While Gauteng hospitals are in crisis, government slashes health budget

While the Gauteng Health Department is the biggest beneficiary in the province’s 2025/26 financial year budget, receiving R67-billion – a 3.7% decrease from the previous year – the DA believes that this allocation is unlikely to improve the province’s healthcare crisis.  

Last year, the department failed to spend R1.1-billion of its 2023/24 budget due to issues with financial controls and poor planning.   

The Gauteng health system has long been in crisis. Other than previous underspending, patients endure delays in oncology treatment and the department struggles to maintain health facilities and secure goods and services. 

“This is the first time I can honestly say I think Gauteng health is going to collapse,” a healthcare worker told Daily Maverick last week. 

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Delivering the  2025/26 budget, Maile said the R67-billion health budget was intended to strengthen the public health system, ensuring equitable, patient-centred care, particularly in underserved communities. Maile delivered the speech at the provincial legislature in darkness, with power supplied by a generator.  

Some initiatives the government intends to focus on include modernising infrastructure, digitising health records, enhancing governance and building capacity to effectively combat both communicable and non-communicable diseases.

The DA’s shadow health MEC, Jack Bloom, said the department was in a severe crisis and Gauteng hospital patients would continue to suffer, with no provision to pay the R4.3-billion owed to suppliers and no money to fill staff vacancies.

The situation would be further worsened by the fact that the budget had not accounted for 1,180 vacant critical positions, nor the 7,131 professional nurses needed to provide quality healthcare, said Bloom.  

In addition, no extra funds had been allocated to repair deteriorating hospitals, none of which met fire and safety standards.

Bloom said the budget had not made any provision for the withdrawal of US Pepfar funding and raised concerns over the department’s ineffective top management, which had struggled to properly allocate the existing budget.

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“I think Premier [Panyaza] Lesufi is neglecting the Gauteng Health Department. He is not treating it like a priority. He said very little about it in his [State of the Province] address, and I think for political reasons he’s not moving against the top management and the MEC who should all be removed.”

Bloom said his party would now write to the National Treasury to ask why the provincial government had failed to allocate extra health spending in line with Finance Minister Enoch Godongwana’s instruction during his national budget speech. 

Russell Rensburg of the Rural health Advocacy Project criticised the province for its continued failures in recent years, citing major scandals such as the cancer care crisis, the Charlotte Maxeke fire and issues at Rahima Moosa as well as Helen Joseph Hospital. 

“All of these have contributed to a significant trust deficit between the department, healthcare workers as well as the communities it serves.”

He said the department should work with stakeholders from the schools of public health, medical schools and civil society to develop a refocused provincial health services strengthening plan to be implemented over the next three years.  

“This should include a review of the efficacy of provincial health management information systems, audit of the provincial hospital and district HR plans and lastly strengthening procurement systems to reduce the impact of corruption on service delivery,” Rensburg said.

Liquidation concerns

A number of departments experienced budget cuts in Gauteng's latest budget, released on 18 March 2025. Graphic by Jocelyn Adamson