Budget’s provincial health focus is helpful, but must come with improved oversight to ensure efficiencies
The employment of more than 800 post-community service doctors over the next three years is an important move by the government to ensure that critical frontline services within the health sector are restored.
However, the Rural Health Advocacy Project urges the government to ensure that these doctors are equally distributed between urban and rural facilities, to ensure that the country’s rural patients also receive quality service and equitable access to healthcare.
Yesterday, Finance Minister Enoch Godongwana tabled a budget allocating an additional R20 billion to health over the next three years.
“The provincial health sector budget is R845 billion over the medium term. This budget will be increased by R20.8 billion over three years to employ 800 post community service doctors, increase the spend on essential goods and services, and reduce accruals. “This increase will also assist the sector in addressing personnel budget pressures,” said Godongwana.
Addressing the persistent spending pressures to restore critical frontline services and invest in infrastructure is essential for improving access to basic services and lifting economic prospects, he added.
RHAP Executive Director Russell Rensburg noted that the provincial equitable share has been increased to allow for the public sector wage bill. He expressed concern that the budget did not address the structural challenges, which include the R22 billion in accruals resulting from an unfunded increase over the last three years.
“It also does not include the real measures to address the wasteful and fruitless expenditures. We welcome the retention of additional capacity, allocations to the NHI directorate and the introduction of the single view patient database. But it is important for rural facilities to be prioritised in this,” said Rensburg.
It is critical that provincial health authorities receive the necessary support and improved oversight to ensure that they can reduce their fruitless and wasteful expenditure, he added.
According to the Auditor General’s Consolidated General Report on National and Provincial Audit Outcomes 2023-24, provinces have been showing indicators of poor financial health such as fruitless and wasteful expenditure. These were signs of significant financial difficulty. The annual unauthorised, irregular, fruitless and wasteful expenditure was R1.49 billion in 2023-24. And the closing balance of provincial irregular expenditure that was not dealt with by the end of the administration stood at R216.58 billion, or 37% of the total balance of R582.40 billion.
RHAP also remains concerned about the minister’s failure to produce a solution to the funding gap created by the withdrawals of US aid.
For more information or for interviews, please contact Palesa Chidi on tchidi@rhap.org.za or via +2778 625 0511.