Clean audits for health departments
CAPE TOWN — The financial management of provincial health departments is improving, Health Minister Aaron Motsoaledi assured MPs yesterday.
Addressing members of Parliament’s health committee as he tabled his department’s annual report for the year to March 31, Dr Motsoaledi said both the Western Cape and North West had received clean audits, and while Limpopo had received a disclaimer, it was only because it had missed the deadline for submitting documents.
Limpopo’s health department, which was placed under national administration in December 2011, was able to account for all the money it had spent, the minister said. “We are celebrating the fact that we have been able to stop the irregular expenditure,” he said.
“We are still battling to bring the other provinces into line but we think we are going to do so,” Mr Motsoaledi said.
A clean audit means the auditor-general is satisfied that an entity has properly accounted for all the money it has been allocated, but does not necessarily mean it is delivering services as it should. Thus a provincial health department can get a clean audit, but still fail to provide adequate care to patients.
The national health department also received an unqualified audit from Auditor-General Terence Nombembe for the 2012-13 fiscal year.
But Mr Nombembe drew attention to the health department’s continued failure to implement proper systems for monitoring conditional grants.
Conditional grants are ringfenced funds earmarked for specific programmes, which are transferred from the Treasury to provincial health departments via the national department.
The national health department is supposed to monitor the performance of the provinces through periodic reports and by visiting the provinces to ensure that the funds are used for their intended purpose.
Mr Nombembe said there were monitoring problems with all of the conditional grants overseen by the health department.
These included the R8.88bn national tertiary services grant, and the R8.77bn HIV/AIDS grant.
Health director-general Precious Matsoso, who is the department’s accounting officer, said in the annual report that where noncompliance with the Division of Revenue Act had occurred it had been rectified “by means of discussion and in some cases delaying transfers”.
The annual report shows only 52% of the R150m conditional grant for the pilot project for National Health Insurance was spent, which the report ascribed to delays in approving business plans, slow procurement of goods and services, and delays in appointing key staff. The department’s chief financial officer, Ian van der Merwe, told MPs there had also been problems with identifying third-party contractors and securing equipment through government tenders.
The report also shows significant underspending of donor funding, which includes funds from the European Union and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, largely because projects were delayed.
The report shows just R421m (45%) of the R936m donor budget for the year under review had been spent.
However, the department’s spending capacity has improved markedly since last year, as it spent 99.4% of its R28.06bn budget, a 36% improvement on last year, Ms Matsoso said.
In a wide-ranging introduction to the annual report, the minister acknowledged the deep-seated problems at the Compensation Commission for Occupational Diseases. It is supposed to pay compensation to mineworkers who contract lung diseases as a result of their jobs, but has for years battled with claims backlogs and staff shortages.