The auditor-general has previously found Gauteng to be the only provincial health department to fail all nine assessed governance areas.
The Gauteng department of health has yet again failed to spend its budget despite crumbling hospitals, staff vacancies, unpaid suppliers, and inadequate equipment.
The department is projected to underspend R725 million in the 2025-26 financial year ending 31 March, the Gauteng finance and economic development department has revealed in an official provincial legislature reply.
National Treasury has only approved a conditional rollover of R261 million of the unspent funds, meaning that R463.5 million will be returned to the national fiscus, according to Jack Bloom, the DA’s spokesperson on health.
The failure to spend the health budget was indefensible when hospitals were crumbling, critical posts remain vacant, suppliers not paid on time and essential equipment is lacking, he said.
Delays blamed for under-expenditure
The under-expenditure was blamed on delays in the completion of projects and submission of invoices by contractors, and the delivery of machinery and equipment, Bloom said.
In December, it was reported that National Treasury would write to Gauteng health MEC Nomantu Nkomo-Ralehoko, to provide reasons against being put under administration and three other MECs of health in other provinces.
“These provinces face a high risk of running out of medication due to a chronic failure to pay service providers in 30 days, salary overspending, persistently high doctor and nurse vacancy rates and budget overruns with neglected infrastructure maintenance,” Bloom said.
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Treasury reportedly raised alarm over the risk of medication stock-outs caused by chronic late payment of service providers and other matters.
Leadership instability and governance failures
Gauteng health’s problems were compounded by the absence of a permanent chief financial officer for more than three years, Bloom said, describing this as “a recipe for financial chaos”.
The auditor-general has previously found Gauteng to be the only provincial health department to fail all nine assessed governance areas, including procurement, revenue and expenditure management, strategic planning, consequence management and the use of conditional grants.
Further instability has followed the suspension of the department’s head, Lesiba Malotana, after failing a lifestyle audit conducted by the Special Investigating Unit (SIU) flagged him as “high risk”, while corruption allegations intensified with more than R2 billion reportedly looted from Tembisa Hospital.
The DA will renew pressure on Gauteng premier Panyaza Lesufi to remove Nkomo-Ralehoko, Bloom said, adding competent and ethical leadership is urgently needed.
Proper spending of the department’s R67 billion budget could significantly improve health care services for Gauteng residents, he said.
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Gauteng expenditure troubles
Motalatale Modiba, the Gauteng department’s spokesperson, had not commented at the time of going to press.
In May last year, provincial Treasury department head Ncumisa Mnyani revealed Gauteng had to return just over R1 billion to the National Treasury because the province’s health and education departments had failed to spend the allocated funds in the 2024-25 financial year.
The province failed to spend R1.8 billion of its allocated funds, with the bulk of that, R1.041 billion, coming from the health and education departments.
In September, Gauteng finance MEC Lebogang Maile said the Gauteng government departments incurred R4.2 billion in new irregular expenditure in the 2024-25 financial year.
This follows more than R700 million spent on a new Johannesburg Forensic Laboratory, though the facility remains incomplete due to shoddy workmanship.
Added to that, all that existed of the Boitumelo Community Health Centre in Emfuleni was a concreted hole in the ground, an incomplete boundary wall and a patch of excavated soil after 10 years and R20 million, as The Citizen previously reported.
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