Spiralling medico-legal claims and deteriorating facility infrastructure have triggered urgent calls for a provincial health rescue plan. The calls include those from the DA, which raised concerns ahead of deliberations by the Mpumalanga Legislature’s Portfolio Committee on Health on the Department of Health’s 2026/27 budget and Annual Performance Plan.

Maintenance funding covers 19 facilities

According to information provided to the committee, 19 healthcare facilities received funding from the department’s maintenance budget during the 2025/26 financial year. Projects covered hospitals, clinics and other health facilities across the province, including repairs to fencing, roofs, doors and windows, renovations, waterproofing, ablution facilities and specialised conversions.

In the Gert Sibande District, maintenance projects were undertaken at Standerton Hospital, Ermelo Hospital, Evander Hospital and Carolina Hospital.

These included repairs to the concrete palisade fence and guardhouse at Standerton Hospital, repairs and waterproofing of the concrete roof structure at Ermelo Hospital, repairs and replacement of doors and frames at Evander Hospital, and renovations to the X-ray facility at Carolina Hospital.

In Ehlanzeni, projects included renovations at Figtree Clinic, fencing and septic tank repairs at Shabalala and Sandriver clinics, repairs to the palisade fence at Shongwe Hospital and roof maintenance at Mpumalanga Nursing College.

Other projects included the conversion of Barberton TB Hospital into a rehabilitation centre, renovations at Cork and Phiva clinics, work at Tintswalo Hospital, and the installation of fencing and guardhouses at Brooklyn and Simile clinics.

The Nkangala District received projects at Witbank Hospital, Kwazamokuhle Clinic and Impungwe Hospital. These included the installation of doors at the ICU and theatre, roof and ceiling repairs, conversion of a paediatric ward into a dental laboratory, and conversion of a maternity ward into a 72-hour mental health facility.

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The annexure records a 100% completion target for all 19 projects. Most are recorded as having reached 100% progress, although the Impungwe Hospital project was listed at 90% completion. The amounts allocated to the projects listed in the annexure add up to about R45.1m.The Barberton TB Hospital project is specifically identified as a donation.

DA labels maintenance spend inadequate

DA MPL Bosman Grobler, however, argues that the scale of maintenance remains inadequate in relation to the province’s overall healthcare infrastructure needs.

“The Mpumalanga Department of Health needs a rescue plan,” he said, arguing that hospitals and clinics are deteriorating while the department faces substantial medico-legal liabilities.

The party further claims that financial pressure from medico-legal claims is contributing to difficulties in maintaining facilities and procuring basic goods and services.

Lowvelder has previously reported on these medico-legal claims, with input from the Department of Health. Grobler also questioned the department’s handling of medico-legal claims, alleging that money intended for other departmental priorities is effectively being redirected to deal with litigation.

The department’s medico-legal exposure has been a significant financial concern.

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It previously confirmed to Lowvelder that its contingent liability for medico-legal claims stood at R6.3b, following 146 new claims valued at about R1.705b during the 2024/25 financial year.

The department reported that 67 of 131 medical-negligence cases recorded during that financial year were related to obstetrics and gynaecology.

The DA has now raised concerns about the relationship between deteriorating infrastructure, staff pressures and patient care, arguing that poor conditions could contribute to further medico-legal exposure.

Department defends infrastructure record

However, the condition of provincial health infrastructure is not uniformly poor, according to the department’s own previous assessment. Its 2024/25 annual report recorded 188 facilities, or 56.3%, as being in fair condition, while 113 facilities (33.8%) were rated good and 11 (3.3%) very good. A further 22 facilities (6.6%) were rated poor or bad.

The department reported completing 11 maintenance and upgrading projects during that reporting period. The provincial government has also previously highlighted infrastructure spending as a priority.

In the 2026 State of the Province Address, Premier Mandla Ndlovu said R1.7b had been allocated to health infrastructure in the previous year, including R183m for maintenance of existing facilities.

The provincial government also reported that 286 of 290 clinics had attained ideal clinic standards. The DA says it intends to submit parliamentary questions to Ndlovu regarding the condition of healthcare facilities and the department’s management of its financial pressures.

The issue is expected to form part of the broader scrutiny of the Department of Health’s 2026/27 budget and performance plans as the legislature considers whether current allocations are sufficient to address infrastructure maintenance, service delivery and the department’s growing medico-legal burden.