KZN Health MEC Nomagugu Simelane. | Supplied
Durban — The KwaZulu-Natal health system is in peril, as historic and ongoing budget cuts leave the Department of Health (DoH) grappling with an estimated overspending of R4.7 billion by the end of September 2024, said DA KZN spokesperson on Health, Dr Imran Keeka.
Keeka, voiced his “deep concern” regarding the financial plight faced by the department emphasising that the gentle reassurances of Premier Thami Ntuli overshadowed the severity of the crisis.
According to Premier Ntuli’s recent media briefing, the figures damaging the department's financial outlook primarily derive from the compensation of employees fees, totalling R3.36bn, which stem from the ongoing issue of unfunded healthcare positions.
Additionally, commitments reflected in the 2024 wage agreement, estimated at R1.9bn, further exacerbated the situation.
“The truth is that the situation is dire, Keeka said.
“The historic and current budget cuts have had a devastating impact on our DoH, with the provincial government left to find the shortfall through its baseline, causing an unsustainable financial strain.” Keeka said.
The premier’s acknowledgement of the department's impending overspending highlights the difficult choices authorities must make – choices that have resulted in staffing limitations, growing surgical backlogs, extended patient waiting times, a shortfall of ambulances on the streets, and a deficiency of nurses in wards, all of which adversely affect patient care, Keeka said.
To counteract this financial crisis, the department has proposed a necessary cost-cutting plan that raises concerns about further impairments to already limited healthcare services. An outline of this plan has surfaced, indicating the potential for further curtailments that the department may not withstand without compromising essential healthcare delivery, Keeka said.
Ntuli recently revealed that as part of the response, engagements between provincial and national treasuries are ongoing to address budget challenges. A step towards sustainability includes implementing a treasury note designed to limit new employment – an essential move considering the budget constraints.
Keeka said despite the collaborative efforts between national and provincial cabinets, which signal a glimmer of hope, there remains a pervasive scepticism regarding whether these initiatives can alter the course of this ailing department.
The Government of Provincial Unity (GPU) faces immense pressure to ensure rigorous oversight and accountability as they tackle the impending crisis, said Keeka.
Alongside these discussions, further pressure mounts as the department struggles with compliance issues related to the Public Finance Management Act (PFMA), specifically in adhering to the requirement of settling invoices within 30 days of receipt. Historical budget cuts from the 2021/22 financial year onwards have severely crippled functionality within the department, making it challenging to fulfil essential duties or recruit necessary personnel across various sectors.
In her budget vote speech, Health MEC Nomagugu Simelane said that the total budget was R 53.8bn.
“Since 2019, the department has lost close to R17bn, which has been taken away from our baseline. This situation is severely crippling, and affects the long-term sustainability of this department and its work,” said Simelane.
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