Gauteng health MEC Dr Gwen Ramokgopa. Picture: GALLO IMAGES
Gauteng health MEC Dr Gwen Ramokgopa. Picture: GALLO IMAGES

The Gauteng health department faces a R10.9bn funding gap as budgeted funds are all taken up by salaries, accumulated debt and payments for negligence.

Earlier in May health MEC Gwen Ramokgopa conceded that the current R40.2bn budget was inadequate to cover requirements, largely due to substantial debt burden consisting of money owed to suppliers.

On Monday DA shadow health minister Jack Bloom reiterated that the extent of the debt pile-up was revealed in a presentation by the department at a meeting of the Gauteng legislature health committee last Friday.

Outstanding payments to suppliers dating back to previous years totalled R4.2bn. Commitments to long-term contracts took up R2.95bn, while possible payments for medical negligence amounted to R3.78bn.

In 2016, the health department’s legal fees amounted to R569m, pushed up by burgeoning negligence cases since 2009.

The department’s chief financial officer, George Mahlangu, on Friday described this as a "dire situation".

Meanwhile, the department also reported that a total of R860m meant for hospital infrastructure had been withheld from the National Treasury pending submission and approvals of plans by the department.

"Our hospitals are falling apart, but available money is not used because of poor planning," Bloom said on Monday. "The provincial government has promised for many years that the health department will be ‘turned around’ but abysmal management continues."

Ramokgopa said the issues plaguing the public health system included the cost of equipment, poor-quality services and inadequate human resources.

Of the total budget, R23.8bn was earmarked for the wage bill and R16.3bn for goods and services, while an estimated R6bn was allocated to accruals, she said.

"This budget is effectively not available," Ramokgopa said, "which means we have not been able to afford services in the past years and the service providers carried the public health system at a huge cost."

The National Treasury’s fourth-quarter provincial budgets and expenditure report for the 2016-17 financial year released in April showed that provincial health departments spent 63% of their health expenditure on salaries. A meagre 4.4% of the total health expenditure went to capital expenditure.

In Limpopo (70.9%)‚ Eastern Cape (65.6%) and Free State (64%) the proportion of the budget that went towards salaries was higher than the national average.

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