Eastern Cape health department admits it can’t pay overtime to doctors, nurses until new financial year

With unpaid bills of R5.3-billion piling up, the Eastern Cape Department of Health admitted to its staff in a letter this week that it will also not be able to pay overtime or performance bonuses until the new financial year. Their unpaid bills are half a billion more than last year.

In an alarming letter setting out the department’s financial woes, its head, Dr Rolene Wagner, said there is an intervention being implemented as they are even finding it difficult to pay for life-saving needs such as the blood bank, laboratory services, medical gas and medicine.

“There is an intervention with the Office of the Premier, Provincial Treasury and the National Department of Health that includes means to begin addressing the historic debt; however, in the meantime, the Department is finding it increasingly difficult to pay all of its core business suppliers for non-negotiables such as the National Health Laboratory Services, Afrox (supplier of medical gas), the South African National Blood Services and medicines and medical supplies.

“Payment arrangements have had to be made with most of these suppliers.

There are other creditors, such as municipal services, security services, facilities maintenance services and telecommunications services, for which payment arrangements have also had to be made. These efforts aim to promote continuity of health services to our communities,” Wagner explained.

The department has faced the same problem for several years and in 2024 an unpaid Telkom bill of R36.5-million shut down the emergency medical services. Contingency plans had to be made to switch the ambulances using a cellphone system over the Easter weekend.

Read more: EC Health Department scrambles to set up new emergency numbers after not paying the phone bill

The department employs 47,087 people.

But, Wagner points out in her letter, their mandate remains “underfunded”.

“The department is facing a significant challenge of meeting all of its obligations within the Cost of Employees (COE) budget of R20,011-billion. This is specifically true of paying overtime and Performance Management and Development System (PMDS) to our employees, on time.”

They had tightened “monitoring and management”.

“There remains, though, a projected overexpenditure of COE by the end of March 2025.”

The department also owes R5.3-billion in unpaid bills. Wagner said most of these are for medico-legal settlements. 

“We are pleased that the integrated medico-legal strategy has seen a significant reduction in new claims against the Department and a significant reduction in payments in settlement of historic claims against the State,” she added.

She said they do not dispute that overtime is due to employees. 

“But at the same time, we have an obligation to pay the basic salaries of all staff, up to the end of the financial year, within the Departmental funding envelopes. To ensure that basic salaries are paid to employees between now and March 2025, from the available budget for cost of employment, securing jobs; and to balance that responsibility against the overtime worked by our employees, management has had to take some difficult decisions.”

Workers who did not receive overtime pay