DEPARTMENT OF HEALTH

DEPARTMENT OF HEALTH

GAUTENG HEALTH TURNAROUND STRATEGY: TOWARDS EFFECTIVE SERVICE DELIVERY, STRENGTHENING PRIMARY

HEALTHCARE AND A CLEAN AUDIT IN 2014.

BRIEFING TO THE PORTFOLIO COMMITTEE ON HEALTH

05 SEPTEMBER 2012

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OUTLlNE

■ Background

■ Current Context

■ Identifying Key Challenges

■ Objectives

■ Gauteng Health Turnaround Strategy in Detail

■ Summary

■ Way Forward

■ Recommendations

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MANAGEMENT SUMMARY

The challenges and plans described in this presentation reflect the inputs of GPG, the MoA with National Government, and the contribution of the Department of Health’s employees and stakeholders in the Turnaround Strategy Workshop.

■ The department is facing a serious situation, particularly regarding financial management.

■ A lot of progress has been made recently– However, we now need a systematic approach to sustain and build on this progress

■ This Turnaround Strategy sets out the interventions required to achieve this with concrete activities and timelines.

■ Indications are that it will take a number of years to completely turn the Department around

■ The on-going support of the Gauteng Provincial Government in this process is acknowledged.

■ The Executive Authority through the Accounting Officer takes responsibility for the successful implementation of this turnaround strategy.

Gauteng POA Analysis 2011/2012: Health

Achieved: 61% Good progress: 29% Some progress: 10% No progress / No report:

0%

RECENT CONTEXT

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IDENTIFYING THE KEY CHALLENGES

The Auditor General (AG)’s findings and the Premier’s Budget Council (PBC) helped to identify the key challenges facing the Department:

The Auditor General’s audit opinions 2009-11 focussed on financial management and information:■ Tangible assets (Qualified 10/11)

■ Revenue and receivables (Qualified 10/11)

■ Employee benefits (Qualified 10/11)

■ Information deficiency (Disclaimer - predetermined objectives 10/11)

■ Evidence for major variances (Disclaimer - predetermined objectives 10/11)

The Premier’s Budget Council Oct 2011 highlighted:■ Delegation to hospital CEOs - especially the four central hospitals - to improve

efficiency in infrastructure maintenance■ Procurement and management concerns at the MSD■ The management and outcomes of the EMS■ Medico-legal and litigation issues; and corruption■ The provincialisation process■ Human Resources issues , including rationalisation and controls on overtime.

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The negative cycle that stops us reaching our objectives

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THE KEY CHALLENGES TACKLED IN THIS STRATEGY

Through the Auditor General (AG)’s findings and the Premier’s Budget Council (PBC) we have identified eight key problem areas:

We then held a 2-day workshop on 1 and 2 March in order to draw on the experience and expertise of colleagues and stakeholders from throughout the health system to understand these problem areas in more detail.

■ Finance and financial management

■ Human resources

■ District health services for Primary health care

■ Hospital management

■ Medico-legal services and litigation

■ Health info management and health info systems (HIS)

■ Communication and social mobilisation

■ Health infrastructure development

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THE OBJECTIVES OF THE TURNAROUND STRATEGY

As well as responding to the obligations of the MoA and implementing the decisions of the PBC and the Provincial Finance Lekgotla, the interventions outlined in this turnaround strategy should lead to:

■More effective utilization of available resources by the department;

■The clearing of debt and accruals;

■Delivery within allocated budgets;

■Improvement of health outcomes;

■Entrenchment of the desired organizational culture and enhanced internal discipline throughout the organization; and

■Improved public and partner confidence

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The positive cycle we need

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There is already work underway to begin to address some of these challenges on a number of fronts. The turnaround plan incorporates this work and builds on it.

The National-Provincial MoA highlighted the need for work on:■ Gauteng Provincial Government: adhering to the PFMA; recovering all debts

owed to the Department within FY12/13 and developing a sustainable reimbursement mechanism.

■ National Government: supporting efficient administration of central hospitals; Health Information Systems (HIS); strengthening PHC services; National Treasury assistance in supply chain

Provincial Extended Finance Lekgotla – November 2011. ■ Top-slicing of the Gauteng Provincial Budget; reallocation of surrendered spending

to Health; quick-win infrastructure projects fast tracked;

■ GDF to develop a process to tackle accruals; allocation of infrastructure budget only to projects that are ready

WORK THAT IS ALREADY UNDERWAY (1 of 4)

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■ 5% top slice health personnel budget 2012/13

■ GDF and Health to collaborate the ensure that the central hospitals are functional

■ 3% top slice (hair –cut) in provincial Equitable Share budget to finance, and set aside the Provincial Revenue Fund for paying accruals

■ GDF and Health to manage debt and collect about R800 million owed

■ GDF and Health to formulate an action plan for clearing accruals

■ Engage service providers with regards to their payments and negotiating uninterrupted supply of goods and services

■ Stringent conditions to be put in place to ensure that no further accruals are incurred after the intervention

■ Clearing of accruals will be managed with Treasury.


There is already work underway to begin to address some of these challenges on a number of fronts. The turnaround plan incorporates this work and builds on it (continued)

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• Accruals have been reduced as follows:

– Accruals as at 31 March 2012: R3.6 billion

– Accruals as at 10 April 2012: R1.8 billion

– Accruals as at 13 June 2012: R374 million

– Accruals as at 28 June 2012: R21 million

Medical Supplies Depot

• R 874m paid in April 2012

• The total paid from 1 April to 28 June 2012: R4.2 billion• The above includes current year and prior year invoices.

• About R190M waiting to be cleared before declaration

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KPMG have been engaged to undertake a diagnostic project which will:

■ Support the Department in developing a detailed understanding of the root causes of the Department’s challenges;

■ Support the move from short-tem crisis management to longer-term development and provide a solid base for improvement, including skills transfer; and

■ Support the implementation of the Turnaround Strategy



THE TURNAROUND STRATEGY IN MORE DETAIL

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1. Finance and Financial Management

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Finance and Financial Management

Challenges Solutions Time frame Progress

Maximisation of outputs and deliverables with the limited inputs and available resources.

■ Establish a Finance Management Committee and demand individual accountability through internal audits.

■ Introduce and implement the National monitoring template for budget management.

■ June 2012

■ FMC is established and is operational

■ Monthly monitoring template for conditional grants in place.

■ All contracts to be reviewed for currency, performance, cost effectiveness against market rates, etc and a report produced.

■ Effective implementation of Cost containment measures especially with pharmaceuticals and laboratory services, and medical equipment procurement and G Fleet.

■ Head Office to conduct monthly reviews of vehicle use.

■ June 2012

■ Audit of all contracts conducted and a database compiled

■ Some savings realised from price negotiations

■ MSD business model re-engineering to realise savings.

■ 185 GG cars withdrawn. Fuel and repairs closely monitored.

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■ Work closely with the NHLS to introduce Electronic Gate-Keeping (EGK).

■ March 2014

■ EGK live in 20 biggest spending hospitals.

■ Saving realised to date is 0.53% out of targeted 5% of the bill (3% realised in the WC from 5 hospitals)

■ Review of the MSD business model as suggested by the AG; in order to increase patient access to medicine, capacity building and skills transfer for staff at the MSD, improve warehousing, development and implement SOPs, establish a ICT system at Regional pharmacies, and central hospitals.

■ May 2012 ■ MSD business model re-engineering to realise savings.

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■ Establish functional Provincial Pharmaceutical and Therapeutic Committee (PPTC) to monitor the use of medicines, ensure rational use of medicines, interrogate scientific evidence for protocols, assist with stock management for availability of EDL and other essential medicines, and to advise the province on all related matters

■ May 2012 ■ PPTC established – two meetings held.

■ Forensic investigation to be instituted at the MSD and institute appropriate corrective measures where indicated

■ Appointment of CFO

■ June 2012 ■ Investigation carried out, preliminary report with the Department

■ Offer made, to assume duty in September.

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Overview of cost containment plan

• An analysis was conducted and it identified the following Top 14 cost drivers of the budget over the MTEF period.

• The top 14 cost drivers of the department account for R6.5b of the R6.8b goods and services budget for FY 2012/13

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Budget 2012/13: Top 14 cost drivers

2011/12 2012/13 2013/14 2014/15

Inventory: Medicine 1,983,967 1,794,393 2,797,365 2,928,772

Inventory: Medical Supplies 1,254,659 1,447,887 896,536 899,303

Property Payments 944,256 1,129,775 1,267,362 1,286,776

Cons/Prof: Laboratory Services 1,328,991 1,003,881 1,239,401 1,145,314

Inventory: Food & Food Supplies 195,927 401,365 226,812 229,593

Contractors 112,692 209,096 148,945 150,551

Inventory: Other Consumables 167,693 134,957 173,800 189,532

Travel And Subsistence 153,633 92,798 92,099 95,231

Inventory: Fuel, Oil And Gas 113,557 80,012 133,725 145,227

Inventory: Stationery & Printing 80,917 68,019 74,307 78,140

Cons/Prof: Business & Advisory Serv 4,024 51,952 3,190 3,390

Communication 123,089 51,199 86,578 92,284

Agency & Suprt / Outsourced Services 202,170 45,680 192,766 197,002

Cons/Prof: Legal Cost 89,569 10,000 51,904 43,779

TOTAL 6,755,144 6,521,014 7,384,790 7,484,894

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Avoiding accruals and debt during the 2012/13 MTEF

■ Demand Plans that to be informed by cost centres for all Health institutions.

■ June 2012 ■ Vetting Committees established at all Institutions.

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Expenditure analysis

• The department has spent R7.156 billion as at 30 June 2012.

• This amount is 29% of the overall original budget (R24.5b).

• The reason for the over expenditure is the payment of accruals carried over from the previous financial years.

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Comparison of expenditure as at June 2011 and June 2012 (2)

FIRST QUARTER EXPENDITURE REPORT ( 30 JUNE 2012 )

Source: Final BAS Reports for June 2012

Economic classification

Main Appropriation

2011/2012 R'000

Adjusted Appropriation

2011/2012 R'000

Main Appropriation

2012/2013 R'000

Adjusted Appropriation

2012/2013 R'000

Total Actual June 2011

R'000

Total Actual 30 June 2012

R'000 % Spent June

2011

% Spent as at 30 June - 2012

Available as at June 2011

R'000

Available as at 30 June

2012 R'000

Current payments 20,086,491 20,376,456 21,896,112 - 5,187,329 6,124,842 25.8% 28.0% 14,899,162 15,771,270

Compensation of employees 13,182,665 13,425,885 15,055,213 - 3,263,857 3,578,340 24.8% 23.8% 9,918,808 11,476,873Goods and services 6,903,826 6,950,571 6,840,899 - 1,923,472 2,546,138 27.9% 37.2% 4,980,354 4,294,761Interest and rent on land - - - - - 364 * * - -364 Current transfers and subsidies 1,260,665 1,378,487 1,362,493 - 266,758 806,341 21.2% 59.2% 993,907 556,152

Provinces and municipalities 563,060 663,060 602,353 - 112,517 459,067 20.0% 76.2% 450,543 143,286Departmental agencies and accounts 13,182 13,182 15,103 - 3 13,187 0.0% 87.3% 13,179 1,916Universities and technikons 1,162 1,162 1,500 - - - 0.0% 0.0% 1,162 1,500Public Corporations & Priv Ent. - - - - - 62 - - - Non profit institutions 641,293 659,369 692,785 - 143,733 313,752 22.4% 45.3% 497,560 379,033Households 41,968 41,714 50,752 - 10,505 20,273 25.0% 39.9% 31,463 30,479Payments for capital assets 1,490,421 1,631,890 1,260,731 - 212,934 224,966 14.3% 17.8% 1,277,487 1,035,765

Buildings and other fixed structures 828,229 809,388 443,149 - 97,561 71,732 11.8% 16.2% 730,668 371,417Machinery and equipment 662,192 822,502 817,067 - 115,373 152,396 17.4% 18.7% 546,819 664,671Software and other intangible assets - - 515 - - - * 0.0% - 515Heritage Assets - - - - - 838 - * - - Payments for financial assets - - - - - - * * - - Grand Total 22,837,577 23,386,833 24,519,336 - 5,667,021 7,156,149 24.8% 29.2% 17,170,556 17,363,187

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Ensure adequate Budget for Health Services and Grants in 2013/14

■ Commission a study on Gauteng funding for Health in order to answer the question: “Is the Gauteng Health Department adequately funded to meet its constitutional imperatives, statutory mandates and strategic objectives?” The outcomes of the study should inform budget processes for 2013/14 MTEF process.

■ Aug 2012 ■ Proposal to be submitted to the Gauteng Planning Commission

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Ensure adequate Budget for Health Services and Grants in 2013/14

■ Establish the necessary controls for implementation of the legislative prescripts, policies, procedures and SOPs

■ Sep 2012 ■ Supply Chain Policy developed

■ Bid Adjudication Committee (BAC) revised

■ Rotation of SCM practitioners implemented

■ Training of CEO’s on SCM rolled out

■ Migration of procurement Officials from GDF to Institutions in Districts

■ Prohibition of Ex Post Facto

■ Withdrawal of manual purchase order books

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To manage revenue and debt.

■ Efficient recovery of R1.1b of outstanding debt amounting to R1.9b

■ Sept 2012 ■ Joint teams established with RAF, Alexander Forbes, National Treasury, National Health, GDF for reconciliation and clearing of debt

■ R20M accessed from NHI Pilot Grant for revenue management at the 4 central hospitals

■ 48 interns deployed at central hospitals through World bank funded NDOH programme

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To manage revenue and debt.

■ Establish strategic partnerships; e.g. with medical schemes, private hospital groups, SARS, Department of Home Affairs (DoHA) etc.

■ Commission the evaluation of the Folateng Programme.

■ Roll out Biometrics to the 20 top spending hospitals as part of the solution

■ Aug 2012

■ March 2013 ■ Full scale implementation at CHBAH and SBAH

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Ensuring that controls are in place for the safeguarding of assets

■ Develop and implement a comprehensive Asset Management Plan for the 2012/13 MTEF

■ June 2012 ■ Partnership with NDoH for I-Chain implementation

■ Train all custodians and managers in the correct procedures relating to assets and monitor training outcomes through performance management and the asset register

■ March 2013

Compliance to the PFMA’s requirements for risk management

■ A twelve (12) -point plan with indicators and a monitoring framework to be developed and implemented

■ July 2012

2. Human Resources

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Human Resources


Rationalisation of staff establishment to manage expenditure on employees and provide good quality health services

■ Persal Cleanup (verification of employees)

■ Ensure adequate budgeting for warm bodies and funded vacant posts.

■ Implement the NSDA-aligned organisational structure.

■ Sept 2012

Shortfall of about R800M identified

• Recommended structure awaiting DPSA approval

Accelerate filling of vacant funded posts in key health professional categories e.g. professional nurses, doctors, pharmacists and pharmacists assistants

■ Develop and implement a comprehensive HRH Plan

■ Monitor by Institution, Chief Directorate and District CoE expenditure through monthly reporting, to align it to the allocated budget

■ Aug 2012

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Human Resources


Develop norms and standards for Human Resources for Health

■ Commission a work study for a report in September 2012.

■ June 2012 ■ Norms and standards are in place

■ National process is underway

Tighten management of overtime and RWOPS for best value for the organisation

■ Review and implement policies on overtime and RWOPS.

■ Sep 2012 ■ Policy on overtime reviewed with capping of option E

■ Abuse of overtime identified with disciplinary action and potential recovery of losses

■ All CEO’s sign off and account for overtime based on need and budget availability

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Human Resources


Tighten management of overtime and RWOPS for best value for the organisation

■ Clinical Heads to also be held accountable for abuse of Overtime and RWOPS by their staff.

■ Nov 2012 ■ Two high profile cases of RWOPS abuse ( One case charged with fraud and corruption and another dismissed)

Increase productivity and accountability through effective performance management

■ Strengthen the implementation of the PMDS in the Department.

■ Ensure comprehensive Induction

■ Communicate the Departmental Code of Conduct clearly

■ Act decisively on cases of poor performance

■ Establish an Ethics Office within Department

■ March 2013

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Human Resources


Align Human resource Development plans with the Strategic Direction of the Department

■ HRD Plan for Pharmacy Assistants and advanced Midwives to be developed for implementation September 2012.

■ July 2012 ■ Training programme underway place for 600 Pharmacy Assistants

■ Policy and budget support for midlevel workers and community health workers.

■ Revive, revise actively implement the MOU with the Three Academic Health faculties in the Province.

■ Dec 2012

■ Sep 2012

3. District Health Services For Primary Health Care

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District Health Services


Accelerate development of District Health Systems

■ Re-organise the three regions and six health districts office (staff and budgets) into Five Health Districts

■ Sept 2012 ■ Three Regions dissolved and staff absorbed in 5 Health Districts

■ Appoint District Managers for the Five Provincial Health Districts

■ July 2012 ■ 4 Districts have full time managers

■ Appoint a DHS manager at Central Office

■ Develop and implement Health District Referral Policies

■ Aug 2012 ■ Recommendations for appointment made

■ Social mobilization for each Health District

■ GSSC migration to follow a District-based model.

■ Mar 2013

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Streamline the provision of Primary Health Care across all spheres of government

■ Develop and implement a provincial PHC reorganisational plan

■ April 2013 ■ Task team appointed

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Align budget and human resources to support District Health Services and implement the Primary Healthcare Reengineering.

■ Budget 2012/13 to increase allocation to the Districts

■ April 2012 ■ Highest budget increase in the current financial year (18%)

■ Development and implement of a costed Provincial Single PHC package

■ April 2013 ■ Driven by NDOH

■ Five year Provincial Business and Operational plan for the implementation of the Primary Health Care re-engineering programme as part of the NHI

■ July 2012 ■ Primary Healthcare teams in place in most wards

■ Primary Healthcare Specialist Teams appointed in all districts

■ School Health Programme initiated

■ Develop and implement a business plan and operational plan for the Tshwane NHI Pilot and the related conditional grant

■ April 2012 ■ Business plan developed and funded

Implement National Facility Improvement Programme

■ Conduct an assessment of compliance with all the National quality indicators and develop quality improvement plans for all institutions and facilities in all health districts

■ Sep 2012 ■ 60% of facilities assessed, improvement plans developed and implemented in collaboration with the NDOH

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Ensure responsive Emergency Medical Services and infrastructure systems including for Planned Patient Transportation

■ Develop and implement an EMS and PPT improvement plan

■ Appoint EMS – CEO

■ Sept 2012 ■ Two consecutive selection interviews unsuccessful

■ Partnerships with the private sector established

Mobilise and support leadership structures of society and communities

■ Ensure that all Hospital Boards and Clinic Committees are in place and fully functional

■ March 2013 ■ Induction completed for all hospital board members.

4. Hospital Management

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Hospital Management


Strengthen governance and environmental control systems in hospital.

■ Ensure adherence to and compliance with National Essential Equipment List, National Essential Drug List, National Essential Laboratory Services List

■ Mar 2014

■ Medical supplies norms and standards to be developed and implemented for all hospitals

■ Mar 2013

Build facilitative relationships among all cadres of Health Service Providers.

■ Establish management/clinical heads to provide a platform for participatory governance and information sharing at all hospitals

■ June 2012

Pay special attention to challenges confronted by nurses.

■ Nurse Manager (Chief Director) to be appointed at Central Office

■ Oct 2012

■ Nursing management strategy to be developed and implemented

■ Nov 2012

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Hospital Management


■ HIV and AIDS, TB and general wellness services to be provided at the workplace

■ April 2013

■ Targeted in-services training and skills development and implemented

■ Sep 2012 ■ Training programme underway

Intensify public education for appropriate utilisation of health services and establishment of effective district – based referral systems

■ Social mobilisation and communication.

■ Development of distribution and utilization plans for and with Family Medicine Specialists

■ Sep 2012

5. Medico-legal services and litigation

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Medico-legal services and litigation


Reduce rates of adverse events and medical negligence, especially in Obstetrics and Gynaecology, Surgery, emergency unit and Orthopaedics.

Reduce work environment related risk-source constraints e.g. Breakdown in equipment. Unavailability of commodities Increased patient volume and

disease burden Utilisation of junior staff with poor

supervision and support.

■ March 2013

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Medico-legal services and litigation


Build capacity on effective management of medico-legal cases

Enter into appropriate settlement negotiations and institute disciplinary measures immediately on confirmation of medico-legal negligence by employees.

Report cases of proven medical negligence to the HPCSA.

Establish a multidisciplinary Case Review Committee of experts.

Conduct a skills audit and implement an appropriate organisational structure for legal services.

Develop and implement a proposal on the use of an ombudsman.

Address challenges with State Attorney Services.

■ April 2013 ■ Appointment of Chief of Legal services in progress

■ Working closely with the office of the Premier and NDOH on case review and court representation

6. Health Information Management and Health Information Systems

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Health Information Management and Systems


Provide Strategic direction for Health Information Systems.

■ Develop and implement a comprehensive , long term ICT strategy for health.

■ Sept 2012

Ensure availability of adequate ICT skills (HR)

■ Perform ICT Skills Audit

■ Recruit Appropriate Staff

■ April 2013 ■ Chief of ICT to assume duty in September 2012

■ Develop and implement an evidence-based and targeted skills development plan

■ March 2014

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Update a full technology equipment and LAN, and provide support and maintenance on equipment.

■ Conduct a full ICT audit ■ Sept 2012

■ Develop and implement an ICT upgrade plan

■ October 2012

■ NDOH to assist with the migration plan for HIS

■ March 2013

■ Overhaul MEDSAS to improve efficiency of Pharmaceutical Services throughout the system.

■ March 2013 ■ MSD reengineering program underway

Streamline systems for unified Health Information System.

■ Through GDF, enforce Telkom to meet contractual obligations

■ June 2012

■ Through the NDOH, develop a business proposal for VPN (Virtual private network) (or alternative)

■ Sept 2012 ■ Driven by NDOH

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Mainstream Information Management and Accountability

■ Develop and implement a costed plan to unify systems based on National e-Health strategy

■ Sept 2012 ■ Driven by NDOH

■ Initiate single HIS

■ Benchmark on good practice and phase in the roll out of effective automated systems

■ March 2015

■ Establish a Provincial Health Information Systems Committee as required by NIHSSA

■ Introduce Information management into PMDS.

■ Sept 2012

■ Adopt, adapt and implement national DHMIS policy to rationalise registers

■ Provide preservation of files.

■ Provide well structured records classification system.

■ Data elements to be regulated by the accounting officer

■ March 2014

■ Development of systematic disposal programme

■ March 2014

7. Communication and Social Mobilisation

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Communication and Social Mobilisation

Challenges Solutions Time Frame Progress

Develop and articulate a communication strategy

■ Gauteng Health Communication strategy is approved and shared with communicators in regions and facilities

■ April-Jun 2012 ■ Communication strategy is in place

Mainstream of communication management throughout the organisation

■ Training of all district and facility managers in key health issues and media management.

■ Appoint communicators for all four central hospitals

■ May’12-Mar’13

■ All four central hospitals have communicators

Develop a service provider identification mechanism

■ Photo, name and contact details of CEOs must be prominently displayed to facilitate filling of complaints

■ Sep 2012

■ Complaints line must be popularised

■ Queue marshals at all facilities to help patients with complaints

■ Apr’12-Mar’13 ■ Queue marshals are in place

■ Written complaints must be responded to within seven days (monitoring and reporting)

■ Commission annual service perception survey

■ Mar 2013

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Communication and Social Mobilisation


Streamline responses to complaints from the public for positive media publicity.

■ Media tours to showcase centres of excellence and new developments in facilities

■ March 2013

■ Programme of the Executive Authority

8. Health Infrastructure Management and Development

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Health Infrastructure


Health infrastructure refurbishment and rehabilitation

■ All institutions to develop and implement costed infrastructure, maintenance and rehabilitation plans

■ Sept 2012

■ Accounting Officer to conduct Quarterly reviews of infrastructure maintenance and rehabilitation plans

■ March 2013

■ Establish strategic partnerships to improve infrastructure management

■ Sep 2012 ■ DBSA and NDOH MOA is in place for seven major funded projects

■ Establish a departmental infrastructure regulatory committee for proper prioritisation, planning, implementation and maintenance

■ Aug 2012

Ensure accountability for infrastructure project planning to produce the risk of delays and scope and budget increases

■ Develop and begin to implement a 5-year Health Infrastructure Plan

■ Sept 2012

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Health Infrastructure

Challenges Solutions Time frame

Improve capacity for effective project management.

■ Conduct a skills audit and capacity improvement plan for the Health Infrastructure Unit at Central Office and in the Districts

■ July 2012 ■ Senior Manager appointed for Infrastructure projects

Prioritise local procurement and economic participation in health infrastructure maintenance and building projects

■ Infrastructure projects to comply with the new Provincial Procurement Policies

■ October 2012 ■ Discussion document on “localization” for maintenance compiled with DID

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In summary …

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The Big 3 Key Activities

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Follow the Money

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The big 3 to give the system hope

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Way forward

• The Gauteng Health Turnaround Strategy will be available on the intranet to all employees.

• Road shows will be conducted to all districts and central hospitals, • Managers will develop performance agreements and operational plans for the

implementation of the Turn Around Strategy• Institutions and Districts will develop operational plans in line with the interventions

outlined in the Turnaround Strategy. • A Performance Monitoring and Evaluation Framework is being developed in consultation

with the Gauteng Planning Commission.• Quarterly reports will be provided to the Gauteng Provincial Government EXCO.

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Recommendations

■ It is recommended that the Health Portfolio Committee notes the Gauteng Health Turnaround Strategy.

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Thank you

DEPARTMENT OF HEALTH

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