Health Minister Dr. Aaron Motsoaledi stated that over ten years of austerity policies have contributed to staff shortages, deteriorating infrastructure, and systemic failures in South Africa's public health system.
Comments following Ombudsman's report
These statements came after the publication of an Ombudsman for Health report concerning the deaths of six healthcare workers in KwaZulu-Natal. Motsoaledi noted that the investigation did not establish direct hospital liability for these cases, but it did reveal persistent issues in human resource management, infrastructure, procurement, and financial administration.
Dr. Motsoaledi emphasized that although the investigation found no evidence of a direct link between the deaths and allegations of workplace harassment, persecution, or poor working conditions, it once again exposed long-standing weaknesses in the national health system.
Key identified problems
According to the minister, recurring investigations by the Ombudsman for Health consistently point to four main problems affecting healthcare facilities. These issues include human resource provision in healthcare, building maintenance, financial management, and procurement matters.
Motsoaledi countered that while these functions are largely under the purview of provincial governments, years of budget cuts have significantly hampered the resolution of these issues. He stressed that healthcare has undergone very severe austerity policies for 10 years, and this problem has been repeatedly presented to the Ministry of Finance.
The Minister added that austerity, like corruption, harms society. He clarified that corruption in public service is not a crime that affects no one, but austerity is not harmless; it endangers the population, especially those who rely on the public health system.
Financial difficulties of provinces
According to the minister, provinces have for years expected to absorb increases in public sector salaries without receiving additional funding from the National Treasury. This forced health departments to redirect funds intended for goods and services.
He recounted that during salary negotiations with trade unions, after reaching an agreed percentage, the Treasury failed to provide the necessary funds, insisting that the provinces must conclude negotiations independently.
Consequences of budget constraints
Years of restricted spending have resulted in many public health buildings being in poor condition. Ombudsman investigations have repeatedly raised concerns about aging infrastructure, repair delays, and unsafe conditions.
Funds originally intended for goods and services have increasingly been used to cover personnel costs. Motsoaledi argued that repeated austerity measures have led to shortages across the entire public health system.
Measures to improve the situation
Motsoaledi welcomed the allocation of R20.9 billion by the Treasury over a three-year period to begin easing financial pressure on the sector, although he noted that more support will be required. As part of broader efforts to address public health challenges, he announced the appointment of a group of 16 experts to review the HR policy implemented since 1994.
This review will include the RWOPS (Remunerative Work Outside the Public Service) policy, which allows certain state doctors to undertake private work. Motsoaledi stated that he wants the experts to assess whether this policy should continue, as it is causing significant dissatisfaction among healthcare workers.