Note to Editors: Find attached soundbite by Madeleine Hicklin MPL.
The medico-legal crisis in the Gauteng Department of Health is so dire that it threatens the province’s fiscal sustainability, undermines healthcare services, and puts the lives of patients in danger.
This was recently revealed to the Finance Portfolio Committee meeting by the Auditor General of South Africa and Dr William Oosthuizen, Head of Department: Legal Affairs at the South African Medical Association (SAMA).
Speaking at a recent Stakeholder Engagement, Dr Oosthuizen said that the R6,658-billion in medico-legal claims for the 2024/2025 financial year were linked to systemic and operational failures in the Gauteng healthcare system. He said the root causes were human resource shortages as a result of an insufficient number of medical personnel and specialists; overburdened facilities unable to manage patient volumes effectively; poor coordination between healthcare facilities, which resulted in inadequate referral pathways; and delayed access to care, as patients often did not reach healthcare facilities in time to receive proper and effective help.
The Auditor General also highlighted that during the same period, the Gauteng Department of Health incurred R1.6 billion in irregular and fruitless expenditure and unauthorised expenditure of R5 078 billion. In addition, some goods, and services to the value of over R1 million were procured without inviting competitive bidders.
Dr Oosthuizen described the medico-legal situation in Gauteng as ‘dire’, with escalating frequency and value of claims with contingent liabilities that threaten the financial and fiscal sustainability of the department. It also affects service delivery and undermines patient care.
The Democratic Alliance (DA) is concerned that the absence of accountable leadership and stewardship has created a weak patient safety culture. Premier Panyaza Lesufi’s austerity and cost-cutting measures, including the termination of commuted overtime and its consequent impact on training, unfilled vacancies, and unavailability of medical officer and registrar posts, has further impacted the diminishing trust levels experienced by state hospitals across the province. The result is that patients, doctors, and nurses – in fact, the healthcare system in general – suffer.
All the above transgressions are flagrant violations of both the Public Finance Management Act (PFMA) and National Treasury regulations.
This litany of dereliction of duty, violations of laws and absence prudent financial management is a result of an uncaring, belligerent government. This government has consistently failed to abide by the rule of law and has refused to apply any real consequence management to officials or MEC found wanting.
The DA demands that Premier Panyaza Lesufi show leadership and hold the MEC of Health, Nomanto Nkomo-Ralehoko, accountable for the dire state of healthcare in this province.
The DA also demands that the former HOD of Health, Lesiba Malotana, also be held accountable for his part in this debacle and not be kept on indefinite suspension at home. The MEC and HOD must be fired with immediate effect.
A DA-led Gauteng government would prioritise patient safety, fiscal discipline, and accountable leadership by appointing appropriately qualified and responsible MECs, HODs and hospital management in all hospitals across the province. Our patients deserve better.