Gauteng Health to return R464m as underspending exposes leadership failures

The Gauteng Department of Health is set to return almost R464 million to the national fiscus after failing to spend its allocated budget before the end of the financial year on 31 March.

The underspending was revealed by the Gauteng Finance and Economic Development Department in response to a question in the provincial legislature by the DA’s Jack Bloom.

Of the R725 million underspent, only R261 million can be rolled over. The rest will be lost to the province.

‘Accommodation of incompetence’

Professor Alex van den Heever from the Wits School of Governance said the situation points to deep leadership and governance failures at the Department.

“I think that’s an accommodation of incompetence, very, very poor leadership,” Van den Heever said.

He said the Department has not had a permanent chief financial officer for years and is currently operating with acting executives, leaving leadership ‘clearly in disarray’.

According to Van den Heever, the Department is also sitting with around R8 billion in accruals, meaning unpaid bills for goods and services already procured.

“That R8 billion is a R2 billion increase over the R6 billion of the financial year before. So, it’s getting worse,” he said.

Tembisa Hospital looms large

Van den Heever also referenced the widely reported procurement scandal at Tembisa Hospital, where about R2 billion was allegedly stolen with little or nothing delivered.

“Tembisa was a case where R2 billion was just stolen from the Department — nothing delivered,” he said.

He added that senior officials currently facing suspension were part of earlier appointment processes linked to the hospital’s financial collapse.

“You have a group of people who either have no idea what they’re doing or are part of syndicates extracting resources from the Gauteng Department and really have no interest in doing their job,” Van den Heever said.

Impact on patient care

The underspending comes despite severe pressure on public health services, including long backlogs in cancer treatment.

“The Department has failed to procure radiation oncology services,” Van den Heever said. “There’s a huge backlog of cancer patients who require radiation treatment, and they were allocated money for that, which they also failed to spend.”

He warned that the consequences are clear: “Patient care is in a poor state overall and potentially getting worse.”

A repeated problem

This is not the first time Gauteng has returned large sums to the National Treasury. In May last year, the province handed back just over R1 billion after the Health and Education departments failed to spend their budgets.

Van den Heever said much of the underspending is linked to capital projects and conditional grants that cannot easily be shifted to other urgent needs, even when shortages elsewhere are severe.

“So, although they have huge shortfalls elsewhere in the Department, they can’t actually switch the money to those functions,” he said.

The latest figures have once again raised questions about whether chronic governance failures, rather than a lack of funding, are driving the crisis in Gauteng’s public health system.

For more information, listen to Van den Heever using the audio player below: