Gauteng’s ongoing cancer treatment crisis has once again come under the spotlight as civil society groups, opposition parties and patients demand urgent action from provincial government.

Despite two high court rulings ordering the Gauteng Department of Health (GDoH) to clear the backlog in radiation-oncology treatment at hospitals such as Steve Biko, there are still major concerns about compliance, accountability, and the human toll of administrative inaction.

In August, the Gauteng High Court reaffirmed that the province’s failure to provide timely radiation therapy to cancer patients violated their constitutional rights to life, dignity, and access to healthcare.

The judgment required the GDoH to update its backlog list, ensure all eligible patients receive treatment, and report transparently on progress, whether through public or private facilities.

The court emphasised that irreversible harm had already occurred, with some patients dying while waiting for treatment and the cancer of others advancing beyond the point where therapy could help.

However, the department’s response to these rulings has drawn harsh criticism.

SECTION27 and the Cancer Alliance, who brought the case, say the GDoH has failed to comply with key parts of the court’s orders, including providing a verified list of patients and detailed progress reports.

They argue that while the department continues to appeal the rulings, patients continue to suffer preventable harm.

Jack Bloom, the DA’s health spokesperson in Gauteng, said the department’s lack of transparency remains deeply troubling.

“The department is still refusing to provide the full details of the cancer treatment backlog dating back many years. This is despite two adverse court judgments, which they are appealing,” Bloom said. “The situation is better at Steve Biko Hospital than at Charlotte Maxeke Johannesburg Hospital, but still cause for concern. They need to expand the use of private hospitals to treat public cancer patients.”

Bloom added that political obstruction is compounding the crisis.

“The DA has tabled a motion of censure in the Provincial Legislature against the Gauteng Health MEC, for her failure to treat patients, but we are going to court as the ANC refuses to allow it to be debated. It is outrageous that this should happen in a democracy, but they are afraid they will lose the vote,” he said.

He also warned that delays in diagnostic services were worsening outcomes.

“Delayed biopsy results at the Johannesburg NHLS laboratory are putting lives at risk, but Tshwane patients are better served by the laboratory at Steve Biko. I however just received a complaint of a patient at Kalafong Hospital in Atteridgeville waiting for a biopsy result for testicular cancer for more than six weeks now, which is terrible,” Bloom said.

For advocacy organisations, the lack of compliance by the GDoH represents not just a bureaucratic failure, but an ongoing human tragedy.

Salomé Meyer, chairperson of the Cancer Alliance, told Rekord the department has yet to meet even the most basic obligations set out by the courts.

“The court ordered them to provide a full updated backlog list of patients to enable us to compare apples with apples,” Meyer said. “They have to show how many patients received treatment, how many did not, how many are no longer eligible because their cancer has metastasised (spread to other parts of the body), how many now require other forms of treatment such as chemotherapy, and how many have passed away. Only with this information can we determine the actual impact of the inaction of the GDoH since this problem was first raised with the Human Rights Commission in 2017.”

Meyer said that despite repeated promises, very little has changed at Charlotte Maxeke Johannesburg Academic Hospital, one of the province’s main oncology centres.

“All patients requiring radiation go onto a waiting list and that is normal but waiting periods should not be longer than three months. When there is not enough equipment or staff, the waiting time grows longer, and palliative cases are prioritised. To our knowledge, the situation remains the same as when we reported it in 2021.”

She explained that procurement delays have been a major obstacle.

“The tender for two new Linac machines to replace old cobalt units has still not been finalised since 2021. These smaller machines were meant to fit into existing bunkers at Charlotte Maxeke, but the CEO at the time declined the allocation. Instead, the funding went to Johannesburg’s Chris Hani Baragwanath and Ga-Rankuwa’s George Mukhari hospitals, where machines were procured in 2022 and are now sitting in storage. Construction of new bunkers only began this year, and installation may only happen in 2026 if the machines are still usable.”

The Cancer Alliance estimates that the province’s oncology budget, amounting to R784-million, has not been fully utilised.

“About R250-million was left unspent,” Meyer said. “The court ordered the GDoH to provide feedback on how this money was spent, but we have not seen any clear reporting.”

She confirmed that tenders were awarded to five private radiation oncology facilities to help address the backlog, but practical challenges remain.
“What the department is doing now is sending current waiting list patients to private facilities to prevent a new buildup, but that does not address those already left behind.”

“The private sector cannot simply take backlog patients without reassessment and they all need new CT scans and diagnostic work. That was not included in the service level agreements.”

According to Meyer, these contracts end in March 2026, and the estimated capacity is about 100 patients per week, depending on private sector availability.

“We have no information on how this is managed,” she said. “We still do not know where we stand with the backlog list because the department refuses to make it public.”

The legal battle continues. The GDoH has appealed all the court orders, and the case was last heard before a full bench in October.

Judgment is pending, but the department has already filed papers with the Supreme Court of Appeal, with further hearings expected in early 2026.

As frustration grows, SECTION27 and the Cancer Alliance have launched a new campaign urging patients who were on the Charlotte Maxeke backlog list but never received radiation treatment to come forward.

“Any person who was on the CMJAH backlog list and did not receive radiation can contact SECTION27 at info@section27.org.za,” Meyer said.

– Questions have been forwarded to the Gauteng Department of Health but no answers have been received at time of publication.

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