The Portfolio Committee on Health and Wellness convened a special meeting on Friday, 14 February 2024, to assess critical challenges facing the Gauteng Department of Health (GDoH). Key focus areas included health infrastructure projects, an update on medico-legal cases, and the ongoing shortage of healthcare personnel, particularly in specialised fields.
The Committee noted that GDoH has introduced a capacity-building implementation plan to take full control of infrastructure projects and maintenance, ensuring timely delivery within budget as the department ultimately remains accountable. The Committee will closely monitor whether this new approach leads to tangible improvements while ensuring the completion and handover of outstanding projects managed by DID.
Declining Medico-Legal Claims Provide Relief
The Committee welcomed the steady decline in medico-legal claims, which previously burdened the department with a contingent liability of over R18 billion in the 2022/23 financial year. By the third quarter of the 2024/25 financial year, the claim value had been reduced by R7.2 billion, bringing the contingent liability down to R7.1 billion. This reduction allows the department to utilise its budget on improving services instead of servicing legal fees.
The Committee has urged the department to explore legislative measures to further mitigate medico-legal claims while ensuring compliance with constitutional and legal frameworks.
Shortage of Health Personnel Requires Urgent Intervention
The Committee reflected on the ongoing shortage of clinical personnel, including specialised doctors and nurses, largely attributed to austerity measures and cost-containment policies. During oversight visits, the Committee observed the severe strain caused by these shortages, despite healthcare workers doing their utmost to sustain the system.
For the 2024/25 financial year, the department finalised a recruitment plan outlining all critical positions needed, including strategic clinical posts. However, approval to fill these posts was not granted due to projected overspending on personnel costs.
As an interim measure, the committee notes the efforts by the department to address staffing gaps. This includes the recruitment for 1,120 interns from township, informal settlement, and hostel (TISH) communities to support new healthcare facilities in various roles.
Recognising that some of these constraints stem from broader systemic issues beyond the department’s control, the Committee will engage with the provincial Treasury and the Office of the Premier to explore sustainable solutions that prioritise healthcare workforce needs.
To further address staffing instability, the Committee has recommended that the department establish a structured recruitment cycle to ensure the timely advertisement and filling of vacancies. This approach aims to reduce the high prevalence of acting appointments in healthcare facilities, which often disrupt service continuity and operational stability.
Additionally, the Committee acknowledged the impact of the recent U.S. Executive Order on the country’s response to HIV and AIDS. In response, the department is developing a service delivery model to ensure continuity of care and effective service provision within public health facilities. The Committee welcomes the department’s proactive measures, particularly the redirection of patients from affected sites to public healthcare facilities to maintain uninterrupted access to treatment.
Chairperson of the Health and Wellness Portfolio Committee, Adv. Ezra Letsoalo, stated: “The Committee remains committed to ensuring that the Department of Health fulfils its mandate to provide quality healthcare services. While we acknowledge the progress in reducing medico-legal claims, persistent infrastructure challenges and staff shortages require urgent and sustainable interventions. We will continue to hold the relevant departments accountable and push for solutions that benefit the people of Gauteng.”
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