Government demonstrates its commitment, pumps R1bn into NHI

The health sector is expected to receive an allocation of R848-billion over the medium term expenditure framework (MTEF), with at least R1-billion directed to the National Health Insurance (NHI).

This was announced by Finance Minister Enoch Godongwana during the 2024 Budget Speech in Cape Town on Wednesday.

“These allocations include R11.6-billion to address the 2023 wage agreement, R27.3-billion for infrastructure, and R1.4-billion for the NHI grant over the same period,” he said. 

“The allocation for the NHI is a demonstration of the government’s commitment to this policy. There remain a range of system-strengthening activities that are key enablers of an improved public healthcare system that must be undertaken.”

He said these activities include:

  • Building a national health information system and digital patient records;
  • Upgrading health facilities and improving quality of care to ensure that they meet the minimum criteria to be certified and accredited for contracting under the NHI;
  • Strengthening facility and district management in preparation for contracting;
  • Granting semi-autonomous status for central (and potentially other) hospitals; and
  • Developing reference prices and provider payment methods for hospitals.

In the 2024 budget review, the National Treasury noted that the budget for the sector is expected to grow slower than inflation over the MTEF “due to the R23.7-billion baseline reductions over the medium term”.

“The function will prioritise greater efficiency, better management of commuted overtime, and intensified promotion of preventative care,” said the Treasury.

“Spending reviews in the sector have led to some savings in vaccine and antiretroviral tenders.

“The health sector continues to recover from service disruptions due to the Covid-19 pandemic, particularly in antiretroviral treatment and tuberculosis screening and treatment.

“The Department of Health and its provincial counterparts will prioritise building tertiary services like oncology through earmarked funds in the national tertiary services grant in provinces with inadequate services.


“This grant grows by 8.8% in 2024/25 as funding is shifted into it from the oncology portion of the National Health Insurance conditional grant.”

Educations sector

Turning to education, Godongwana said the sector will receive about R25.7-billion in “carry-through costs of the wage increase over the medium term”.

“At the same time, we were able to protect the budgets of critical programmes such as the school nutrition programme. The programme provides food to pupils in almost 20 000 schools. 

“The early childhood development grant is allocated R1.6-billion, rising to R2-billion over the medium term.”

Firm eye

The government is expected to keep a firm eye on value for money, as consolidated government spending is expected to reach R2.37-trillion in 2024/25, R2.47-trillion in 2025/26, and R2.6-trillion in 2026/27.

This is according to the National Treasury’s 2024 budget review.

Said the Treasury: “The government’s priority is to enhance spending quality and minimise inefficiency while ensuring sustainable public finances — in other words, to increase the value for money from this spending.”

The bulk of the 2024-202525 budget will go to basic and tertiary education, peace, and security.

“While R69.4-billion is added to this function for the carry-through costs of the 2023 public-service wage agreement over the medium term, there are baseline reductions of R49.8-billion in other areas,” it said.

“Improved efficiency in the procurement of learner-teacher support materials and in the management of the placement of educators will continue.

“Spending in the post-school education and training sector grows by 2.5% over the medium term.

“Spending in the education and training authorities and the national skills fund grows by 3.9% over the medium term, allowing the institutions to improve the quality of their offerings.” – SAnews.gov.za

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