042 950 383 297 - 1 426 247 1 426 246 1 100,0% 1 048 097 1 484 139
Travel and subsistence 548 - - 548 295 253 53,8% 450 593
Training and development 1 750 - - 1 750 - 1 750 - 2 500 341
Operating payments 150 - - 150 - 150 - 1 000 -
Transfers and subsidies - - - - 132 - 132 - 193 193
Households - - - - 132 - 132 - 193 193
Social benefits - - - - 132 - 132 - 193 193
Payments for capital assets 3 120 683 - 455 053 - 63 061 2 602 569 2 351 357 251 212 90,3% 897 451 461 323
Buildings and other fixed structures 3 119 183 - 455 053 - 63 061 2 601 069 2 351 168 249 901 90,4% 883 592 451 786
Buildings 3 119 183 - 455 053 - 63 061 2 601 069 2 351 168 249 901 90,4% 883 592 451 786
Other fixed structures - - - - - - - - -
Machinery and equipment 1 500 - - 1 500 189 1 311 12,6% 13 859 9 537
Transport equipment - - - - - - - - 468
Other machinery and equipment 1 500 - - 1 500 189 1 311 12,6% 13 859 9 069
Payment for financial assets - - - - - - - - -

4 959 493 - - 717 260 4 242 233 4 041 357 200 876 95,3% 2 090 143 2 053 885
NOTES TO THE APPROPRIATION STATEMENT

1. Transfers and subsidies as per Appropriation Act after Virements:
Detail of these transactions can be viewed in the note on Transfers and subsidies, disclosure notes and annexures to the
Annual Financial Statements.
2. Detail of specifically and exclusively appropriated amounts voted after Virements:
Detail of these transactions can be viewed in note 1 Annual Appropriation to the Annual Financial Statements.
3. Detail on payments for financial assets
Detail of these transactions per programme can be viewed in the note on Payments for financial assets to the Annual
Financial Statements.
4. Explanations of material variances from Amounts Voted after Virements:
Final Actual Variance as

Appropriation Expenditure Variance a % of Final
4.1 Per programme Appropriation
R’000 R’000 R’000 0%
Administration 3 697 845 3 695 016 2 829 0%
District Health Services 18 366 611 17 959 247 407 364 2%
Emergency Medical Services 1 681 370 1 680 801 569 0%
Provincial Hospital Services 9 942 279 9 905 850 36 429 0%
Central Hospital Services 19 612 633 19 254 052 358 581 2%
Health Sciences and Training 901 268 787 210 114 058 13%
Health Care Support Services 391 264 388 844 2 420 1%
Health Facilities Management 4 242 233 4 041 357 200 876 5%
TOTAL 58 835 503 57 712 377 1 123 126 2%
The under spending in programmes and items emanates from the following critical uses:
• Commitments that were made before closure of the financial year within goods and services.
• Delays in the filing of vacant posts Planned posts to be filled within the Health Sciences and Training programme.
• Slow progress made in filling of posts in the operationalisation of the 24-hour clinic programme plan.
• Infrastructure projects commitments that were not paid at year-end
• The closure of some ECDs sites during the financial year and operated towards the latter period of the year.
Final Actual Variance Variance as

Appropriation Expenditure a % of Final
Appropriation
4.2 Per economic classification
R’000 R’000 R’000 %
Current payments
Compensation of employees 31 567 144 31 474 850 92 294 0%
Goods and services 20 442 658 20 099 251 343 402 2%
Interest and rent on land 1 584 1 584 0 0%
Provinces and municipalities 520 489 520 489 0 0%
Departmental agencies and accounts 23 352 23 532 0 0%
Higher Education Institutions 15 459 12 871 2 588 17%
Non-profit Institutions 656 870 602 710 54 160 8%
Households 588 931 627 894 (38 963) (7%)
NOTES TO THE APPROPRIATION STATEMENT


Appropriation
4.2 Per economic classification
R’000 R’000 R’000 %
Payments for capital assets
Buildings and other fixed structures 2 601 069 2 351 646 249 423 10%
Machinery and equipment 2 417 921 1 997 704 420 217 17%
Payments for financial assets 26 26 0
TOTAL 58 835 503 57 712 377 1 123 126 2%
The following economic classification items:

• Compensation of employees- underspending of R92 million because of challenges with timeous appointment of
clinical staff. Appointments were made later than anticipated.
• Goods and services - underspending on maintenance projects and also R343 million underspending on laboratory
services
• Transfers and subsidies – ECD sites closed down due to lockdown and claims submitted were therefore lesser in
terms of demands made.
• Payment for capital assets- There were delays in delivery of machinery and equipment especially those of Health
Technology equipment.
.

Appropriation
4.3 Per conditional grant
R’000 R’000 R’000 0%
Health Facility Revit Grant 968 210 968 435 (225) 0%

National Health Insurance Grant 53 674 44 393 9 281 17%
National Tertiary Services Grant 5 144 483 4 776 790 367 693 7%
Soc Sec Epwp Incen Grnt For Prov 30 524 30 153 371 0%
Health Prof Train and Dev Component 1 095 020 1 046 082 48 938 4%
Hr Capacitation Component 305 274 305 215 59 0%
EPWP Intergrated Grant For Prov 2 196 2 196 - 0%
HIV and Aids Component 4 605 692 4 605 692 - 0%
Covid-19 Component 744 481 744 481 - 0%
Tuberculosis Component 89 062 89 325 (263) 0%
Community Outreach Service Comp 458 896 360 328 98 568 21%
Human Paplvirus Vacc Component 30 427 29 815 612 2%
Covid-19 Disaster Response Grant 115 996 115 997 (1) 0%
Total 13 643 935 13 118 902 525 033
National Health Insurance - Underspending incurred due to delays in submission of travel claims by sessional doctors.
National Tertiary Services - The grant is mainly underspending on machinery and equipment, however, there are
commitments to the value of R362.3 million and the department submitted a rollover application.
Health Professions Training & Development Component - The grant is mainly underspending on machinery and
equipment, however, there are commitments to the value of R46 million and the department submitted a rollover
application.
STATEMENT OF FINANCIAL PERFORMANCE

Note 2020/21 2019/20

R’000 R’000
REVENUE
Annual appropriation 1 58 835 503 51 578 819

Departmental revenue 2 513 787 728 245
TOTAL REVENUE 59 349 290 52 307 064
EXPENDITURE
Current expenditure
Compensation of employees 3 31 474 850 29 203 077
Goods and services 4 20 099 256 17 117 833
Interest and rent on land 5 1 584 2 381
Total current expenditure 51 575 690 46 323 291

Transfers and subsidies 7 1 787 311 2 310 824
Total transfers and subsidies 1 787 311 2 310 824
Expenditure for capital assets

Tangible assets 8 4 349 350 2 035 549
Total expenditure for capital assets 4 349 350 2 035 549
Payments for financial assets 6 26 3 999
TOTAL EXPENDITURE 57 712 377 50 673 663
SURPLUS FOR THE YEAR 1 636 913 1 633 401
Reconciliation of Net Surplus for the year
Voted funds 1 123 126 905 156

Annual appropriation 598 093 614 607
Conditional grants 525 033 290 549
Departmental revenue 513 787 728 245
STATEMENT OF FINANCIAL POSITION

as at 31 March 2021
Note 2020/21 2019/20

R’000 R’000
ASSETS
Current Assets 1 419 023 798 903

Unauthorised Expenditure 9 10 758 10 758
Cash and cash equivalents 10 1 387 193 763 034
Prepayments and advances 11 - 30
Receivables 12 21 072 25 081
Non-current assets 201 635 172 223

Investments 13 54 000 54 000
Receivables 12 147 635 118 223
TOTAL ASSETS 1 620 658 971 126
LIABILITIES
Current Liabilities 1 448 358 810 406

Voted funds to be surrendered to the Revenue Fund 14 1 139 525 588 709
Departmental revenue to be surrendered to Revenue Fund 15 88 387 108 598
Payables 16 220 446 113 099
TOTAL LIABILITIES 1 448 358 810 406
NET ASSETS 172 300 160 720
Represented by:
Capitalisation reserve 54 000 54 000
Recoverable revenue 118 300 106 720
TOTAL 172 300 160 720

STATEMENT OF CHANGES IN NET ASSETS

2020/2021 2019/2020
R’000 R’000
Capitalisation Reserves
Opening balance 54 000 54 000
Closing balance 54 000 54 000
Recoverable revenue
Transfers: 11 580 27 297
Debts recovered (286) 232
Debts raised 11 866 27 065
TOTAL 172 300 160 720

CASH FLOW STATEMENT

Note 2020/21 2019/20

R’000 R’000
CASH FLOWS FROM OPERATING ACTIVITIES
Receipts 59 333 125 52 302 763

Annual appropriated funds received 1.1 58 830 485 51 578 819
Departmental revenue received 2 502 242 723 029
Interest received 2.3 398 915
Net (increase)/decrease in working capital 111 386 (107 781)

Surrendered to Revenue Fund (1 101 290) (1 446 014)
Current payments (51 574 106) (46 320 910)
Interest paid 5 (1 584) (2 381)
Payments for financial assets (26) (3 999)
Transfers and subsidies paid (1 787 311) (2 310 824)
Net cash flow available from operating activities 18 4 980 194 2 110 854
Payments for capital assets 8 (4 349 350) (2 035 549)

Proceeds from sale of capital assets 11 147 4 301
Decrease in non-current receivables (29 412) (29 261)
Net cash flows from investing activities (4 367 615) (2 060 509)
CASH FLOWS FROM FINANCING ACTIVITIES
Increase in net assets 11 580 27 297

Net cash flows from financing activities 11 580 27 297
Net increase in cash and cash equivalents 624 159 77 642

Cash and cash equivalents at beginning of period 763 034 685 392
Cash and cash equivalents at end of period 18 1 387 193 763 034
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 Foreign currency translation
Cash flows arising from foreign currency transactions are translated into South African Rands using the spot
exchange rates prevailing at the date of payment / receipt.
6 Comparative information
6.1 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.
6.2 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.
7 Revenue
7.1 Appropriated funds
Appropriated funds comprise 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.
7.2 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 amount owing to the relevant revenue fund at the reporting date is recognised as a payable in the statement
of financial position.
ACCOUNTING POLICIES
7.3 Accrued departmental revenue

Accruals in respect of departmental revenue (excluding tax 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.
Accrued tax revenue (and related interest and / penalties) is measured at amounts receivable from collecting
agents.
Write-offs are made according to the department’s debt write-off policy
8 Expenditure
8.1 Compensation of employees
8.1.1 Salaries and wages
Salaries and wages are recognised in the statement of financial performance on the date of payment.
8.1.2 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.
8.2 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.
8.3 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.
8.4 Leases
8.4.1 Operating leases
Operating lease payments made during the reporting period are recognised as current expenditure in the statement
of financial performance on the date of payment. Operating lease payments received are recognised as departmental
revenue.
The operating lease commitments are recorded in the notes to the financial statements.
Operating lease payments received are recognised as departmental revenue.
8.4.2 Finance leases
Finance lease payments made during the reporting period are recognised as capital expenditure in the statement of
financial performance on the date of payment. Finance lease payments received are recognised as departmental
revenue.
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.
• Finance lease payments received are recognised as departmental revenue.
ACCOUNTING POLICIES
9 Aid Assistance
9.1 Aid assistance received
Aid assistance received in cash is recognised in the statement of financial performance when received. In-kind aid
assistance is recorded in the notes to the financial statements on the date of receipt and is measured at fair value.
Aid assistance not spent for the intended purpose and any unutilised funds from aid assistance that are required to
be refunded to the donor are recognised as a payable in the statement of financial position.
9.2 Aid assistance paid
Aid assistance paid is recognised in the statement of financial performance on the date of payment. Aid assistance
payments made prior to the receipt of funds are recognised as a receivable in the statement of financial position.
10 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.
11 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.
12 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.
13 Investments
Investments are recognised in the statement of financial position at cost.
14 Financial assets
14.1 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.
14.2 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.
15 Payables
Payables recognised in the statement of financial position are recognised at cost.
16 Capital Assets
16.1 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.
ACCOUNTING POLICIES
16.2 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.
Subsequent expenditure that is of a capital nature forms part of the cost of the existing asset when ready for use.
16.3 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.
16.4 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.
17 Provisions and Contingents
17.1 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.
17.2 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.
17.3 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.
17.4 Capital commitments
Capital commitments are recorded at cost in the notes to the financial statements.
ACCOUNTING POLICIES
18 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.
19 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 or written off.
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.
20 Irregular expenditure
Irregular expenditure is recorded in the notes to the financial statements when confirmed after its assessment. 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 reduced from the note when it is either condoned by the relevant authority, transferred to
receivables for recovery, not condoned and removed or written-off.
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.
21 Changes in accounting estimates and errors
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.
22 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.
23 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.
24 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.
25 Related party transactions
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.
The number of individuals and the full compensation of key management personnel is recorded in the notes to the
financial statements.
ACCOUNTING POLICIES
26 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.
27 Public-Private Partnerships
Public Private Partnerships are accounted for based on the nature and or the substance of the partnership. The
transaction is accounted for in accordance with the relevant accounting policies.
A summary of the significant terms of the PPP agreement, the parties to the agreement, and the date of
commencement thereof together with the description and nature of the concession fees received, the unitary fees
paid, rights and obligations of the department are recorded in the notes to the financial statements.
28 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.
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 Provincial
Departments:
PROGRAMME 2020/21 2019/20

Final Actual Funds not Final Appropriation
Funds received Appropriation received
Received
R’000 R’000 - R’000 R’000
1. Administration 3 697 845 3 697 845 - 1 482 145 1 482 145
2. District Health Services 18 366 611 18 366 613 (2) 16 557 681 16 557 681
3. Emergency Medical Services 1 681 370 1 681 370 - 1 541 714 1 541 714
4. Provincial Hospital Services 9 942 279 9 942 279 - 9 274 405 9 274 405
5. Central Hospitals 19 612 633 19 607 613 5 020 19 111 200 19 111 200
6. Health Science and Training 901 268 901 268 - 1 151 743 1 151 743
7. Health Care Support Services 391 264 391 264 - 369 788 369 788
8. Health Facilities Management 4 242 233 4 242 233 - 2 090 143 2 090 143
Total 58 835 503 58 830 485 5 018 51 578 819 51 578 819
1.2 Conditional grants

2020/21 2019/20
R’000 R’000
Total grants received 13 638 917 12 002 758
Total 13 638 917 12 002 758
Funds relating to Conditional grant were received not in full as indicated above. Expenditure spent at R12 billion will see
to funds rolled-over in line with the request made to the Provincial Treasury.
2. DEPARTMENTAL REVENUE
Note 2020/21 2019/20

R’000 R’000
Sales of goods and services other than capital assets 2.1 464 512 628 763
Fines, penalties and forfeits 2.2 20 54
Interest and rent on land 2.3 398 915
Sales of capital assets 2.4 11 147 4 301
Transactions in financial assets and liabilities 2.5 37 532 94 212
Transfer received 2.6 178 -
Departmental revenue collected 513 787 728 245

Reasons for the decrease in revenue collection during the 2020/21 financial year can be attributed to the lockdown restrictions in
the country due to COVID 19 pandemic. This has negatively affected revenue collection in the following ways:
• RAF offices were closed due to the lockdown resulting in claims not being processed.
• Later than anticipated implementation of Uniform Patient Fees Schedule Tariffs for 2020/21 financial period.
• Decreased number of patients seen in the hospitals affecting revenue collected from other state departments, medical
aids and self-paying patients.
2.1 Sales of goods and services other than capital assets
2020/21 2019/20
R’000 R’000
Sales of goods and services produced by the Department 463 202 627 419
Sales by market establishment 36 061 30 261
Administrative fees 6 239 6 245
Other sales 420 902 590 913
Sales of scrap, waste and other used current goods 1 310 1 344
Total 464 512 628 763
• Under-collection on sales of goods and services other than capital was due to patient fees under-collected for the year.
• The over-collection on sales by market establishment is made up of collections from nurses and doctors residences,
parking fees and other revenue generating items.
2.2 Fines, penalties and forfeits
2020/21 2019/20
R’000 R’000
Fines 20 54
Total 20 54
2.3 Interest, dividends and rent on land
2020/21 2019/20
R’000 R’000
Interest Charged 398 915
Total 398 915
2.4 Sale of Capital assets
2020/21 2019/20
R’000 R’000
Machinery and equipment 11 147 4 301
Total 11 147 4 301
2.5 Transactions in financial assets and liabilities
2020/21 2019/20
R’000 R’000
Receivables 11 481 17 609
Stale cheques written back 88 -
Other Receipts including Recoverable Revenue 25 963 76 603
Total 37 532 94 212

The Department collected revenue as part of its obligation to recover debt. A total of R11,4 million was collected as stated
above. Recoverable revenue has reduced from R76 million to R25 million due to write offs
2.6 Transfers received
2020/21 2019/20
R’000 R’000
Public corporations and private enterprises 178 -
Total 178 -
3. COMPENSATION OF EMPLOYEES
3.1 Salaries and Wages
2020/21 2019/20
R’000 R’000
Basic salary 19 795 690 18 199 763
Performance award 158 481 412 365
Service Based 20 474 21 099
Compensative/circumstantial 3 570 851 3 357 762
Periodic payments 387 908 326 167
Other non-pensionable allowances 3 821 515 3 479 894
Total 27 754 919 25 797 050
3.2 Social Contributions
2020/21 2019/20
R’000 R’000
Employer contributions
Pension 2 340 997 2 167 652
Medical 1 371 777 1 231 913
UIF 1 622 1 710
Bargaining council 5 529 4 752
Insurance 6 -
Total 3 719 931 3 406 027
Total compensation of employees 31 474 850 29 203 077

Average number of employees 80 864 77 162
The increase in expenditure from R25,6 billion to R27,7 billion speaks to the recruitment process on posts filled and
relating to COVID 19. This also includes the filling of posts relating to clinical staff operating in the 24-hour clinic strategy.

4. GOODS AND SERVICES
2020/21 2019/20
Note
R’000 R’000
Administrative fees 11 946 9 726
Advertising 13 771 4 106
Minor assets 4.1 39 638 23 846
Bursaries (employees) 8 991 1 481
Catering 11 472 5 836
Communication 71 891 56 482
Computer services 4.2 271 750 284 524
Consultants: Business and advisory services 352 948 371 706
Laboratory services 2 874 612 2 562 841
Legal services 173 341 133 864
Contractors 302 337 302 538
Agency and support / outsourced services 294 126 292 420
Audit cost – external 4.3 25 489 60 270
Fleet services 181 897 170 741
Inventory 4.4 9 510 779 9 119 570
Consumables 4.5 2 635 550 585 892
Operating leases 439 940 270 587
Property payments 4.6 2 822 399 2 812 777
Rental and hiring 15 968 1 385
Transport provided as part of the Departmental activities 437 904
Travel and subsistence 4.7 14 883 25 510
Venues and facilities 786 3 886
Training and development 12 658 12 681
Other operating expenditure 4.8 11 647 4 260
Total 20 099 256 17 117 833
Operating expenditure: Relates to courier and laundry services.

Bursaries – A higher number of beneficiaries in this year resulted in this item increasing.
Rental and hiring – increased costs because of warehouse rental to store COVID-19 related good
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 procurement of medical supplies and other consumables.
Agency and support / outsourced services: Relates to payments, amongst others, for medical waste removal, payments
to nursing agencies.
Legal Services represent legal costs paid to the State Attorney.
4.1 Minor assets
2020/21 2019/20
R’000 R’000
Tangible assets 39 638 23 846
Total 39 638 23 846

4.2 Computer services
2020/21 2019/20
R’000 R’000
External computer service providers 271 750 284 524
Total 271 750 284 524
4.3 Audit cost – External
2020/21 2019/20
R’000 R’000
Regularity audits 25 489 25 966
Investigations - 34 304
Total 25 489 60 270
4.4 Inventory
Note
4 2020/21 2019/20
R’000 R’000
Clothing material and accessories 11 217 913
Food and food supplies 317 670 347 160
Fuel, oil and gas 278 187 345 993
Learning, teaching and support material 1 041 2 320
Materials and supplies 43 542 27 254
Medical supplies 4 365 994 3 950 926
Medicine 4 381 040 4 351 888
Other supplies 4.4.1 112 088 93 116
Total 9 510 779 9 119 570
• Inventory item increased from R9,1 billion reported in 2019/20 to R9,5 billion in the financial year under review. This is
due to the increase in expenditure for COVID 19 material supplies and medical supplies procured and used during the
202/21 financial year.
4.4.1 Other supplies
2020/21 2019/2020
R’000 R’000
Other 112 088 93 116
Total 112 088 93 116
• Other supplies consist of toiletries, plastics, paper and related items.


4.5 Consumables
2020/21 2019/20
R’000 R’000
Consumable supplies 2 493 708 449 911
Uniform and clothing 127 663 120 776
Building material and supplies 16 641 28 649
Communication accessories - 8 141
IT consumables 11 446 11 668
Other consumables 2 337 958 280 677
Stationery, printing and office supplies 141 842 135 981
Total 2 635 550 585 892
Other consumables: Includes fuel supplies, gas supplies, laboratory consumables and medical kits.
4.6 Property payments
2020/21 2019/20
R’000 R’000
Municipal services 374 104 615 288
Property maintenance and repairs 1 263 344 1 488 073
Other 1 184 951 709 416
Total 2 822 399 2 812 777
The amount disclosed under other includes security services, cleaning and payment of laundry services.
4.7 Travel and subsistence
2020/21 2019/20
R’000 R’000
Local 14 877 18 553
Foreign 6 6 957
Total 14 883 25 510
4.8 Other operating expenditure
2020/21 2019/20
R’000 R’000
Professional bodies, membership and subscription fees 155 378
Resettlement costs 666 640
Other 10 826 3 242
Total 11 647 4 260
5. Interest and rent on land
2020/21 2019/20
R’000 R’000
Interest paid 1 584 2 381
Total 1 584 2 381

6. PAYMENTS FOR FINANCIAL ASSETS
2020/21 2019/20
R’000 R’000
Debts written off 26 3 999
Total 26 3 999
6.1 Debts written off
2020/21 2019/20
R’000 R’000
Nature of debts written off
Ex- employees and supplier debts written off 26 3 999
Total debt written off 26 3 999
This amount represents staff debts written off during the year. The written- offs are in accordance with the Department’s
policy and the Prescription Act. All measures were taken to ensure that all debt due to the Department is recovered.
7. TRANSFERS AND SUBSIDIES
2020/21 2019/20
Note
R’000 R’000
Provinces and municipalities 32 520 489 705 393
Departmental agencies and accounts Annex 1B 23 352 22 135
Higher education institutions Annex 1C 12 871 1 488
Non-profit institutions Annex 1F 602 710 672 292
Households Annex 1E 627 889 909 516
Total 1 787 311 2 310 824
The decrease in transfers was because of the last phase of EMS provincialisation at Ekurhuleni metro, the last tranche was
transferred during September 2020 and the remaining budget was reprioritized to other items within the EMS programme.
8. EXPENDITURE FOR CAPITAL ASSETS
2020/21 2019/20
Note
R’000 R’000
Tangible assets 4 349 350 2 035 549
Buildings and other fixed structures 31 2 351 645 451 787
Machinery and equipment 29 1 997 705 1 583 762
Total 4 349 350 2 035 549
8.1 Analysis of funds utilised to acquire capital assets – 2020/21
Voted funds Total

R’000 R’000
Tangible assets 4 349 350 4 349 350
Buildings and other fixed structures 2 351 645 2 351 645
Machinery and equipment 1 997 705 1 997 705
Total 4 349 350 4 349 350

8.2 Analysis of funds utilised to acquire capital assets – 2019/20
Voted funds Total

R’000 R’000
Tangible assets
Buildings and other fixed structures 451 787 451 787
Machinery and equipment 1 583 762 1 583 762
Total 2 035 549 2 035 549
8.3 Finance Lease expenditure included in Expenditure for Capital Assets
2020/21 2019/20
R’000 R’000
Tangible assets
Total 58 792 58 880
9. UNAUTHORISED EXPENDITURE
9.1 Reconciliation of unauthorised expenditure
2020/21 2019/20
R’000 R’000
Opening balance 10 758 -
As restated - 10 758
Closing Balance 10 758 10 758
10. CASH AND CASH EQUIVALENTS
2020/21 2019/20
R’000 R’000
Consolidated Paymaster General Account 1 425 359 774 597
Cash receipts 33 (3)
Disbursements (39 116) (12 698)
Cash on hand 917 1 138
Total 1 387 193 763 034
Included in the reported balance of R1, 3 billion reported above is an amount of R1,4 billion for the Department’s PMG
account. Of this R1, 4 billion, there was an allocation of R569 millions of voted funds and a further R412 million funding
on conditional grants. These funds forms part of the allocation that has been required for Rollover to the 2021/ 22 financial
year. Cash on hand amounted to R917 000 consisting of funds to be surrendered

11. PREPAYMENTS AND ADVANCES

2020/21 2019/20
R’000 R’000
Travel and subsistence - 30
Total - 30
12. RECEIVABLES
2020/21 2019/20

Note Non-
Current current Total Current Non-current Total
R’000 R’000 R’000 R’000 R’000 R’000
Claims recoverable 12.1 1 460 - 1 460 1 570 - 1 570
Recoverable expenditure 12.2 1 318 - 1 318 1 233 - 1 233
Staff debt 12.3 13 512 147 635 161 147 18 586 118 223 136 809
Other debtors 12.4 4 782 - 4 782 3 692 - 3 692
Total 21 072 147 635 168 707 25 081 118 223 143 304
Receivables are made up of current balance amounting to R21,072 million with non- current receivables reported at R147
million. Staff debt increased from R136 million to R161 million due to challenges experienced by tracing agents on ex-
employees. Majority of these were found to be unemployed during the debt recovery process
12.1 Claims recoverable
2020/21 2019/20
R’000 R’000
Provincial Departments 1 460 1 570
Total 1 460 1 570
12.2 Recoverable expenditure (disallowance accounts)
2020/21 2019/20
R’000 R’000
Disallowance Damages & Losses 1 318 1 233
Total 1 318 1 233
12.3 Staff Debt
2020/21 2019/20
R’000 R’000
Breach of Contract 88 335 79 387
Employees 12 193 9 784
Ex-employees 50 437 37 936
Fraud 15 16
Suppliers 9 881 9 416
Other 286 270
Total 161 147 136 809

12.4 Other Debtors
2020/21 2019/20
R’000 R’000
Private Telephone 6 -
Salary Disallowance Account 23 23
Salary reversal Control Account - 3 344
Sal: Bargaining Councils 4 627 -
Salary: Deduction Disallowance 75 17
Salary: Tax Debt 51 308
Total 4 782 3 692
12.5 Impairment of receivables
2020/21 2019/20
R’000 R’000
Estimate of impairment of receivables 98 891 58 876
Total 98 891 58 876
The increase in the balance of impairment as indicated above, came as a result of the increased in non-recoverability of
staff debt during the financial year under review
13. INVESTMENTS
2020/21 2019/20
R’000 R’000
Non-Current
Shares and other equity
Investment in Medical Supplies Depot 54 000 54 000
Total 54 000 54 000
The investments amount represents the initial investment in Medical Supplies Depot, no further investment was made
during the period.
14. VOTED FUNDS TO BE SURRENDERED TO THE REVENUE FUND
2020/21 2019/20
R’000 R’000
Transfer from statement of financial performance 1 123 126 905 156
Voted Funds not received (5 018) -
Paid during the year (567 292) (755 913)
Closing balance 1 139 525 588 709

15. DEPARTMENTAL REVENUE TO BE SURRENDERED TO THE REVENUE FUND
2020/21 2019/20
R’000 R’000
Transfer from Statement of Financial Performance 513 787 728 245
Paid during the year (533 998) (690 101)
16. PAYABLES – current
Note 2020/21 2019/20

R’000 R’000
Amounts owing to other entities (Medical Supplies Depot) 191 124 102 054
Other payables 16.1 29 322 11 045
Total 220 446 113 099
16.1 Other payables
2020/21 2019/20
R’000 R’000
Housing Loan Guarantees 1 1
Medical Aid 330 337
Salary: ACB Recalls 1 852 496
Salary: Bargaining Council 35 5
Salary: Income Tax 19 722 4 863
Salary: Pension Fund 738 662
Telkom Control Account 2 695 2 466
Other 3 949 2 215
Total 29 322 11 045
The increase in the salary income tax is what remained in the suspense account of the Department by year- end. These
relates to tax payments due to SARS and will be paid or cleared in the new financial year. There were salaries recalled
during the year-end amounting to R1,8 million that will be cleared in the new financial year.

17. NET CASH FLOW AVAILABLE FROM OPERATING ACTIVITIES
2020/21 2019/20
R’000 R’000
Net surplus as per Statement of Financial Performance 1 636 913 1 633 401
Add back noncash/cash movements not deemed operating activities 3 343 281 477 453
Increase in receivables 4 009 (2 729)
Decrease in prepayments and advances 30 (30)
Decrease in other current assets - (10 758)
Decrease in Payables - Current 107 347 (94 264)
Proceeds from Sale of Capital Assets (11 147) (4 301)
Voted Funds not received (5 018) -
Expenditure on capital assets 4 349 350 2 035 549
Surrenders to Revenue Fund (1 101 290) (1 446 014)
Net cash flow generated by operating activities 4 980 194 2 110 854
18. RECONCILIATION OF CASH AND CASH EQUIVALENTS FOR CASH FLOW PURPOSES
2020/21 2019/20
R’000 R’000
Consolidated Paymaster General account 1 425 359 774 597
Cash receipts 33 (3)
Disbursement (39 116) (12 698)
Cash on hand 917 1 138
Total 1 387 193 763 034
19. CONTINGENT LIABILITIES

2020/21 2019/20
Note
R’000 R’000
Liable to
Claims against the Department Annex 3B 24 494 229 23 792 948
Intergovernmental payables (unconfirmed balances) Annex 5 499 216 -
Total 24 993 445 23 792 948
• The Labour Appeal Court (LAC) declared the salary increases for the 2020/2021 financial year unlawful and invalid.
The LAC ruling has been appealed and referred to the Constitutional Court. The ruling by the Constitutional Court will
confirm if the department will be obligated to pay the salary increases in dispute.
• Contingent liabilities increased to R24 billion due to the increase in the number of medical legal cases. The Department
also reported a balance of 499 million as unconfirmed and this is due to unconfirmed balances with other Departments.
20. COMMITMENTS
2020/21 2019/20
R’000 R’000
Capital commitments
Building and Other Fixed structure 1 397 252 1 453 384
Machinery and Equipment 820 569 475 692
Total 2 217 821 1 929 076
Capital commitments were reported R1,3 billion based on projects contracted and awarded to various contractors. There
were also R820 million for medical machinery and equipment.

21. ACCRUALS AND PAYABLES NOT RECOGNISED
21.1 Accruals
2020/21 2019/20
R’000 R’000
Listed by economic classification 30 Days 30+ Days Total Total
Goods and services 124 663 639 972 764 635 441 744
Capital Assets - 148 565 148 565 -
Total 124 663 788 537 913 200 441 744
Listed by programme level 2020/21 2019/20

R’000 R’000
Administration 372 498 26 136
District Health Services 126 204 92 328
Emergency Medical Services 47 858 13 955
Provincial Hospital Services 201 385 192 733
Central Hospital Services 155 503 101 673
Health Training and Sciences 2 002 2 698
Health Care Support Services 7 750 12 221
Total 913 200 441 744

21.2 Payables not recognised.
2020/21 2019/20
Listed by economic classification 30 Days 30+ Days R’000 R’000
Goods and services 2 224 087 1 658 071 3 882 158 3 651 513
Transfers and subsidies - 16 16 16
Capital assets - 241 170 241 170 -
Total 2 224 087 1 899 257 4 123 344 3 651 529
Listed by programme level 2020/21 2019/20

R’000 R’000
Administration 2 392 345 1 451 261
District Health Services 381 881 408 727
Emergency Medical Services 8 784 82 672
Provincial Hospital Services 600 994 823 748
Central Hospital Services 601 491 679 524
Health Training and Sciences 6 564 7 962
Health Care Support Services 32 662 15 087
Health Facilities Management 98 623 182 548
Total 4 123 344 3 651 529
Confirmed balances with other Departments 32 228 83 544

Confirmed balances with other government entities 966 070 475 413
Total 998 298 558 957
The increase in the balance of reported payables not recognised speaks to challenges experienced by the Department
on cash availability for payment of suppliers. This amounted to R4,1 billion by 31 March 2021.

22. EMPLOYEE BENEFITS
2020/21 2019/20
R’000 R’000
Leave entitlement 1 370 798 1 058 926
Service bonus 733 613 690 817
Performance awards 382 563 224 380
Capped leave commitments 286 474 337 238
Long Service Award 25 779 18 847
Total 2 799 227 2 330 208
The lapsing period for utilisation of leave entitlement was revised from June to December the following year hence the
increase in the balances reported from R1 billion to R1,3 billion and also is attributed to the impact of Covid-19 pandemic.
23. LEASE COMMITMENTS
23.1 Operating leases
Buildings and
other fixed Machinery and
structures equipment Total
2020/21 R’000 R’000 R’000
Not later than 1 year 44 587 72 622 117 209
Later than 1 year and not later than 5 years 100 160 91 910 192 070
Total lease commitments 144 747 164 532 309 279
Buildings and
other fixed Machinery and
structures equipment Total
2019/20 R’000 R’000 R’000
Not later than 1 year 48 530 53 507 102 037
Later than 1 year and not later than 5 years 144 747 24 327 169 074
Total lease commitments 193 277 77 834 271 111
23.2 Finance leases
Machinery and
equipment Total
2020/21 R’000 R’000
Not later than 1 year 36 329 36 329
Later than 1 year and not later than 5 years 15 918 15 918
Later than five years 6 6
Total lease commitments 52 253 52 253

Machinery and
equipment Total
2019/20 R’000 R’000
Not later than 1 year 23 243 23 243
Later than 1 year and not later than 5 years 16 737 16 737
Total lease commitments 39 980 39 980
24. ACCRUED DEPARTMENTAL REVENUE
2020/21 2019/20
R’000 R’000
Sales of goods and services other than capital assets 2 620 763 1 958 010
Total 2 620 763 1 958 010
Accrued Departmental revenue speaks to the increase in estimate which could have been collected if all patients who
received health care services paid their dues. the Impact of COVID- 19 pandemic had an adverse effect on revenue
collection for the year.
24.1 Analysis of Accrued Departmental revenue
2020/21 2019/20
R’000 R’000
Opening balance 1 958 010 2 982 039
Less: amounts received (339 777) (505 390)
Add: amounts recorded 1 307 294 1 166 496
Less: amounts written-off/reversed as irrecoverable (304 764) (1 685 135)
Closing balance 2 620 763 1 958 010
24.2 Accrued Department revenue written off

2020/21 2019/20
Nature of losses R’000 R’000
Patient Debts written off 304 764 1 685 135
Total 304 764 1 685 135
24.3 Impairment of accrued Departmental revenue
2020/21 2019/20
R’000 R’000
Estimate of impairment of accrued Departmental revenue 2 474 952 1 491 068
Total 2 474 952 1 491 068
The impairment on accrued Departmental Revenue speaks to revenue emanating from current debts owed to the
Department. This amongst other things include patient fees and rental of clinical staff occupying state properties.

25. IRREGULAR EXPENDITURE
25.1 Reconciliation of irregular expenditure
2020/21 2019/20
R’000 R’000
Opening balance 15 869 639 13 550 645
Add: Irregular expenditure – relating to prior year 133 801 483 713
Add: Irregular expenditure – relating to current year 3 787 993 1 835 281
Closing balance 19 791 433 15 869 639
Analysis of awaiting condonation per age classification

Current year 3 787 993 1 835 281
Prior years 16 003 440 14 034 358
Total 19 791 433 15 869 639
25.2 Details of irregular expenditure – added current year
2020/21
Incident Disciplinary steps taken R’000

Waste Removals Under investigation (Internal investigation 91 817
Telkom V-Block The matter was referred to the NPA and State Attorney 33 774
Fumigation Under investigation (Internal investigation) 8 210
Consignment Stock Under investigation (Internal investigation 431 146
Security Contracts Under investigation (Internal investigation) 548 609
Outsourced Nursing Staff Under investigation (Internal investigation) 118 792
Cleaning Contracts Under investigation (Internal investigation) 14 667
BAC Deviations Under investigation (Internal investigation) 24 671
Sundry payments Under investigation (Internal investigation) 6 505
Covid-19 Expenditure Under investigation by the SIU 2 394 514
Procurement process not followed Under investigation (Internal investigation) 249 089
Total 3 921 794
25.3 Details of the non-compliance where an institution is involved in an inter-institutional arrangement
Incident 2020/21
R’000
COVID-19 Procurement committed by DID 761 628
Non-Compliance disclosed by the implementing agent as per guidelines.
25.4 Details of the non-compliance where an institution is involved in an inter-institutional arrangement under
assessment
2020/21
Incident
R’000
Non-compliance with procurement process under assessment 471 225

26. FRUITLESS AND WASTEFUL EXPENDITURE

26.1 Reconciliation of fruitless and wasteful expenditure
2020/21 2019/20
R’000 R’000
Fruitless and wasteful expenditure – relating to current year 224 598 9 353
Less: Amounts resolved - (484 378)
26.2 Analysis of awaiting condonation
Current 233 951 9 353

Total 233 951 9 353
26.3 Analysis of Current year’s (relating to current and prior years) fruitless and wasteful expenditure
2020/21
Disciplinary steps taken/criminal
Incident proceedings R’000
Interest on Litigations Under investigation 1 584
Price overcharging on PPE Under investigation by the SIU 223 014
Total 224 598
New cases on Fruitless and wasteful expenditure amounts to 224 million consisting of the price overcharge on procurement
of PPE as well as interest paid on litigation claims.
27. RELATED PARTY TRANSACTIONS
2020/21 2019/20
Payments made R’000 R’000
Goods and services 4 450 511 4 589 826
Total 4 450 511 4 589 826
Year end balances arising from payments

Payables to related parties 924 769 398 352
Total 924 769 398 352
Medical Supplies Depot is a related party to the Department, falling under the control of one MEC with the Department.
MSD supplies medicine to the Department.
28. KEY MANAGEMENT PERSONNEL
No. of 2020/21 2019/20

Individuals R’000 R’000
*Political Office Bearers (MEC) 2 1 658 2 099
**Level 15 to 16 10 17 204 15 736
**Level 14 29 39 311 38 374
Family members of key management personnel 2 629 1 137
Total 58 802 57 346
*The department had 2 MEC’s in the year under review. The department also had an Acting MEC for a period of two
months. The department did not remunerate the Acting MEC.
**Key management include all staff members who drive the strategy of the department.

29. MOVABLE TANGIBLE CAPITAL ASSETS
Opening balance Additions Disposals Closing Balance

R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT
8 046 554 2 090 367 (131 216) 10 005 705

Transport assets 965 838 466 542 (63 846) 1 368 534
Computer equipment 278 349 38 458 (4 456) 312 351
Furniture and office equipment 166 144 15 607 (1 661) 180 090
Other machinery and equipment 6 636 223 1 569 760 (61 253) 8 144 730
TOTAL MOVABLE TANGIBLE 8 046 554 2 090 367 (131 216) 10 005 705
CAPITAL ASSETS UNDER INVESTIGATION
Number Value
R’000
Machinery and Equipment (Included in additions are assets under
investigation that were damaged by fire at Carletonville Hospital 911 19 191
29.1 ADDITIONS TO MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE PERIOD
ENDED 31 MARCH 2021
Received
current, not
paid
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 1 997 528 88 109 (58 791) 63 521 2 090 367
Transport assets 550 013 - (51 002) (32 469) 466 542
Computer equipment 35 534 892 - 2 032 38 458
Furniture and office equipment 15 277 116 - 214 15 607
Other machinery and equipment 1 396 704 87 101 (7 789) 93 744 1 569 760
TOTAL MOVABLE TANGIBLE
CAPITAL ASSETS 1 997 528 88 109 (58 791) 63 521 2 090 367
29.2 DISPOSALS
Sold for Non-cash Total disposals Cash Received

cash disposal Actual
R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 63 395 67 821 131 216 11 147

Transport assets 63 395 451 63 846 11 147
Computer equipment - 4 456 4 456 -
Furniture and office equipment 1 661 1 661 -
Other machinery and equipment 61 253 61 253 -
TOTAL DISPOSAL OF MOVABLE TANGIBLE
CAPITAL ASSETS 63 395 67 821 131 216 11 147

29.3 MOVEMENT IN MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE PERIOD ENDED
31 MARCH 2020
Opening Prior Period

balance Error Additions Disposals Closing Balance
R’000 R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 6 552 312 (1 890) 1 608 180 (112 048) 8 046 554
Transport assets 653 174 - 314 988 (2 324) 965 838
Computer equipment 271 346 (1 616) 42 656 (34 037) 278 349
Furniture and office equipment 165 076 8 461 (7 393) 166 144
Other machinery and equipment 5 462 716 (274) 1 242 075 (68 294) 6 636 223
TOTAL MOVABLE TANGIBLE
CAPITAL ASSETS 6 552 312 (1 890) 1 608 180 (112 048) 8 046 554
29.3.1 Prior period error
2019/20
R’000
Nature of prior period error
Adjustment of values (1 890)
Total prior period errors (1 890)
29.4 MOVEMENT IN MINOR ASSETS PER THE ASSET REGISTER FOR THE PERIOD ENDED AS AT 31 MARCH
2021
Machinery and equipment Total

R’000 R’000
Additions 51 357 51 357
Disposals (9 439) (9 439)
TOTAL MINOR ASSETS 740 660 740 660

Number of minor assets at cost 606 495 606 495
TOTAL NUMBER OF MINOR ASSETS 606 495 606 495
MINOR CAPITAL ASSETS UNDER INVESTIGATION

Number Value
R’000 R’000
Machinery and Equipment 911 19
MOVEMENT IN MINOR ASSETS PER THE ASSET REGISTER FOR THE PERIOD ENDED AS AT 31 MARCH 2020
R’000 R’000
Additions 26 638 26 638
Disposals (35 349) (35 349)
TOTAL MINOR ASSETS 698 742 698 742

Number of minor assets at cost 612 419 612 419
TOTAL NUMBER OF MINOR ASSETS 612 419 612 419

MAJOR ASSETS TO BE TRANSFERRED IN TERMS OF S42 OF THE PFMA – 31 MARCH 2020

No of Assets Value of Assets
R’000
Machinery and Equipment 1 900
Total 1 900
30. INTANGIBLE CAPITAL ASSETS 31 MARCH 2021
Opening balance Disposals Closing Balance

R’000 R’000 R’000
SOFTWARE 55 617 (1 363) 54 254
TOTAL INTANGIBLE CAPITAL ASSETS 55 617 (1 363) 54 254
30.1 DISPOSALS OF INTANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH
2021
Non-cash disposal Total Disposals

R’000 R’000
SOFTWARE 1 363 1 363
TOTAL DISPOSALS OF INTANGIBLE 1 363 1 363
INTANGIBLE CAPITAL ASSETS 31 MARCH 2020

Opening balance Disposals Closing Balance
R’000 R’000 R’000
SOFTWARE 55 617 - 55 617
TOTAL INTANGIBLE CAPITAL ASSETS 55 617 - 55 617
31. MOVEMENT IN IMMOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31
MARCH 2021
Opening balance Additions Disposals Closing Balance

R’000 R’000 R’000 R’000
BUILDINGS AND OTHER FIXED
STRUCTURES 3 445 495 471 431 (2 732 847) 1 184 079
Other Fixed Structures 3 445 495 471 431 (2 732 847) 1 184 079
TOTAL IMMOVABLE TANGIBLE CAPITAL
ASSETS 3 445 495 471 431 (2 732 847) 1 184 079

31.1 ADDITIONS TO IMMOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31
MARCH 2021
Capital Work in
Cash Non-Cash Progress Total
R’000 R’000 R’000 R’000
BUILDING AND OTHER FIXED
STRUCTURES 2 351 645 66 783 (1 946 998) 471 431
Other Fixed Structures 2 351 645 66 783 (1 946 998) 471 431
TOTAL ADDITIONS TO IMMOVABLE
TANGIBLE CAPITAL ASSETS 2 351 645 66 783 (1 946 998 471 431
31.2 DISPOSAL OF IMMOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31
MARCH 2021
Non-Cash Disposal Total disposals

R’000 R’000
BUILDING AND OTHER FIXED STRUCTURES 2 732 847 2 732 847
Other fixed structures 2 732 847 2 732 847
TOTAL ADDITIONS TO IMMOVABLE CAPITAL TANGIBLE ASSETS 2 732 847 2 732 847
31.3 MOVEMENT IN IMMOVABLE TANGIBLE ASSET REGISTER FOR 2019/20
Opening Prior Year Error Closing

balance Additions Balance
R’000 R’000 R’000 R’000
BUILDINGS AND OTHER FIXED
STRUCTURES 3 182 367 (28 118) 291 246 3 445 495
Other fixed structures 3 182 367 (28 118) 291 246 3 445 495
TOTAL IMMOVABLE TANGIBLE CAPITAL
ASSETS 3 182 367 (28 118) 291 246 3 445 495
31.4 CAPITAL WORK-IN-PROGRESS AS AT 31 MARCH 2021
Opening Current Ready Closing

balance Year for use balance
1 April 2019 WIP (Assets to the AR) 31 March 2021
R’000 R’000 R’000 R’000
Buildings and other fixed structures 1 324 515 1 946 996 (66 783) 3 204 728
TOTAL 1 324 515 1 946 996 (66 783) 3 204 728

Planned, Planned,
construction not construction
started started 2020/21
Amount
Age analysis on ongoing projects R’000
0 to 1 year - 9 1 788 500
1 to 3 Years 1 10 839 163
3 to 5 Years 6 4 577 065
Longer than 5 Years - - -
Total 3 204 728
The construction for the 7 planned projects has not started due to budget constraints and reprioritisation to deliver within a
community 24 hour service.

Payables not recognised relating to Capital WIP
Amounts relating to progress certificates received but not paid at year end and therefore not included
in capital work-in-progress 134 340
CAPITAL WORK-IN-PROGRESS AS AT 31 MARCH 2020
Opening Ready for use

balance (Assets to the Closing balance
1 April 2019 Current Year WIP AR) 31 March 2020
R’000 R’000 R’000 R’000
Buildings and other fixed structures 1 191 789 451 786 (319 060) 1 324 515
TOTAL 1 197 789 451 786 (319 060) 1 324 515

2019/20
Amount
Age analysis on ongoing projects R’000
1 to 3 Years 143 416
3 to 5 Years 1 181 099
Total 1 324 515
31.5 Assets to be transferred in terms of S42 of the PFMA - 2020/21
Buildings and other fixed structures No of Assets Value of Assets

R’000
Other Fixed Structures 52 1 184 079
Total 52 1 184 079
31.6 Assets to be transferred in terms of S42 of the PFMA -2019/20
Buildings and Other Fixed Structure No of Assets Value of Assets

R’000
Other fixed structures 5 2 664 998
Total 5 2 664 998
31.7 Prior Year error
Amount before Prior year error Restated

the error amount
Nature of the Prior year error Note
R’000 R’000 R’000
Immovable Asset 31 3 473 613 (28 118) 3 445 495

32. Covid-19 Response Expenditure
2020/21 2019/20
R’000 R’000
COVID 19 Response Expenditure
Compensation of employees 735 059 -
Goods and services 3 067 072 -
Transfers and subsidies 128 -
Expenditure for capital assets 2 165 126 -
Total 5 967 384 -

There are no comparatives for his note because the COVID-19 pandemic only affected expenditure from 2021.

33. Non- Adjusting Events after Reporting
Nature of Event- Fire

A fire incident that took place at Charlotte Maxeke Hospital in April 2021 has caused a substantial damage of Assets and
inventory. This will have an impact in the financial year 2021/22.
34. STATEMENT OF CONDITIONAL GRANTS RECEIVED
318
NAME OF GRANT ALLOCATION SPENT 2019/2020

DEPARTMENT Division of Roll DORA Other Total Amount Amount Under / % of Division Amount
Revenue Overs Available received spent by available of spent by
Act/ by Department funds Revenue Department
Provincial Department spent by Act
Grants Department
R’000 R’000 R’000 R’000 R’000 R’000 % R’000 R’000
Comprehensive
HIV and AIDS 4 530 092 112 859 (37 259) - 4 605 692 4 605 694 4 605 692 - 100% 4 419 786 4 315 326
Health
Professional
Training &
Development 1 078 088 30 932 - (14 000) 1 095 020 1 095 020 1 046 082 48 938 96% 1 060 479 1 029 247
Hospital
Facilities
Revitalisation
Grant 968 210 - - - 968 210 968 210 968 435 (225) 100% 859 028 859 012
National Tertiary
Services 5 025 579 144 604 (25 700) - 5 144 483 5 144 483 4 776 790 367 693 93% 4 977 048 4 831 512
Human
Papillomavirus
Vaccine Grant 30 427 - - - 30 427 30 427 29 815 612 98% 25 084 25 058
EPWP Social
Sector Incentive
Grant 29 930 594 - - 30 524 30 524 30 153 371 99% 26 197 25 498
EPWP
Integrated
Grant to
Provinces 2 196 - - - 2 196 2 196 2 196 - 100% 2 187 2 187
Human
Resources
Capacitating
Grant 257 920 - 33 354 14 000 305 274 305 254 305 215 59 100% 223 292 223 291
Tuberculosis
Component
89 801 - (739) - 89 062 89 062 89 325 98 568 100% 85 120 101 145
Community
Outreach
Service Comp 462 701 - (3 805) - 458 896 458 896 360 328 9 281 79% 270 779 246 355
National Health
Insurance 53 674 - - - 53 674 53 674 44 393 - 83% 53 758 53 579
NAME OF GRANT ALLOCATION SPENT 2019/2020

DEPARTMENT Division of Roll DORA Other Total Amount Amount Under / % of Division Amount
Revenue Overs Available received spent by available of spent by
Act/ by Department funds Revenue Department
Provincial Department spent by Act
Grants Department
R’000 R’000 R’000 R’000 R’000 R’000 % R’000 R’000
COVID-19
Component 750 655 (6 174) 744 481 744 481 744 481 - - - -
COVID-19
Disaster
Response
Grant 115 996 - - - 115 996 115 996 115 997 (1) 100% - -
Total 13 395 269 288 989 (40 323) - 13 643 935 13 643 917 13 118 902 525 033 96% 12 002 758 11 712 210
35. STATEMENT OF CONDITIONAL GRANTS AND OTHER TRANSFERS PAID TO MUNICIPALITIES
2020/21 2019/20
GRANT ALLOCATION
DoRA and other Adjustments Total Actual Division of Revenue Actual
transfers Available Transfer Act Transfer
NAME OF MUNICIPALITY R’000 R’000 R’000 R’000 R’000

City of Johannesburg Metro 171 584 - 171 584 171 584 285 429 285 428
City of Tshwane Metro 79 145 - 79 145 79 145 66 475 66 475
Ekurhuleni Metro 359 770 (112 381) 247 389 247 389 337 299 337 299
West Rand District Council 11 223 - 11 223 11 223 8 248 8 248
Sedibeng District Council 11 148 - 11 148 11 148 8 769 7 943
TOTAL 632 870 (112 381) 520 489 520 489 706 220 705 393
319
ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTS
320
ANNEXURE 1A
STATEMENT OF CONDITIONAL GRANTS AND OTHER TRANSFERS PAID TO MUNICIPALITIES (Unaudited Annexure)
NAME OF GRANT ALLOCATION TRANSFER SPENT 2019/20

MUNICIPALITY DoRA Roll Total Actual Funds Re- Amount Amount Unspent % of Division Actual transfer
and other Overs Available Transfer Withheld allocations received spent by funds of
transfers by National by Revenue
Treasury municipality Act
or National
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 144 091 - - 144 091 144 091 - - 144 091 144 091 - - 136 192 136 192
City of Tshwane
Metro 55 118 - - 55 118 55 118 - - 55 118 55 118 - - 52 096 52 096
Ekurhuleni Metro 154 360 - - 154 360 154 360 - - 154 360 154 360 - - 145 898 145 898
HIV AND AIDS

Category A
City of
Johannesburg
Metro 27 493 27 493 27 493 27 493 27 493 25 135 25 135
City of Tshwane
Metro 24 027 24 027 24 027 24 027 24 027 14 379 14 379
Ekurhuleni Metro 18 109 18 109 18 109 18 109 18 109 14 368 14 368
Category B -
West Rand District

Council 11 223 11 223 11 223 11 223 11 223 8 248 8 248
NAME OF GRANT ALLOCATION TRANSFER SPENT 2019/20

MUNICIPALITY DoRA Roll Total Actual Funds Re- Amount Amount Unspent % of Division Actual transfer
and other Overs Available Transfer Withheld allocations received spent by funds of
transfers by National by Revenue
Treasury municipality Act
or National
R’000 R’000 R’000 R’000 R’000 R’000 % R’000 R’000 R’000 % R’000 R’000
Sedibeng District
Council 11 148 11 148 11 148 11 148 11 148 8 769 7 943
City of
Johannesburg
Metro 69 016 124 102
City of Tshwane
Metro -
Ekurhuleni Metro 187 301 (112 381) 74 920 74 920 74 920 74 920 177 033 177 033
Category C
West Rand District
Council
TOTAL
632 870 (112 381) 520 489 520 489 520 489 520 489 651 134 651 134
ANNEXURE 1B
STATEMENT OF TRANSFERS TO DEPARTMENTAL AGENCIES AND ACCOUNTS
TRANSFER ALLOCATION TRANSFER 2019/20
Adjusted Roll Adjustments Total Actual % of Final
Appropriation Overs Available Transfer Available Appropriation
funds
Transferred
DEPARTMENTAL AGENCY/ ACCOUNT R’000 R’000 R’000 R’000 R’000 % R’000
Health and Welfare Seta (HW-SETA) 23 352 - - 23 352 23 352 100% 22 135
Total 23 352 - - 23 352 23 352 100% 22 135
ANNEXURE 1C
STATEMENT OF TRANSFERS TO HIGHER EDUCATION INSTITUTIONS
321
322
TRANSFER ALLOCATION TRANSFER 2019/20

% of
Adjusted Actual Available
Roll Total Amount not funds Final
Appropriation Overs Adjustments Available Transfer transferred Transferred Appropriation
NAME OF HIGHER EDUCATION INSTITUTION R’000 R’000 R’000 R’000 R’000 R’000 % R’000
University of Witwatersrand 3 000 1 759 4 759 2 380 2 379 50% 441
University of Johannesburg 6 183 (1 683) 4 500 4 412 88 98% 550
Sefako Makgatho Health Science University 2 000 600 2 600 2 451 149 94% 184
University of Pretoria 4 276 (676) 3 600 3 628 (28) 101% 313
TOTAL 15 459 - 15 459 12 871 2 588 83% 1 488
ANNEXURE 1D STATEMENT OF TRANSFERS TO NON-PROFIT INSTITUTIONS (Unaudited Annexure)
TRANSFER ALLOCATION EXPENDITURE 2019/2020

Adjusted % of
Appropriation Total Actual Available funds Final
Act Roll overs Adjustments Available Transfer transferred Appropriation
NON-PROFIT INSTITUTIONS R’000 R’000 R’000 R’000 R’000 % R’000
Transfers - -
Community Based Services (Mental Health 220 803 84%
220 803 - 186 164 173 907
NPOs)
HIV AND aids (NGOS) 104 000 - 104 000 86 362 83% 85 828
Nutrition Provincial (NGOs) 65 227 (60 524) 4 591 4 591 100% 58 627
Community Health Clinic (Witkoppen Clinic) 14 826 (6 233) 8 593 8 593 100% 14 053
Community Based Services (EPWP NPOs) - - - - - 38 243
Community Based Services (Specialised -

Services NPOS & Rehabilitation) 1 883 - 1 883 0 1 785
Nelson Mandela Children’s Hospital 317 000 - 317 000 317 000 100% 300 000
- -
TOTAL 723 739 (66 757) 656 870 602 710 - 672 292
TRANSFER ALLOCATION EXPENDITURE 2019/20

% of
ANNEXURE 1E Adjusted Available
STATEMENT OF TRANSFERS TO HOUSEHOLDS Appropriation Roll Total Actual funds Final
Act Overs Adjustments Available Transfer Transferred Appropriation
HOUSEHOLDS R’000 R’000 R’000 R’000 R’000 % R’000
Transfers
- 5 918 22%
Household Employee Benefit: Injury on Duty 6 968 (1 050) 1 289 9 105

Household Employee Benefit: Leave Gratuity 95 777 - (1 005) 94 772 112 969 119% 91 891
- - - - -
Household Employee Benefit: Post-retirement benefit
- - - - -
Household: Other Transfers(Cash)
Household Bursaries: (non-employee) 251 612 - - 251 612 121 505 48% 234 579
Household Claims against State (Cash) - - 236 629 236 629 392 126 166% 512 587
- -
H/H Donations &Gifts (Cash) - - - -
TOTAL 354 357 - 234 574 588 931 627 889 - 848 162
ANNEXURE 1 F-
STATEMENT OF GIFTS, DONATIONS AND SPONSORSHIPS RECEIVED
2020/21 2019/20
NATURE OF GIFT, DONATION OR
SPONSORSHIP R’000 R’000
NAME OF THE DONOR
Received in Kind Various Items 587 702 2 002
Various Donors Other Machinery and Equipment 72 803 -
Pharmaceuticals 89 065 21 971
TOTAL 749 570 23 973

323
324
ANNEXURE 1 G
STATEMENT OF GIFTS, DONATIONS AND SPONSORSHIPS MADE
2020/21 2019/20
NATURE OF GIFT, DONATION OR
NAME OF THE DONOR SPONSORSHIP R’000 R’000
Sanitisers to Gauteng Department of Transport 4 198 -
Total 4 198
ANNEXURE 3B
STATEMENT OF CONTINGENT LIABILITIES AS AT 31 MARCH 2021
Nature of Liability Opening Prior Restated Liabilities Liabilities paid/

Balance Year Opening incurred cancelled/ Closing Balance 31
1 April 2020 Error Balance during the year reduced during March 2021
the year
R’000 R’000 R’000 R’000 R’000 R’000
Claims against the
Department
Medico – Legal matters 21 227 633 14 576 21 242 209 1 192 079 556 420 21 877 868
Civil Claims 1 143 388 - 1 143 388 61 525 10 859 1 194 054
Vehicle Liability 12 610 - 12 610 480 100 12 990
Premature termination of - - -
contracts 1 394 317 1 394 317 1 394 317
Medical Legal to -
Mediation 15 000 15 000 - - 15 000
TOTAL 23 792 948 14 576 23 807 524 1 254 084 567 379 24 494 229
325
326
ANNEXURE 4
CLAIMS RECOVERABLE
Government Entity Confirmed balance Unconfirmed balance Total

outstanding outstanding
31/03/2021 31/03/2020 31/03/2021 31/03/2020 31/03/2021 31/03/2020
R’000 R’000 R’000 R’000 R’000 R’000
Department
Mpumalanga: Department of Health (C5) - - 291 56 291 56
Eastern Cape: Department of Health (D2) - - - 23 - 23
Limpopo Department of Health and Social Development (P4) - - - 235 - 235
Western Cape: Department of Health (U3) - - 198 99 198 99
Free State Department of Health (V5) - - 229 167 229 167
North West Health (3Y) - - 698 623 698 623
KZN Department of Health (3K) - - 118 311 118 311
Limpopo Province Education ( P8) - - 26 - 26 -
National Department of Water & Sanitation ( 36 ) - - - 26 - 26
National Department of Correctional Services (95) - - - 48 - 48
KZN PROV GOV Education (2K) - - 34 - 34 -
Mpumalanga Department of Health & Social Services(Patient fees) - 26 860 5 071 - 5 071 26 860
Eastern Cape 43 43
Department of Correctional Services (Patient fees) - - 22 302 24 884 22 302 24 884
South African Police Services (Patient fees) - - 24 955 20 895 24 955 20 895
Limpopo Department of Health and Social Development (Patient - 37 918 3 662 - 3 662 37 918
fees)
North West Department of Health and Social Development (Patient - 62 165 29 731 29 731 62 165
fees)
SA National Defence Force (Patient fees) - - 3 114 1 080 3 114 1 080
National Department of Health (Patient Fees) - - - -
National Department of Justice (Patient Fees) - 19 197 4 696 4 696 19 197

Gauteng Emergency Medical Services (Special event fees) - 689 1 154 689 1 154
TOTAL - 146 140 95 857 49 601 95 857 195 741
Patient Fees to the value of R194 million is included on Annexure 4 but not reflecting on BAS.
ANNEXURE 5
INTER-GOVERNMENT PAYABLES
GOVERNMENT ENTITY Confirmed balance Unconfirmed balance TOTAL

31/03/2021 31/03/2020 31/03/2021 31/03/2020 31/03/2021 31/03/2020
R’000 R’000 R’000 R’000 R’000 R’000
DEPARTMENTS
Gauteng Office of the Premier (G6) 843 68 - - 843 68
Department of Justice
1 7445 79 726 497 674 - 515 119 79 726

Gauteng Department of E-Government 31 60 - - 31 60
Department of Communication and information Systems - 18 - - - 18
Department of Higher Education - 1 - - - 1
Gauteng Department of Social Development 109 - - 109
Department of Infrastructure - - - - - -
Gauteng Department of Agriculture 132 - - 132
Eastern Cape Department of Health 39 14 - - 39 14
Northern Cape Department of Health 248 - - 248
Kwa-Zulu Natal Department of Health 553 95 - - 553 95
South African Police Service 34 - - 34
Northwest Department of Health 257 28 - - 257 28
Western Cape department of Health 134 - - 134
Limpopo Department of health 213 108 - - 213 108
- -
National department of Public Works 2 769 2 769

Department of Trade and industry - - - - - -
Statistics S.A 40 - - - 40 -
Gauteng Infrastructure Financing Agency 8 503 - - - 8 503 -
Gauteng Treasury 30 - - - 30 -
National department of water and Sanitation 139 - - - 139 -
National Department of Public Works 4 195 - - - 4 195 -

Subtotal 32 288 83 544 497 674 - 529 962 83 544
327
328
GOVERNMENT ENTITY Confirmed balance Unconfirmed balance TOTAL

31/03/2021 31/03/2020 31/03/2021 31/03/2020 31/03/2021 31/03/2020
R’000 R’000 R’000 R’000 R’000 R’000
OTHER GOVERNMENT ENTITY

Current
Medical Supplier Deport 924 769 392 988 924 769 392 988
Medical Supplies Deport (Salary) - -
G-Fleet 39 556 77 061 1 542 41 098 77 061
Special Investigating Units 1 745 - 1 745
Subtotal 966 070 470 049 1 542 967 612 470 049
TOTAL 998 358 553 593 497 674 1 479 574 553 593
ANNEXURE 6
INVENTORIES
Inventories Note 2020/21 2019/20

R’000 R’000
Opening balance 1 915 465 1 077 960
Add/(Less): Adjustments to prior year balance - -
Add: Additions/Purchases – Cash 9 510 779 9 119 570
Add: Additions - Non-cash - -
(Less): Disposals - -
(Less): Issues (4 598 782) (5 583 211)
Add/(Less): Received current, not paid (Paid current year, received prior year) - -
Add/(Less): Adjustments (5 670 768) 2 698 854
Closing balance 1 270 439 1 915 465
A fire at Charlotte Maxeke Academic Hospital stores has affected the balances. The Department is in a process to quantify
the loss
The additions on Annexure 6 are based on BAS expenditure, whereas the additions from institutions are based on physical
receipts.
This is a permanent difference until the department procures a inventory System
329
330
ANNEXURE 7
MOVEMENT IN CAPITAL WORK IN PROGRESS FOR THE YEAR ENDED 31 MARCH 2021
Ready for use (Asset

Current Year Capital register) / Contract
Opening balance WIP terminated Closing balance
R’000 R’000 R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES

Other fixed structures 1 324 515 1 946 996 (66 783) 3 204 728
TOTAL 1324 515 1 946 996 (66 783) 3 204 728
MOVEMENT IN CAPITAL WORK IN PROGRESS FOR THE YEAR ENDED 31 MARCH 2020
Ready for use (Asset

Opening Prior period Current Year Capital register) / Contract
balance error WIP terminated Closing balance
R’000 R’000 R’000 R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES
1 191 789 451 786 (319 060) 1 324 515
Other fixed structures 1 191 789 - 451 786 (319 060) 1 324 515
TOTAL 1 191 789 451 786 (319 060) 1 324 515
Despite challanges
posed by COVID-19 , we
were able to maintain
availability of vital and
essential medicines
above 97% and 95%.
PART F
PART A:
GAUTENG
MEDICAL
SUPPLIES
DEPOT
(MSD)
General Information
COUNTRY OF INCORPORATION AND South Africa
DOMICILE
NATURE OF BUSINESS AND PRINCIPAL The rendering of pharmaceutical services by
ACTIVITIES making essential medicines available at all
different levels of healthcare in the Gauteng
Provincial Administration in an efficient and
effective manner.
ACCOUNTING OFFICER Dr. S. Zungu (Acting)
REGISTERED OFFICE 35 Plunkett Avenue

Hurst Hill
Johannesburg
Gauteng
2092
BUSINESS ADDRESS 35 Plunkett Avenue

Hurst Hill
Johannesburg
Gauteng
2092
POSTAL ADDRESS Private Bag X2

Auckland Park
Johannesburg
2006
CONTROLLING ENTITY Gauteng Department of Health
BANKERS First National Bank of South Africa
AUDITOR The Auditor-General of South Africa
CONTACT NUMBER +27 11 628 9000

Report of the Accounting Officer

The Accounting Officer of the Gauteng Department of Health (the Department) hereby submits the
annual report for the Gauteng Medical Supplies Depot, to the Executive Authority of the Gauteng
Department of Health, and the Gauteng Provincial Legislature of the Republic of South Africa.
1. Introduction
On 15 March 2020, the president announced the declaration of a national state of disaster following
the World Health Organization declaring the covid-19 outbreak a pandemic. The president also
announced the lockdown measures to be implemented in South Africa. Various sets of regulations,
circulars and instructions were issued that changed our lives forever.
However, during this time the entity continued to operate. In accordance with the issued regulations,
staff and client numbers were limited and health safety measures introduced. During different
lockdown levels, the entity continued to provide uninterrupted services such as distribution of
essential medicines to Gauteng Health Facilities.
2. Our performance against predetermined objectives

The Gauteng Department of Health’s Strategic Plan, was used as a basis for developing the entity’s
Operational Plan. This approach ensured that the entity’s predetermined objectives are clearly
aligned to those of the Department.
For the year under review the entity had predetermined objectives categorised under three business
units namely; Office of the CEO, Pharmaceutical Services and Finance and Administration, with
Pharmaceutical Services being the core business.
Business Unit 1: Office of the CEO
During the year under audit, the entity developed and facilitated approval of the APP by the HOD
and MEC. The entity also developed audit intervention plan to improve audit outcome. However,
the centralised provincial extension of contracts makes it difficult for the entity to reduce irregular
expenditure. The depot is also in the process of employing more human resource for planning,
monitoring and evaluation unit to limit the findings on performance monitoring and reporting.
GAUTENG MEDICAL SUPPLIES DEPOT

REPORT OF THE ACCOUNTING OFFICER
Table 1: Office of the CEO Business Unit Actual Performance

Indicators Annual target Annual Actual Annual Actual Annual Comments Action Plans
2019/20 target Achievement Achievement
2020/21 2019/20 2020/21
Percentage Unqualified Improved audit Unqualified Unqualified Annual target not Management to request
implementation audit opinion outcome for audit opinion audit opinion achieved. permission to opt out of
of the approved with no 2020/21 with material centralised contracts.
audit outcome material findings on Reasons:
implementation findings for Audit of Centralised Management requested
plan 2019/20 Predetermined procurement central office to assist
objectives and processes. with investigation of
Compliance Irregular, Unauthorised,
Delays in Fruitless and Wasteful
investigation of Expenditure.
irregular, fruitless
and wasteful Management to
expenditure. perform a thorough
reconciliation of
Discrepancies commitments with
on commitments accruals and payables
schedule before submission to
auditors.
Percentage NA Approved New target Approved Achieved Target Achieved
implementation APP 2021/22 (not available APP available
of project in 2019/20)
for the
formalisation
of the Trading
Entity status of
MSD
Business Unit 2: Pharmaceutical Services Business unit
Pharmaceutical Services Business unit constitutes the core business of the Medical Supplies Depot.
It has 5 predetermined objectives, of which 4 predetermined objectives were achieved. The reason
for non-achievement on the one objective is stated in table 2.
The entity has generally observed a notable progress over the past financial year; achieving 4
out of 5 predetermined objectives was remarkable under the current pandemic. Performance on
Pharmaceutical Services Business unit is outlined in table 2, below.

Table 2: Pharmaceutical Services Business Unit Actual Performance

Indicators Target Target Q1 Q2 Q3 Q4 Actual Actual Comments Action Plans
2019/20 2020/21 Annual Annual
Achievement Achievement
2019/20 2020/21
Percentage 90% 90% 84% 90% 90% 90% 87% 89% Target not Continue
availability achieved, to penalise
of essential deviation of 1%: suppliers
medicines for late
at the Reasons: deliveries
Medical
Supplies Some EML items Continue
not awarded to buy-out
on contracts against
necessitating suppliers
buyout on that are not
quotation performing
Delivery of Continue to
orders exceeding follow-up
lead times. orders with
suppliers
Manufacturing on a daily
constraints such basis.
as capacity
and packaging
issues.
Percentage 80% 80% 72% 80% 83% 86% 77% 80% Target achieved Continue
of orders to penalise
satisfied suppliers
in full for late
within one deliveries
working
day Continue
to buy-out
against
suppliers
that are not
performing
Continue to
follow-up
orders with
suppliers
on a daily
basis

Indicators Target Target Q1 Q2 Q3 Q4 Actual Actual Comments Action Plans

2019/20 2020/21 Annual Annual
Achievement Achievement
2019/20 2020/21
Percentage <2% <2.00% 0.12% 0.04% 0.04% 0.20% 1.00% 0.40% Target achieved Stock with
of expired less than
stock 12 months
expiry
date is not
received
without
a stock
protection
letter:
There
are shelf
marshals
in every
store who
rotate stock
according
to expiry
dates and
put coloured
stickers to
mark short
dated stock
to ensure
that stock
that expires
first is used
first (First
Expiry First
Out).
Percentage 95% 99% 94% 100% 100% 96% 98% Target over- Items on
of achieved. dues out
medicines prioritised.
tested Batches are
within 2 recorded so
working that a batch
days is not tested
more than
once even
if delivered
at different
dates to the
depot.
Percentage 70% 70% 79% 79% 79% 80% 79% 79% Target over- Continuous
of achieved. monitoring
medicines of items list
delivered and supplier
directly
from
suppliers to
healthcare
facilities

Business Unit 3: Finance and Administration
Managing staff turnover is important for the entity, it helps to measure both the effectiveness of the
human resources internal systems and the overall management of the entity.
During the year under review the entity experienced a relatively small number of employees leaving.
While the entity cannot prevent staff from leaving, the low staff turnover is a good indication that staff
generally is happy to work for the entity. Table 3 below is a performance indicator for staff turnover.
Table 3: Finance and Administration Business Unit Actual Performance

Indicators Annual Annual Q1 Q2 Q3 Q4 Actual Actual Comments Action Plans
Target Target Annual Annual
2019/20 2020/21 Achievement Achievement
2019/20 2020/21
Percentage <5% <5% 1% 1% 0% 1% 4% 1% Target Conduct

of staff achieved exit
turnover interviews.
3. SCOPA Resolutions
To ensure that the Provincial Legislature perform its oversight functions properly, the entity submitted
its annual report through the Gauteng Department of Health and appeared before the Standing
Committee on Public Accounts (SCOPA) to respond to the questions raised by the committee based
on the audited report by AGSA.
Based on the previous year findings SCOPA issued a list of questions in relation to the AGSA
findings, notable in the findings is reoccurring audit findings and irregular expenditure. The entity
has developed and submitted responses to the SCOPA through GDOH, the same responses were
requested and submitted to AGSA. In response to the audit findings the entity has developed and
implemented Audit Intervention Plan which is monitored monthly.
4. Financial Performance
The entity continued to improve its financial management to ensure that it achieves its ultimate goal
of a clean audit opinion. In this regard, commitments were submitted to the AGSA in a form of Audit
Intervention Plan aimed at ensuring that recommendations made by both internal audit and the
AGSA are implemented. The plan was based on the findings issued.
Spending Trends
31 March Variance from 31 March Variance from 31 March Variance from 31 March 2018
Description 2021 Prior 2020 Prior 2019 Prior Amount
Amount Year Amount Year Amount Year R
R R R
Revenue 4 977 808 597 13.82% 4 373 490 282 6.98% 4 088 067 270 6.89% 3 824 656 198
Cost of Sales 4 740 861 445 13.81% 4 165 422 611 6.98% 3 893 397 373 6.89% 3 642 542 348
Expenditure:
Personnel 81 503 210 0.99% 80 706 118 12.50% 71 738 604 4.98% 68 334 539
Expenditure:
General 59 036 516 7.15% 55 095 257* -10.95% 30 985 761 8.19% 28 639 876
Net Surplus 154 844 598 11.92% 138 356 885 8.49% 127 529 262 17.34% 108 678 509
* Figure restated

The increase in medicines has led to the increase in revenue and the cost of sales in the 2020/2021
financial year compared to the previous years.
Personnel expenses increased due to more scarce skills posts on the staff establishment being filled.
General Expenditure was slightly higher in the 2020/2021 financial year when compared to the prior
year due to general increase in prices.
5. Utilisation of donor funds

On behalf of the provincial department of Health, the Depot received medicines from different
suppliers as outlined in table 4 below.
The depot acts as a conduit of the department of health, therefore does not receive any economic
benefit from the donation. The donation is disclosed by the GDOH in their books.
Table 4: GDoH donated stock.

Code Item Discription Donor Qty Item Price Value
Received
TB1220 Isoniazid Tablets Patient Ready Sanofi-Aventis Sa
Pack;300mg;28’S (Pty) Ltd 16 700 R 184,20 R 3 076 141,67
DON.HIV1. P Test Kit, Human Immunodeficiency Population Services
Virus Detection Donation; In Vitro International
HIV Rapid Test 19 450 R 65,89 R 1 281 560,50
ARV1515 Emtricitabine And Tenofovir Hetero Drugs South
Disoproxil Fumarate Tablets 200mg Africa (Pty) Ltd
and 300mg;30’S 227 000 R 132,25 R 30 020 750,00
ARV1510/1 Emtricitabine and Tenofovir Mylan (Pty) Ltd
Disoproxil Fumarate Tablets 200mg
and 300mg;30’S 308 R 62,87 R 19 363,96
TBD1600 Rifapentine 150 Mg; Tablet;24’S Sanofi-Aventis Sa
(Pty) Ltd 18 280 R 109,40 R 1 999 831,27
ARV1150 Dolutegravir, Lamivudine, Mylan (Pty) Ltd
Tenofovir Tablet (Option
2);50mg;300mg;300mg
Tablet;28/30’S 290 599 R 91,16 R 26 491 004,84
ARV1151 Dolutegravir, Lamivudine, Mylan (Pty) Ltd
Tenofovir Tablet (Option
2);50mg;300mg;300mg
Tablet;28/30’S 294 061 R 89,02 R 26 177 310,22
R 89 065 962,46
6. Corporate governance arrangements
The entity has developed a comprehensive risk management strategy in line with the requirements
of the Treasury Regulations in order to manage risks of the entity.
The entity uses the services of audit committee which consist of external members. In terms of the
Audit Committee Charter, five meetings were held during the reporting year.
The effectiveness of the entity’s system of internal controls is conducted by Gauteng Shared Internal
Audit who issued a report to management for implementation.
7. Prior modifications to audit reports

There were no prior modifications to the audit reports for the entity.
8. Events after the Reporting date

No events to report by the entity after the reporting date.
9. 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).
10. Investigations
The entity did not conduct any investigations other than Nexus Forensic investigation in 2012.
11. Other
The Depot is incurring costs related to price increases not recovered from demanders. This is mostly
attributable to the back dated approval of contract price increases by the Gauteng Department of
Finance.
12. Acknowledgement(s)/ or Appreciation

Management would like to acknowledge the enormous contributions made towards the entity by all
our stakeholders including our employees who work tirelessly to ensure that the depot achieves its
mandate of procuring, storing and distribution of medicines to all healthcare facilities in the Gauteng
Department of Health, the Gauteng Department of Health, Gauteng Provincial Treasury and other
organs of State.
Our sincere appreciation also goes to our valued suppliers especially those who have been supplying
us with medicines as per the contractual lead times at all times to ensure that we always have
medicines to supply our healthcare facilities.
13. Conclusion
The financial year 2020/2021 had many challenges facing Medical Supplies Depot. Despite all these
challenges management is pleased to report success stories in terms of service delivery towards
the people of Gauteng. The MSD has been able to improve payment of invoices within 30 days.
The entity is pleased that it has been able to distribute medicines to all healthcare facilities as per
the delivery schedule and on time. We are looking forward to a better 2021/2022 financial year and
intend to provide an improved service to our clients.
14. Approval and sign off

The financial statements as set out have been approved by the Accounting Officer.
Ms. Z. Rhemtula
Acting CEO: MSD
22 July 2021
Report of the Auditor-General

Report of the auditor-general to Gauteng Provincial Legislature on Gauteng
Medical Suppliers Depot
Report on the audit of the financial statements

Opinion
1. I have audited the financial statements of the Gauteng Medical Supplies Depot set out on pages
349 to 376, which comprise the statement of financial position as at 31 March 2021, the statement
of financial performance, statement of changes in net assets, and cash flow statement for the
year then ended, as well as notes to the financial statements, including a summary of significant
accounting policies.
2. In my opinion, the financial statements present fairly, in all material respects, the financial position
of the Gauteng Medical Supplies Depot as at 31 March 2021, and its financial performance and
cash flows for the year then ended in accordance with South African Standards of Generally
Recognised Accounting Practice (SA Standards of GRAP) and the requirements of the Public
Finance Management Act of South Africa, 1999 (Act No. 1 of 1999) (PFMA).
Emphasis of matters
3. I draw attention to the matters below. My opinion is not modified in respect of these matters.
Restatement of corresponding figures
4. As disclosed in note 25 to the financial statements, the corresponding figures for 31 March 2020
were restated as a result of an error in the financial statements of the trading entity at, and for the
year ended, 31 March 2021.
Irregular expenditure
5. As disclosed in note 20 to the financial statements, the trading entity incurred irregular expenditure
of R49 336 924. The majority of the irregular expenditure was caused by non-compliance with
treasury regulation on competitive bidding and non-compliance with recruitment policy.
Responsibilities of the accounting officer for the financial statements
6. The accounting officer is responsible for the preparation and fair presentation of the financial
statements in accordance with the Standards of GRAP and the requirements of the PFMA, and for
such internal control as the accounting officer determines is necessary to enable the preparation of
financial statements that are free from material misstatement, whether due to fraud or error.
7. In preparing the financial statements, the accounting officer is responsible for assessing the trading
entity’s ability to continue as a going concern, disclosing, as applicable, matters relating to going
concern and using the going concern basis of accounting unless the appropriate governance
structure either intends to liquidate the trading entity or to cease operations, or has no realistic
alternative but to do so.

REPORT OF THE AUDITOR-GENERAL
Auditor-general’s responsibilities for the audit of the financial statements
8. My objectives are to obtain reasonable assurance about whether the financial statements as a whole
are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report
that includes my opinion. Reasonable assurance is a high level of assurance but is not a guarantee
that an audit conducted in accordance with the ISAs will always detect a material misstatement when
it exists. Misstatements can arise from fraud or error and are considered material if, individually
or in aggregate, they could reasonably be expected to influence the economic decisions of users
taken on the basis of these financial statements.
9. A further description of my responsibilities for the audit of the financial statements is included in the
annexure to this auditor’s report.
Report on the audit of the annual performance report

10. In accordance with the Public Audit Act 25 of 2004 (PAA) and the general notice issued in terms
thereof, I have a responsibility to report on the usefulness and reliability of the reported performance
information against predetermined objectives for selected programmes presented in the annual
performance report. I performed procedures to identify material findings but not to gather evidence
to express assurance.
11. My procedures address the usefulness and reliability of the reported performance information,
which must be based on the trading entity’s approved performance planning documents. I have
not evaluated the completeness and appropriateness of the performance indicators included in the
planning documents. My procedures do not examine whether the actions taken by the trading entity
enabled service delivery. My procedures do not extend to any disclosures or assertions relating to
the extent of achievements in the current year or planned performance strategies and information
in respect of future periods that may be included as part of the reported performance information.
Accordingly, my findings do not extend to these matters.
12. I evaluated the usefulness and reliability of the reported performance information in accordance
with the criteria developed from the performance management and reporting framework, as defined
in the general notice, for the following selected programmes presented in the trading entity’s annual
performance report for the year ended 31 March 2021:
Programmes Pages in the annual performance

report
Business unit 2 – pharmaceutical service business unit 337 – 338
13. I performed procedures to determine whether the reported performance information was properly
presented and whether performance 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.
14. I did not identify any material findings on the usefulness and reliability of the reported performance
information for this programme:
• Business unit 2 – pharmaceutical service business unit


Other matters
15. I draw attention to the matters below.
Achievement of planned targets
16. Refer to the annual performance report on pages 337 to 338 for information on the achievement of
planned targets for the year and management’s explanations provided for the under achievement
of targets.
Adjustment of material misstatements
17. I identified material misstatements in the annual performance report submitted for auditing.
These material misstatements were in the reported performance information of business unit 2 –
pharmaceutical service business unit. As management subsequently corrected the misstatements,
I did not raise any material findings on the usefulness and reliability of the reported performance
information.
Report on the audit of compliance with legislation

18. In accordance with the PAA and the general notice issued in terms thereof, I have a responsibility
to report material findings on the trading entity’s compliance with specific matters in key legislation.
I performed procedures to identify findings but not to gather evidence to express assurance.
Procurement and contract management
19. Goods and services of a transaction value above R500 000 were procured without inviting
competitive bids and deviations were approved by the accounting officer but it was practical to
invite competitive bids, as required by Treasury Regulation 16A6.1 and paragraph 3.4.1 of Practice
Note 8 of 2007/2008 and TR 16A6.4. Similar non-compliance was also reported in the prior year.
Expenditure management
20. Effective and appropriate steps were not taken to prevent irregular expenditure amounting to R49
336 924, as disclosed in note 20 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 irregular expenditure was
caused by non-compliance with treasury regulation on competitive bidding and non-compliance
with recruitment policy.
Consequence management
21. Disciplinary steps were not taken against the officials who had incurred or permitted irregular,
fruitless and wasteful expenditure, as required by section 38(1)(h)(iii) of the PFMA.
22. I was unable to obtain sufficient appropriate audit evidence that disciplinary steps were taken against
officials who had incurred irregular, fruitless and wasteful expenditure, as required by section 38(1)
(h)(iii) of the PFMA. This was because investigations into irregular expenditure were not performed.

Other information
23. 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.
24. 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 on it.
25. 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.
26. When I do receive and read the report of the accounting officer, if I conclude that there is a material
misstatement therein, I am required to communicate the matter to those charged with governance
and request that the other information be corrected. If the other information is not corrected, I may
have to retract this auditor’s report and re-issue an amended report as appropriate. However, if it is
corrected this will not be necessary.
Internal control deficiencies

27. 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 basis for the opinion, the findings on the annual performance report
and the findings on compliance with legislation included in this report.
28. The accounting officer did not take disciplinary steps against liable officials who permitted irregular,
fruitless and wasteful expenditure following the recommendations made in the nexus forensic
investigation report.
29. The accounting officer did not exercise adequate oversight responsibility to investigate some
identified instances of irregular, fruitless and wasteful expenditure and ensure that consequence
management is instituted against liable officials.
30. The accounting officer did not provide adequate oversight responsibility over senior management
to ensure that effective steps are taken to prevent irregular, fruitless and wasteful expenditure.
31. Senior management did not adequately review the annual performance report in order to ensure
that it is aligned to the operational plan. As a result, material findings were raised in the annual
performance report and were subsequently corrected by management.

32. Action plans were adequately developed by senior management and monitored by risk management;
however, these risk-mitigating actions were not adequately implemented to prevent repeat findings
from reoccurring.
Johannesburg
31 July 2021

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 trading
entity’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 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 relating to events or conditions that
may cast significant doubt on the ability of the Gauteng Medical Supplies Depot 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 my 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
operating as a going concern
• evaluate the overall presentation, structure and content of the financial statements, including
the disclosures, and determine whether the financial statements represent the underlying
transactions and events in a manner that achieves fair presentation
• obtain sufficient appropriate audit evidence regarding the financial information of the entities
or business activities within the group to express an opinion on the consolidated financial
statements. I am responsible for the direction, supervision and performance of the group audit.
I remain solely responsible for my audit opinion.

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 provide the accounting officer with a statement that I have complied with relevant ethical
requirements regarding independence, and to communicate with them all relationships and other
matters that may reasonably be thought to bear on my independence and, where applicable,
actions taken to eliminate threats or safeguards applied.

STATEMENT OF FINANCIAL POSITION
as at 31 March 2021
Amounts in Rand Note 2021 2020
ASSETS
Current Assets
Inventories 2 297 116 549 155 206 832
Trade and other receivables from exchange transactions 3 925 227 860 399 413 237
Cash and cash equivalents 5 175 795 910 592 950 897
1 398 140 319 1 147 570 966
Non-Current Assets
Property, plant and equipment 4 7 675 886 10 880 561
7 675 886 10 880 561
Total Assets 1 405 816 205 1 158 451 527
LIABILITIES
Current Liabilities
Trade and other payables from exchange transactions 6 413 242 373 321 280 806
Provisions 7 5 787 833 4 952 147

Finance lease obligations 8 280 359 339 284
419 310 565 326 572 237
Non-Current Liabilities
Financial lease obligations 8 322 464 540 712
322 464 540 712

Total Liabilities 419 633 029 327 112 949
Net Assets 986 183 176 831 338 578
Contributed Capital 9 104 376 790 104 376 790

Accumulated surplus 881 806 386 726 961 788
Total Net Assets 986 183 176 831 338 578

STATEMENT OF FINANCIAL PERFORMANCE
Amounts in Rand Note 2021 2020*
REVENUE
Revenue from exchange transactions

Sale of Goods 10 4 977 808 597 4 373 490 282
Finance income 10 2 455 159 12 137 589
Other income 11 172 415 145 505
TOTAL REVENUE FROM EXCHANGE TRANSACTIONS 4 980 436 171 4 385 773 376
Revenue from non-exchange transactions

Penalties 12 26 683 403 24 852 222
Services in - kind * 12 29 126 195 28 955 273
TOTAL REVENUE FROM NON - EXCHANGE TRANSACTIONS 55 809 598 53 807 495
TOTAL REVENUE 5 036 245 769 4 439 580 871
EXPENSES
Employee related costs 13 (81 503 210) (80 706 118)
Depreciation 4 (3 830 327) (3 200 679)

Finance costs - finance leases (205 787) (208 814)
Cost of goods sold (4 740 861 445) (4 165 422 611)
Distribution costs (7 317 400) (7 907 740)
Operational costs* 14 (47 590 441) (43 746 799)
TOTAL EXPENSES (4 881 308 610) (4 301 192 761)
OTHER LOSSES
Loss on disposal of assets 16 (92 561) (31 225)
* Restated

STATEMENT OF CHANGES IN NET ASSETS
Amounts in Rand Contributed Capital Accumulated Surplus Total
Balance at 31 March 2019 104 376 790 588 604 903 692 981 693
Surplus for the year - 138 356 885 138 356 885
Balance at 31 March 2020 104 376 790 726 961 788 831 338 578
Surplus for the year - 154 844 598 154 844 598
Balance at 31 March 2021 104 376 790 881 806 386 986 183 176

STATEMENT OF CASH FLOWS
Amounts in Rand Note 2021 2020
Cash flows from operating activities
Receipts
Sale of goods and services 4 478 677 377 4 614 618 300
Finance income 2 455 159 12 137 589

Other receipts 11 172 415 145 505
Total receipts 4 481 304 951 4 626 901 394
Payments
Compensation of employees (80 965 948) (79 256 144)
Goods and services (4 816 292 817) (4 192 913 438)

Finance costs (205 787) (208 814)
Total payments (4 897 464 552) (4 272 378 396)
Net cash generated from operating activities 16 (416 159 601) 354 522 998
Cash flows from investing activities
Purchase of property, plant and equipment 4 (638 022) (3 925 195)

Net cash outflow from investing activities (638 022) (3 925 195)
Cash flows from financing activities
Repayment of finance lease liability (357 364) (349 244)

Net cash outflow from financing activities (357 364) (349 244)
(Decrease) / increase in cash and cash equivalents (417 154 987) 350 248 559
Cash and cash equivalents at the beginning of the year 592 950 897 242 702 338
Cash and cash equivalents at the end of the year 5 175 795 910 592 950 897

ACCOUNTING POLICIES
1.1 Basis of preparation
These financial statements were prepared in accordance with the Standards of Generally Recognised
Accounting Practices (GRAP) issued by the Accounting Standards Board in accordance with the
Public Finance Management Act, 1999 (Act No.1 of 1999) as amended by the Public Finance
Management Amendment Act (Act No. 29 of 1999).
1.2 Presentation currency
The financial statements are presented in South African Rand, which is the functional currency of
theentity.
1.3 Rounding
Unless otherwise stated, all financial figures have been rounded to the nearest Rand (R).
1.4 Going concern assumption
The annual financial statements were prepared on a going concern basis, which assumes that
theentity 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
inthe 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 infuture periods.
Provisions
Provisions are recognised in the financial statements when there is a present 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
reliableestimate on 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.

ACCOUNTING POLICIES
1.6 Significant judgements and estimates (Continued)
Depreciation and amortization
Depreciation and amortisation recognised on property, plant and equipment is determined with
reference to the useful lives and residual values of the underlying items. The useful lives and
residual values of assets are based on management’s estimation of the asset’s condition,
expected condition at the end of the period of use, its current use, expected future use and the
entity’s expectations about the availability of finance to replace the asset at the end of its useful
life. In evaluating the how, the condition, and use of the asset inform the useful life and residual
value. Management considers the impact of technology and minimum service requirements of the
assets.
1.7 Financial instruments
Initial recognition
The entity recognises a financial asset or a financial liability in its Statement of Financial Position
when, and only when, the entity becomes a party to the contractual provisions of the instrument.
This is achieved through the application of trade date accounting.
Upon initial recognition, the entity classifies financial instruments or their component parts as financial
liabilities or financial assets in conformity with the substance of the contractual arrangement and to
the extent that the instrument satisfies the definitions of a financial liability or a financial asset, in
accordancewith the standards of GRAP on Financial instruments - GRAP 104.
Trade and other receivables
Trade and other receivables are initially recognised at fair value plus transaction costs that
are directly attributable to the acquisition and subsequently stated at amortised cost, using the
effective interest ratemethod.
Cash and cash equivalents
Cash and cash equivalents are measured at amortised cost using the effective interest rate method.
Cash includes cash on hand and cash with banks. Cash equivalents are short-term highly liquid
investments that are held with registered banking institutions with maturities of three months or
less and are subject to an insignificant risk of change in value. For the purposes of the Cash Flow
Statement, cashand cash equivalents comprise cash on hand and deposits held on call with banks.
Trade and other payables
Trade payables are initially measured at fair value plus transaction costs that are directly
attributable to the acquisition and are subsequently measured at amortised cost using the
effective interest rate method.

ACCOUNTING POLICIES
1.7 Financial instruments (Continued)
Gains and losses

A gain or loss arising from a change in the fair value of a financial asset or financial liability
measuredat fair value is recognised in surplus or deficit.
For financial assets and financial liabilities measured at amortised cost or cost, a gain or loss is
recognised in surplus or deficit when the financial asset or financial liability is derecognised or
impairedor through the amortisation process.
Off-setting
The entity does not offset financial assets and financial liabilities in the Statement of Financial
Positionunless a legal right of set-off exists and the parties intend to settle on a net basis.
Impairments
All financial assets measured at amortised cost are subject to an impairment review. The entity
assesses at the end of each reporting period whether there is any objective evidence that a
financialasset or group of financial assets is impaired.
If there is objective evidence that an impairment loss on financial assets measured at amortised
cost has been incurred, the amount of the loss is measured as the difference between the
asset‘s carrying amount and the present value of estimated future cash flows (excluding future
credit losses that have not been incurred) discounted at the financial asset‘s original effective
interest rate (i.e. the effective interest rate computed at initial recognition). The 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.
1.8 Inventories
Initial recognition and measurement
Inventories are initially recognised at cost. Cost refers to the purchase price, plus taxes, transport
costsand any other costs in bringing the inventories to their current location and condition.
Subsequent measurement
Inventories is measured at the lower of cost and the net realisable value. Inventories are stated
on a weighted average cost basis with the same cost formula being used for all inventories
having a similarnature and use at the entity.
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 recognised as an expense in the period that the inventory
was sold, distributed, written off or consumed, unless that cost qualifies for capitalisation to the
cost of another asset.

ACCOUNTING POLICIES
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
areinitially 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
lessaccumulated depreciation and impairment losses.
Depreciation
Depreciation is calculated on the depreciable amount, using the straight-line method over the
estimated useful lives of the assets. Components of assets that are significant in relation to the
whole asset and that have different useful lives are depreciated separately. The depreciable amount
is determined after taking into account an assets’ residual value, where applicable.
The assets’ residual values, useful lives and depreciation methods are reviewed when there is an
indicator that useful lives or depreciation has changed and adjusted prospectively, if appropriate.
The annual depreciation rates are based on the following estimated asset useful lives:
Asset classification Average useful lives (Years)

Fixtures and fittings 4 - 15
Plant and equipment 2 - 23
Office furniture 2 - 24
Computer equipment 2 - 23
Cellphones & Accessories 2
Leased assets 3-5

ACCOUNTING POLICIES
1.9 Property, plant and equipment (Continued)

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 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
inthe period that the impairment is identified.
An impairment is reversed only to the extent that the asset’s carrying amount does not exceed the
carrying amount that would have been determined had no impairment been recognised. A reversal
ofthe impairment is recognised in the Statement of Financial Performance.
Derecognition
Items of property, plant and equipment are derecognised when the asset is disposed of or when
there are no further economic benefits or service potential expected from the use of the asset.
The gain or loss arising on the disposal or retirement of an item of property, plant and equipment is
determined as the difference between the sales proceeds and the carrying value and is recognised
in the Statement of Financial Performance.
Leases
The entity as a lessee in an operating lease
Assets subject to operating leases, i.e. those leases where substantially all of the risks and rewards
ofownership are not transferred to the lessee through the lease, are not recognised in the Statement
of Financial Position. The operating lease expense is recognised over the course of the lease
arrangement.
The lease expense recognised for operating leases is charged to the Statement of Financial
Performance on a straight-line basis over the term of the relevant lease. To the extent that the
straight-lined lease payments differ from the actual lease payments the difference is recognised in
the Statement of Financial Position as either lease payments in advance (operating lease asset)
or lease payments payable (operating lease liability) as the case may be. This resulting asset or
liability is measured as the undiscounted difference between the straight-line lease payments and
the contractual lease payments.
The operating lease liability is derecognised when the entity’s obligation to settle the liability is
extinguished. The operating lease asset is derecognised when the entity no longer anticipates
economic benefits to flow from the asset.
The entity as lessee in a finance lease

Leases are classified as finance leases where substantially all the risks and rewards associated
with ownership of an asset are transferred to the entity through the lease agreement. Assets
subject to finance leases are recognised in the Statement of Financial Position at the inception of
the lease, as isthe corresponding finance lease liability.
Assets subject to a finance lease, as recognised in the Statement of Financial Position, are measured
(at initial recognition) at the lower of the fair value of the assets and the present value of the future
minimum lease payments. Subsequent to initial recognition these capitalised assets are depreciated
over the contract term.

ACCOUNTING POLICIES
The finance lease liability recognised at initial recognition is measured at the present value of the future
minimum lease payments. Subsequent to initial recognition this liability is carried at amortised cost, with
the lease payments being set off against the capital and accrued interest. The allocation of the lease
payments between the capital and interest portion of the liability is effected through the application of
the effective interest method.
1.10 Leases ( continued)
The entity as a lessee in a finance lease ( continued)
The finance charges resulting from the finance lease are expensed, through the Statement of
Financial Performance, as they accrue. The finance cost accrual is determined using the effective
interest method.
The finance lease liabilities are derecognised when the entity’s obligation to settle the liability is
extinguished. The assets capitalised under the finance lease are derecognised when the entity no
longerexpects any economic benefits or service potential to flow from the asset.
1.11 Contributed Capital
The purpose of this reserve is to ensure that there are sufficient cash resources to fund the
workingcapital requirements of the entity.
Contributed capital consists of the following items:

• Cash received from the Gauteng Department of Health; and
• Transfers from accumulated surplus based on Treasury approval in terms of Treasury Regulations.
1.12 Revenue from exchange transactions
Sale of Goods is recognised by the entity for goods sold, the value of which approximates
theconsideration received or receivable, excluding indirect taxes, rebates and discounts.
Finance income
Bank interest is recognised on a time - proportioned basis using the effective interest method
1.13 Revenue from non-exchange transactions- Penalties, gifts, donations, including goods in-
kind.
Penalties , gifts and donations , including goods in kind , shall be recognised as income in the
period it isreceived provided that all if the following conditions have been satisfied:
• The amounts of all penalties , donations, gifts, and goods - in- kind can be measured reliably;
• There is an existing signed contract with supplier that includes a paragraph on penalties ; and
• It is probable that the economic benefits comprising of the penalty , gift, donations and goods in
kind will flow to the entity
With regards to donations received relating to pharmaceutical medicines ,Gauteng Medical

Supplies Depot does not account for the economic benefit received in the Statement of Financial
Performance, as the depot is considered to be only a conduit for hospitals and to control the
receipt of donations for the Department.

ACCOUNTING POLICIES
1.14 Irregular expenditure
Irregular expenditure as defined in section 1 of the PFMA is expenditure other than unauthorised
expenditure, incurred in contravention of or that is not in accordance with a requirement of any
applicable legislation, including -
a. this Act;
b. the State Tender Board Act, 1968 (Act No. 86 of 1968), or any regulations made in terms of the Act;
or
c. any provincial legislation providing for procurement procedures in that provincial government.
Irregular expenditure excludes unauthorised expenditure. Irregular expenditure is accounted for as
an expense in the Statement of Financial Performance.
Irregular expenditure is disclosed in the notes to the financial statements and removed from the
note when it is either condoned by the relevant authority or transferred to receivables when it is
deemed to be recoverable.
1.15 Fruitless and wasteful expenditure

Fruitless and Wasteful expenditure is defined as expenditure that was made in vain and would
have beenavoided had reasonable care been exercised , therefore:
- It must be recovered from responsible official ( a debtor account should be raised ) ; or
- Written off (if responsibility cannot be determined).
Such expenditure is treated as expenditure in the Statement of Financial Performance and where
recovered, it is subsequently accounted for as revenue in the Statement of Financial Performance.
Due to nature of business at the entity (where expired stock and stock breakages is inherent to its
business), expired and stock breakages will only be recognised as fruitless and wasteful expenditure
if their total value is higher than 2% of average stock holding.
Qualitative consideration would also be considered to disclose fruitless and wasteful expenditure.
Recovery of Irregular and fruitless and wasteful expenditure
The recovery of Irregular, fruitless and wasteful expenditure is based on legislated procedures, and
is recognised when the recovery thereof from the responsible officials is probable. The recovery of
irregular, fruitless and wastefulexpenditure is treated as other income.
1.16 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
that are rendered, except for non-accumulating 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
Retirement benefit costs
The entity provides retirement benefits for its employees through a defined contribution 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.
1.17 Events after reporting date

Two types of events can be identified:
• those that provide evidence of conditions that existed at the reporting date (adjusting events after
thereporting date); and
• those that are indicative of conditions that arose after the reporting date (non-adjusting events after
the reporting date).
The entity will adjust the amounts recognised in the financial statements to reflect adjusting events
after thereporting date once the event occurred.
The entity will disclose the nature of the event and estimate its financial effect or a statement
that such estimate cannot be made in respect of all material non-adjusting events, where non-
disclosure could influence the economic decisions of users taken on the basis of the financial
statements.
1.18 Related Parties
The Entity operates in an economic sector currently dominated by entities directly or indirectly
owned by the South African Government. As a consequence of the constitutional independence of
the three spheres of government in South Africa, only entities within the Gauteng Provincial sphere
of government are considered to be related parties.
Only transactions with related parties that are not at arm’s length or not in the ordinary course of
business are disclosed.
Key Management Personnel
Key Management Personnel includes all persons having the authority and responsibility for
planning,directing and controlling the activities of the entity. This includes:

ACCOUNTING POLICIES
• The senior management team of the entity, including the chief executive officer, the pharmaceutical
services director and the director of finance and administration.
1.19 Commitments
Commitments 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 entity
will discharge its responsibilities thereby incurring future expenditure that will result in the outflow of
cash.
1.20 Standards, amendments to standards and interpretations issued not yet effective.
The following Standards of GRAP and / or amendments thereto have been issued by the Accounting
Standards Board, but will only become effective in future periods or have not been given an effective
date by the Minister of Finance. The entity has not early-adopted any of these new Standards or
amendments thereto, but has referred to them for guidance in the development of accounting policies
in accordance withGRAP 3 as read with Directive 5:
Standard name and number Effective date( if applicable) Expected impact

GRAP 104 - Financial Approved and not yet effective It is expected that there will
Instruments be a significant impact on the
impairment of financial assets.

Amounts in Rand 2021 2020
2 INVENTORIES
Medicine 296 301 136 154 864 569
Consumable stores 815 412 342 263
Total Inventories 297 116 549 155 206 832
The amount of inventories recognised as an expense during the period amounted to R 4 744 840
474(2020: R 4 168 025 610) and details thereof are as follows:
Cost of goods sold 4 740 861 445 4 165 422 611
Inventory utilised in consumable stores 2 651 800 1 073 627
Inventory written off 1 327 229 1 529 372
Total inventory recognised as an expense 4 744 840 474 4 168 025 610
The entity uses the Weighted average cost method.

3 TRADE AND OTHER RECEIVABLES FROM EXCHANGE TRANSACTIONS
Gross Balances
Trade receivables - Gauteng Department of Health 924 769 164 398 351 959
Other receivables 458 696 1 061 278
925 227 860 399 413 237
Reconciliation of allowance for impairment

Balance at the beginning of the year - (9 743 946)
Trade and other receivables written off - 8 831 940
Other receivables - System error generated receivables - 912 006
Net Balance 925 227 860 399 413 237
As at 31 March 2021, the ageing of trade receivables from exchange transactions that were due
but not impaired is as follows:
< 30 days 686 080 858 398 620 020
> 30 days 239 146 802 793 217
Total 925 227 660 399 413 237
4. PROPERTY, PLANT AND EQUIPMENT

Cost Accumulated Carrying Cost Accumulated Carrying value
depreciation valueat depreciation at
end of the end of the year
year
Owned assets
Computer equipment 6 841 519 (4 042 802) 2 798 717 7 821 447 (3 884 577) 3 936 870
Cellphones & Accessories 83 704 (62 434) 21 270 83 704 (20 332) 63 372
Fixtures and fittings 39 001 (1 015) 37 986 10 625 (9 883) 742
Office furniture 5 602 978 (5 241 068) 361 910 5 574 196 (4 896 948) 677 248
Plant and equipment 22 662 717 (18 749 579) 3 913 138 23 673 376 (18 311 090) 5 362 286
ACCOUNTING POLICIES
Closing balance 35 229 919 (28 096 898) 7 133 021 37 163 348 (27 122 830) 10 040 518
Leased Assets
Motor vehicles - G-Fleet 1 084 500 (734 924) 349 576 1 084 500 (486 263) 598 237
Office equipment 405 371 (212 082) 193 289 325 173 (83 367) 241 806
Closing balance 1 489 871 (947 006) 542 865 1 409 673 (569 630) 840 043
Total 36 719 790 (29 043 904) 7 675 886 38 573 021 (27 692 460) 10 880 561
Note:
Included in the entity’s fixed asset register are items of Office furniture and in particular shelving as at 31 March 2021 with zero-rand book value. Management assesses at each
reporting date if there is a need to revise the useful lives at year-end as required by GRAP 17, paragraph .56. The outcome of the assessment revealed that there was no need to
revise the useful lives of assets other than shelving. The revision of the useful lives relating to the shelving was not performed due to the impractical and complex nature especially
given the COVID-19 conditions. Management intends to seek services of an expert to deal with this matter in the new year.
In terms of GRAP 17 paragraph 88, the entity spent R365 400 (2020: R219 301) on maintenance and repairs of assets. This amount was not capitalised to the cost of assets.
363
4. PROPERTY, PLANT AND EQUIPMENT (continued)
2021- Reconciliation of Property, Plant & Equipment

364
Carrying value Adjustments Additions Disposals Accumulated Depreciation Carrying value at

at beginning depreciation on end of
of the year disposals the year
Owned assets
Computer equipment 3 936 870 - 184 975 (1 164 903) 1 139 165 (1 297 390) 2 798 717
Cellphones & Accessories 63 372 - - - - (42 102) 21 270
Fixtures and fittings 742 - 39 000 (10 624) 10 568 (1 700) 37 986
Office furniture 677 248 - 380 703 (351 921) 337 797 (681 917) 361 910
Plant and equipment 5 362 286 - 33 343 (1 044 002) 991 352 (1 429 841) 3 913 138
10 040 - 638 021 (2 571 450) 2 478 882 (3 452 950) 7 133 021
Leased Assets
Motor vehicles - G-Fleet 598 237 - - - - (248 661) 349 576
Office equipment 241 806 - 80 198 - - (128 715) 193 289

840 043 - 80 198 - - (377 376) 542 865
Total 10 880 - 718 219 (2 571 450) 2 478 882 (3 830 326) 7 675 886
2020 - Reconciliation of Property, Plant &

Carrying value Adjustments Additions Disposals Depreciation Carrying value at

at beginning end of
Owned assets of the year the year
Computer equipment 1 037 548 - 3 755 685 (96 997) 78 291 (837 657) 3 936 870
Cellphones & Accessories 18 334 - 83 704 (54 185) 52 454 (36 935) 63 372
Fixtures and fittings 1 442 - - - - (700) 742
Office furniture 1 003 136 - 23 246 (51 459) 50 163 (347 838) 677 248
Plant and equipment 6 976 547 - 62 560 (120 753) 116 633 (1 672 701) 5 362 286
9 037 007 3 925 195 (323 394) 297 541 (2 895 831) 10 040 518
Leased Assets
Motor vehicles - G-Fleet 210 917 - 584 600 - - (197 280) 598 237
Office equipment 22 408 - 332 338 (199 823) 194 451 (107 568) 241 806
233 325 916 938 (199 823) 194 451 (304 848) 840 043
-
Total 9 270 332 - 4 842 133 (523 217) 491 992 (3 200 679) 10 880 561
Note:
Included in the entity’s fixed asset register are items of property, plant and equipment at 31 March 2020 with zero-rand book value. Management assesses at each reporting date
if there is a need to revise the useful lives at year end as required by GRAP17, paragraph 56. The outcome of the assessment resulted in no changes being made to the existing
useful lives as these assets are no longer in an ideal working condition. The total acquisition cost of these assets is R701 923 and accumulated depreciation to-date is: R701 923.
The intention by management is to replace these affected assets within the next 12 months. There have been delays in replacing these assets caused by the National State of
Disaster due to COVID-19.
In terms of GRAP 17 paragraph 88, the Entity spent R 219 301 on maintenance and repairs of the assets. This amount was not capitalized to the cost of the assets.

5. CASH AND CASH EQUIVALENTS

Cash and cash equivalents consists of:
Bank balance 175 790 910 592 949 397

Petty cash 5 000 1 500
Total Cash and cash equivalents 175 795 910 592 950 897
Cash and cash equivalents earn interest at floating rates based on daily bank deposit rates. The
financeincome is recognised in the Statement of Financial Performance.
No cash and cash equivalents were pledged as security at 31 March 2021
The entity had the following bank accounts at 31 March 2021:
FNB Cheque Account 175 790 910 592 949 397
6. TRADE AND OTHER PAYABLES FROM EXCHANGE TRANSACTIONS
Trade payables from exchange transactions 409 412 240 317 221 437
Service bonus accrual* 2 324 937 2 365 657

Other accruals 1 505 196 1 693 712
413 242 373 321 280 806
At 31 March 2021, the ageing of trade payables was as follows:
< 30 days 363 243 483 317 221 437

> 30 days 46 168 757 -
409 412 240 317 221 437
*Service bonus is accrued and the calculation is based on the employee’s gross
salary.It is normally paid out in the employee’s birthday month.


7. PROVISIONS
Provision for Performance Bonus* 667 936 799 057

Provision for Leave pay** 5 119 897 4 153 090
Total 5 787 833 4 952 147
Reconciliation of Provision for Performance Bonus:
Balance at the beginning of the year 799 057 1 307 383

Amount utilised (167 964) (1 351 302)
Unused amount reversed (631 093) 43 919
Amount raised 667 936 799 057
Balance at the end of the year 667 936 799 057
Reconciliation of Provision for Leave:
Balance at the beginning of the year 4 153 090 3 883 799

Amount paid during the year (288 585) (331 154)
Unused amount reversed (3 864 505) (3 552 645)
Amount raised during the year 5 119 897 4 153 090
Balance at the end of the year 5 119 897 4 153 090
* Performance bonus
Provision for performance bonus is based on assessment of employees’ performance for the year and according
to the entity’s policy. The actual obligation amount cannot be determined as the performance assessments are
finalised after financial year-end.
** Leave
Provision for leave pay is a liability as a result of employees accumulated leave days balances at the reporting
date using the current salary rates. The amount is uncertain as some of the leave balances will be forfeited if
not used within 6 months after the end of leave cycle.
8. FINANCE LEASE OBLIGATIONS

Minimum lease payments
Within 1 year 396 969 537 951
Within the 2nd to 5th year inclusive 400 894 726 538
797 863 1 264 489
Less: Future finance charges (195 039) (384 493)
Present value of lease obligations 602 824 879 996
The present value of lease obligations can be analysed as follows:
Within 1 year 280 359 339 284
Within the 2nd to 5th year inclusive 322 464 540 712
602 823 879 996
Disclosed as:
Current liabilities 280 359 339 284
Non-Current Liabilities 322 464 540 712
602 823 879 996
The finance lease obligations at 31 March 2021 was in respect of photocopier machines and motor vehicles.The
average interest rates is 16 % for photocopiers and 28% for motor vehicles. The end dates for these leased
items are as follows:

Photocopiers machines Motor vehicles:

8 Machines: March 2022 1 Motor vehicle: April 2021
1 Machine: February 2023 2 Motor vehicles: July 2022
1 Machine: April 2023
2 Machines: May 2023
9 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 capitalrequirements.
** Transfers from accumulated surplus to increase contributed capital occurred in 2007 (R 26 000 000) andin 2009
(R 24 376 790) after treasury approval was obtained.
10 REVENUE FROM EXCHANGE TRANSACTIONS - REVENUE

Rendering of goods* 4 977 808 597 4 373 490 282
Finance income** 2 455 159 12 137 589
TOTAL INCOME 4 980 263 756 4 385 627 871
* The Medical Supplies Depot renders pharmaceutical services to all different levels of healthcare in the Gauteng
Provincial Administration. The different levels of healthcare are primary healthcare facilities, district hospitals,
regional hospitals, tertiary and academic hospitals.
** The Depot earns interest at floating rates based on daily bank deposit rates.
11 REVENUE FROM EXCHANGE TRANSACTIONS - OTHER INCOME

Parking fees 86 400 89 520
Commission fees 44 215 45 185
Other income 41 800 10 800
TOTAL OTHER INCOME 172 415 145 505
12 REVENUE FROM NON-EXCHANGE TRANSACTIONS

Penalties* 26 683 402 24 852 222
Late delivery penalties 8 748 619 9 393 863
Buy-Out charges 17 934 783 15 458 359
CEO Remuneration** 693 619 1 452 442

Rent land and buildings*** 28 432 576 27 502 831
Total Revenue from Non-Exchange 55 809 597 53 807 495

*The Medical Supplies Depot charges two kinds of penalties in terms of the General Conditions Contract (GCC) as
follows:
a) Late delivery penalties – These are time-based penalties against suppliers on delayed deliveriesconsidering
the applicable lead-times, among other things.
b) Temporary incapacity penalties – These are penalties charged against contracted suppliers who fail to meet an
order placed in their favour.
** The entire remuneration of Ms. N Thipa (Retired Chief Executive Officer) amounting to R 346 857 was paid by
the Gauteng Department of Health. Ms. N Thipa worked as CEO for one month in the current financial year. Mr. D
Malele (Depot Manager) was appointed acting CEO for the remaining 11months of the financial year. Whilst the
entire remuneration of Ms. Thipa was paid by the Gauteng Department of Health, that of Mr. Malele was only in
respect of the acting allowance amounting to R 346 762.
***The entity uses the Land and Buildings for free provided for by Gauteng Department of InfrastructureDevelopment.
The market value of rent for similar commercial properties in Auckland Park, Johannesburg is estimated at R 28
432 576 per annum.

13 EMPLOYEE RELATED COSTS

Basic salary 54 588 710 54 628 349
Long service award 43 594 76 290
Qualification bonus 17 370 48 597
Overtime 1 082 875 620 457
Standby allowance 108 770 106 466
Acting allowance - 23 552
Housing allowance 3 168 002 2 965 322
Non-pensionable salary 3 153 870 3 272 738
Service bonus 4 336 441 4 509 467
Bargaining council 18 340 17 480
Performance bonus 835 901 842 976
Medical aid contributions 4 823 895 4 244 692
Travel claims 91 911 112 285
Leave 1 433 069 611 886
Intern salaries 51 225 101 688
Pension fund contributions 7 055 618 7 071 431
Service in- kind : CEO remuneration 693 619 1 452 442
81 503 210 80 706 118
Defined contribution plan
The entity provides retirement benefits for its employees through a defined contribution plan for
government employees. These benefits are funded by both employer and employee contributions.
Employer contributionsto 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.
Deficit for the year

Contribution payable for the year 7 096 532 7 101 685
Contributions paid 7 055 618 7 071 431
Deficit (40 914) (30 254)

14 OPERATIONAL COSTS
Rental and hiring 437 508 586 981
Repairs and maintenance 1 055 590 1 196 812
Communication 229 428 354 143
Stationery and printing 800 364 973 472
SITA computer services 2 560 301 2 528 403
Audit fees 551 793 153 134
External training 22 213 459 602
Inventory written off* 1 327 229 1 529 372
Cleaning services 1 698 794 1 534 030
Professional accounting and other advisory services 1 294 390 1 119 460
Security services 4 019 025 3 287 805
Medical supplies 993 676 -
External computer services 726 896 -
Toiletries 268 589 -
Other operational costs 31 604 645 30 023 585
Total 47 590 441 43 746 799
* Inventory written off relates to expired and broken stock that was written off during the period under
review.
15 OPERATING LEASE
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 151 493 231 142
Within 2 to 5 years inclusive 44 298 41 015
195 791 272 157
The lease agreements are not renewable at the end of the lease terms. The operating leases are in
respectof office equipment, plant, and equipment. There is no escalation clause in all operating leases
at 31 March 2021 and thus no straight-lining adjustment was required.
16 NET CASH GENERATED FROM OPERATIONS

Surplus for the year 154 844 598 138 356 885
Adjustment for:
Depreciation on property, plant and equipment 3 830 327 3 200 679
Net movement in provisions 835 686 (239 035)
Scrapping of property, plant and equipment 92 561 31 225
Inventory written off 1 327 229 1 529 372
Operating surplus before changes in working capital 160 930 401 142 879 126
Movement in working capital
(Increase) / decrease in inventories (143 236 946) 51 930 512
(Increase) / decrease in trade and other receivables (525 814 623) 216 275 796
Increase / (decrease) in trade and other payables 91 961 567 (56 562 436)
Net (decrease) / increase in working capital (577 090 002) 211 643 872
Net cash generated from operating activities (416 159 601) 354 522 998

17 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 not at arm’s
length.
Related party balances

Amounts included in trade receivables regarding related parties:
Gauteng Department of Health 924 769 164 398 351 959
Related party transactions

Amounts included in revenue regarding related parties:
Gauteng Department of Health 4 977 808 597 4 373 490 282
REMUNERATION OF KEY MANAGEMENT

The entity’s key management personnel are the following:
- Chief Executive Officer
- Director : Pharmaceutical Services
- Director : Finance and Administration

RELATED PARTIES (Continued)
Acting Acting Director Finance and

Chief DirectorPharmaceutical Administration:
2021 Executive Services: Mr. X Mahleza
Officer: Mr. S Langa Total
Mr. D
Malele
Salary 939 561 678 709 740 128 2 358 398
Bonuses and 78 297 61 701 61 677
performance 201 675
payments
Allowances 178 109 146 084 162 414 486 607
Pension Contribution 122 144 88 232 96 217 306 593
Total 1 318 111 974 726 1 060 436 3 353 273
2020 Director Finance and Acting Director Finance

Administration: and Administration:
Mr. X Mahleza Mr. K M Kasumba Total
Salary 904 922 493 416 98 280 1 496 618

Bonuses and
performance 77 140 - - 77 140
payments
Allowance 170 649 106 200 29 344 306 193
Pension Contribution 117 640 64 144 12 776 194 560
Acting allowance - - 23 552 23 552
Total 1 270 351 663 760 163 952 2 098 063
Service in-kind
In the current financial year, the Gauteng Department of Health rendered the services listed below at no
cost to theentity:
• Corporate Services (Including Human Resources, Risk management, Finance, and IT services).
Gauteng Audit Services also provided internal audit services at no cost to the entity.
• The value of these services could not be reliably estimated.
• The entire remuneration of the Chief Executive Officer of the entity (Ms. N Thipa) who retired at the
end of April 2020 amounting to R 346 857 (2020: R 1 452 442) was paid by the Gauteng Department
of Health. Mr. D Malele (Depot Manager) was appointed acting CEO for the remaining 11months of the
financial year at a cost of R346 762.

18 FINANCIAL RISK MANAGEMENT

General
The main risks faced by the trading entity are interest rate risk, credit risks, currency 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:
Amounts in Rand
2021 Within 1 year Within 2 - 5 Total
years
Finance lease obligations 280 359 322 464 602 823

Trade payables 409 412 240 - 409 412 240
2020 Within 1 year Within 2 - 5 Total
years
Finance lease obligations 339 284 540 712 879 996

Trade payables 317 221 437 - 317 221 437
The entity’s financial instruments are linked to the South African prime interest rate.
The following table demonstrates the sensitivity to a reasonable possible change in interest rates,
with allother variables held constant of the entity’s surplus before taxation:
Increase in
interest
Amounts in Rand rate by: Effects on surplus
2021
Finance lease obligations 1% 6 028
Trade payables 1% 4 094 122
Finance lease obligations 1% 8 800

Trade payables 1% 3 172 214

FINANCIAL RISK MANAGEMENT ( continued)
Credit Risk
Financial assets, which potentially subject the Entity 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 Entity 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 Entity, 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 Entity 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 Entity follows-up strongly on outstanding monies to ensure that there is money
available to release a weekly runof 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 exposed to credit risk at the reporting date were as follows:
Trade and other receivables ( less than 3 months) 924 769 164 398 351 959
Cash and cash equivalents (less than 3 months) 175 795 910 592 950 897
Liquidity Risk
The Entity maintains a large amount of inventory, the maximum turnover period for the inventory kept
however isthree months.
Liquidity risk is managed as follows :

Proper stock management processes are in place where stock ordered based on economic order
quantities. The turnover period of stock kept at the depot is three months. On a monthly basis, the
entity identifies slow moving items and a communication is sent to health facilities with an inventory
list of the items as a reminder thatthe stock is available.
Currency Risk
The Entity 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 National Treasury for a price adjustment
based on the fluctuation of foreign exchange rates.

19 FRUITLESS AND WASTEFUL EXPENDITURE
Reconciliation of fruitless and wasteful expenditure:

Opening Balance 30 713 299 25 742 325
Current year fruitless and wasteful expenditure - -
Prior year fruitless and wasteful expenditure identified in the - 4 970 974
current year
Closing Balance 30 713 299 30 713 299
Broken and expired stock is only recorded as fruitless and wasteful expenditure if it
exceeds 2% ofthe average inventory on hand.
Management has referred the fruitless and wasteful expenditure cases to the risk management
and internal controlunit for investigation.
20 IRREGULAR EXPENDITURE
Reconciliation of irregular expenditure:

Opening Balance 1 395 557 014 1 389 392 472
Current year Irregular expenditure ** 7 143 736 4 976 871
Prior year Irregular expenditure identified in the current 42 193 188 1 187 671
year***
Closing Balance 1 444 893 938 1 395 557 014
Action taken by management regarding irregular expenditure
**Current year irregular expenditure
There are five (5) contracts that accounted for the current year irregular
expenditure:
- Cleaning services 1 584 636 660 265
- Security services 3 944 765 3 268 619
- Accounting services - 743 838
- Repairs and Maintenance - 127 092
- Pest control and Gardening services 15 960 175 560
- Distribution services 1 479 650 -
- Waste removal services 1 498 1 497
- Purchase of goods 117 228
7 143 736 4 976 871
*** Prior year Irregular expenditure identified in the current year
* Sourced from Nexus forensic investigation report
Management has taken the following steps to eliminate the reoccurrence of this irregular
expenditure:
• The centralised tender process to replace the expired contracts for cleaning, security and distribution
services is underway.
• The entity is engaging with the GDOH to end the extension of the expired contract for Medical Waste
Removal Services.

21 COMMITMENTS
Approved, contracted and not provided for in the statement of financial position.
Contractual commitments
- Distribution services - 1 689 875
- Cleaning services - 924 371
- Operational orders placed but goods not delivered 631 096 609 789
- Pharmaceutical orders placed but goods not delivered 656 701 981 1 022 409 613
657 333 077 1 025 633 648
22 COMPARATIVES
There were no changes to the prior year presentation and disclosure.
23 CHANGE OF 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. Depreciationis to be calculated on a straight line basis for the remaining useful lives.
The change in the useful lives of the assets had the following impact on depreciation
Current year
Computer Equipment (6 863)
Office Furniture (330 992)
Plant & Equipment 249 737
(88 118)
24 CONTINGENT LIABILITIES
Nature of contingent liability

Public sector salary increases dispute for the 2020/21 financial year
The Labour Appeal Court (LAC) declared the salary increases for the 2020/2021 financial year unlawful
and invalid. The LAC ruling has been appealed and referred to the Constitutional Court. The ruling by
the Constitutional Court expected around June 2021, will confirm if the entity will be obligated to pay the
salary increases in dispute. The amount of the possible liability cannot be reliably estimated.
25 PRIOR PERIOD ERROR
Services in -Kind
Services in kind relating to the free use of the Land and Buildings at 35 Plunkett Avenue, Auckland Park,
Johannesburg to the amount of R 27 502 831 were erroneously omitted in the annual financialstatements.
The effect of the restatement on the individual financial statement lines is as follows:
Statement of Financial Performance
Increase in Revenue from non - exchange transactions - 27 502 831
Services in-kind
Increase in Operational costs 27 502 831
26 EVENTS AFTER REPORTING DATE

There were no events after reporting dates.

REPORT OF THE AUDIT COMMITTEE
Report of the Audit Committee – Cluster 03

We are pleased to present our report for the financial year ended 31 March 2021.
Audit Committee and Attendance
The Audit Committee consists of the external Members listed hereunder and is required to meet
a minimum of at least two times 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, the Annual Performance Report, the Annual report of the Depot and the Auditor-General
of South Africa’s (AGSA) Audit and Management Reports.
Non-Executive Members
Name of Member Number of Meetings attended
Mr. Stanley Ngobeni (Chairperson) 05

Mr. Leon Langalibalele 02
Ms. Lungelwa Sonqishe 03
Ms. Shelmadene Petzer 05
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. Dumisani Malele (Former- Acting CEO) 04

Ms. Zuleka Rhemtula (Acting CEO) 01
Mr. Xolani Mahleza (Director: Finance) 05
Ms. Lee-ann Doorasamy (Chief Risk Officer) 05
Mr. Kweyama Velile (Chief Audit Executive) 05

The Audit Committee noted that the CEO attended all the scheduled Audit Committee meetings.
Therefore, the Audit Committee is satisfied that the Depot adhered to the provisions of the GPG
Audit Committee Charter in relation to ensuring that there is proper representation by the Accounting
Officer.

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 (including IT control)
Based on the results of the formal documented review of the design, implementation and
effectiveness of the depot’s system of internal controls conducted by the internal audit, Office of
the Provincial Accountant-General (PAG) and Auditor-General of South Africa (AGSA) during the
financial year ended 31 March 2021, and in addition, considering information and explanations given
by management plus discussions held with the external auditor on the results of their audit, the
Audit Committee concluded that the depot’s system of internal financial controls is not effective and
material internal control breaches come to the Audit Committee’s attention.
Information and Communication Technology (ICT) Governance
The Audit Committee concluded that ICT Governance of the depot is not adequate, thus there is a
need for implementation of integrated ICT governance strategy and strengthening of ICT governance
structure. Furthermore the depot continue to operate in an old ICT infrastructure which increase ITC
risk exposure.
Internal Audit
• Audit Committee concluded that internal audit performance and effectiveness is atisfactory:
• Reviewed and approved the annual Internal Audit plans and evaluated the independence,
effectiveness and performance of the internal audit function;
• Considered the reports of the Internal Auditors on the depot’s systems of internal control;
• Reviewed issues raised by internal audit and the adequacy of corrective action taken by
management in response thereto;
• Internal Audit was assessed to be Generally Conformant with the International Standards for
Professional Practice of Internal Auditing.
Risk Management
The Audit committee reviewed the depot’s policies on risk management and strategy (including
IT Governance) and monitored the implementation of risk management policy and strategy and
concluded that depot’s risk management maturity level and business continuity management is
satisfactorily.
Combined assurance
The Audit committee reviewed the plans and reports of the external and internal auditors and other
assurance providers including management and concluded that these were not adequate to address
all significant risks facing the depot , thus Audit Committee further recommend the finalization and
the fully implementation of Combined assurance framework/strategy at the depot level.
The quality of quarterly reports submitted in terms of the PFMA and the Division of Revenue
Act
Based on the quarterly review of in-year monitoring systems and reports, the Audit Committee is
partially satisfied with the quality, accuracy, uselessness, reliability, appropriateness and adequacy of
the depot in-year reporting systems.
Compliance with the relevant laws and regulations
The Audit Committee considered reports provided by management, internal assurance providers
and the independent auditors regarding compliance with legal and regulatory requirements and

concluded that the depot did not comply with the enabling laws and regulations as well as its policies
the audited annual financial statements and annual performance report be accepted and read
and standard operating procedures.
together with the report of the Auditor-General.
Evaluation of Annual Financial Statements
Following the review by the Audit Committee of the Annual Financial Statements for the year ended
31 March 2021 before and after the audit, the Audit Committee is of the view that, in all material
One-on-One Meetingwith
respects, it complied withthethe Accounting
relevant Officer
provisions of the PFMA and GRAP and fairly presents the
financial position at that date and the results of its operations and cash flows for the year then ended.
The Audit Committee has met with the Accounting Officer for the department and other key members
Final Auditor General’s Report
from the department and Provincial Treasury to discuss actions to be taken to address the internal
control deficiencies
The Audit Committee concurs and accepts the conclusions of the Auditor-General on the Annual Fi-
nancial Statements, which is the unmodified audit opinion with findings (unqualified audit with em-
One-on-One Meetings
phasis of matters with the Executive
and non-compliance). Authority
Consequently, the Audit Committee is of the opinion that the
audited annual financial statements and annual performance report be accepted and read together
with the report of the Auditor-General.
The Audit Committee has met with the Executive Authority for the department to apprise the MEC
on the performance
One-on-One Meetingofwith
the the
Depot.
Accounting Officer
The Audit Committee

Auditor-General has metAfrica
of South with the Accounting Officer for the department and other key members
from the department and Provincial Treasury to discuss actions to be taken to address the internal
control deficiencies
The Audit Committee has met with the AGSA to ensure that there are no 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
Conclusion
the performance of the Depot.
Auditor-General of South Africa

The Audit Committee wishes to acknowledge the commitment and support of Honourable MEC,
The Audit Committee
Provincial has met withand
Accountant-General the AGSA to ensure
her team, that there are no and
Director-General unresolved issues.AGSA staff,
her team,
management
Conclusion and staff of the depot. The political and administrative leadership instability in the depot
played ultimate and big role towards and improved and positive financial and non-financial
The Audit Committee wishes to acknowledge the commitment and support of Honourable MEC,
performance.
Provincial Accountant-General and her team, Director-General and her team, AGSA staff, management
and staff of the depot. The political and administrative leadership instability in the depot played
ultimate and big role towards and improved and positive financial and non-financial performance.
Stanley Ngobeni
…………………………………………
Date: 13Ngobeni
Stanley August 2021
Date: 13 August 2021
Notes
GAUTENG PROVINCE
HEALTH
45 Commissioner St, Johannesburg, 2000

Private Bag X085, Marshalltown, 2107
Tel: +27 355 3000 | Fax: +27 11 355 3811
Web: www.gauteng.gov.za
Hotline: 08600 11000
PR215/2021
ISBN: 978-0-621-49615-4

2021 Gauteng Health Annual Report

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2021 Gauteng Health Annual Report

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DEPARTMENT OF HEALTH

Dental Specialist 17 169

SUPPORT STAFF 7 352

249 129 LEVEL (13)

217 717 96 345

87 181 101 300

43 555 221 1 022 840

PROVINCIAL TOTAL HEALTH

9 905 850 57 712 377 TRAINING

HEALTH FACILITIES ADMINISTRATION

Gauteng Department of Health

01 PART A: GENERAL INFORMATION 3

02 PART B: PERFORMANCE INFORMATION 21

03 PART C: GOVERNANCE 162

04 PART D: HUMAN RESOURCES 183

05 PART E: FINANCIAL INFORMATION 207

06 PART F: GAUTENG MEDICAL SUPPLIES DEPOT 333

30 - 38 41 - 124 162 - 379

4 -18 A performance 39 - 74 Performance of the

Gauteng Provincial Government | Health | Annual Report 2020/2021

Telephone number: 011 355 3477

2. Abbreviations and Acronyms

AARTO Administration Adjudication of Road Traffic Offences

IMCI Integrated Management of Childhood Illnesses

The advent of the COVID-19

Despite COVID-19 pandemic,

Regarding COVID-19, our recovery rate is an Fraud, Security and Risk

4.2 Overview of the Financial Results of the Department

Patient Fee tariff

Overview of expenditure per budget programme

Programme 2020/21 2019/20

4.3 Virements/Rollovers 4.4 Supply Chain Management

To the best of my knowledge and belief, I confirm the following:

7. Legislative and other Mandates

The Department’s core mandate is to:

8. Entities Reporting to the MEC

Name of Entity Legislative Mandate Financial Relationship Nature of Operations

MEC FOR HEALTH

1 022 840 clients were put on the

Part B: Performance Information

2. OVERVIEW OF DEPARTMENTAL PERFORMANCE

2.1. SERVICE DELIVERY ENVIRONMENT

Table 2.1.1: Integrated school health services

Table 2.1.3: Breakdown of COVID-19 cases

COVID-19 Screening and Testing

COVID-19 Vaccination Rollout

Risk Communication and Community Engagement

2.2. SERVICE DELIVERY IMPROVEMENT PLAN

Table 2.2.1 Main services and standards: Mental health services

25 teams have been

Table 2.2.2: Batho Pele arrangements with beneficiaries

Table 2.2.3: Service Delivery Information Tool

Table 2.2.4: Complaints Mechanism

Table 2.2.5: Complaints Mechanism: Communications

2.3 ORGANISATIONAL ENVIRONMENT

Phases Part Posts Cost of Posts

Group Category Number Total Cost

In order to strengthen strategic governance and leadership, the Department establishment a

2.4 KEY POLICY DEVELOPMENTS AND LEGISLATIVE CHANGES

3. ACHIEVEMENTS OF INSTITUTIONAL IMPACT AND OUTCOMES

GDoH 2025 Impact Outcome Gauteng progress during 2020/21

GDoH 2025 Impact Outcome Gauteng progress during 2020/21

4. INSTITUTIONAL PROGRAMME PERFORMANCE INFORMATION

• Quality of health services in public health facilities improved.