Public health expenditure has ballooned to R183bn over the past 20 years, but a large chunk of provincial health budgets is spent on salaries, a review released on Tuesday shows. Simultaneously, poor-quality primary healthcare services and a growing burden of noncommunicable diseases crippled the system, said the South African Health Review. The report by public health organisation Health Systems Trust analyses health sector challenges, reform initiatives and their implications for transformation of public healthcare. Managing editor of the South African Health Review Ashnie Padarath said the review had identified areas where sustained and concerted action was required. "It paints a mixed picture and shows evidence of progress in many of the programmes that are needed to ensure the successful implementation of NHI [National Health Insurance]." In real terms, health spending increased from R68m in 1995 and is expected to reach R176.5m by 2019. The report found that public health spen...

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