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Daily Maverick
2 days ago
- Health
- Daily Maverick
Questions over tripling of Gauteng Health's security budget
In just two years, the Gauteng health department's spending on security has more than tripled. Spotlight tries to get to the bottom of the ballooning bills and what it means for governance in the department. The Gauteng Department of Health's projected R2.54-billion spend on security contracts for 2025/2026 has received the thumbs up, fuelling suspicion in various quarters. It comes as the department claims to lack the funds to fill vacancies, pay all suppliers on time or continue fulfilling doctors' overtime contracts. The R2.54-billion is more than three times the R838-million the department spent two years earlier in 2023/2024. This was revealed at the end of May in response to questions raised in the Gauteng Legislature by the Democratic Alliance (DA), the official opposition in the province. In 2024/2025, the department's security spending was just above R1.76-billion. Jack Bloom, DA shadow MEC for health in Gauteng, calls the proposed expenditure 'unjustified', given that the department is failing to meet its health service delivery targets. According to him, security companies charge R77-million per year for guarding services at Chris Hani Baragwanath Hospital, and more than R72-million annually at Charlotte Maxeke Hospital. At Tara Hospital, the new security contract costs R14-million a year – a sharp increase from the previous year's R4.2-million contract, which had provided 21 guards for the facility. Bloom says that, according to the department's own assessment, only five additional guards were needed at Tara Hospital, increasing the total to 26. However, the current contract pays for 46 guards. 'This means they are paying about R5-million a year for 20 guards they do not need,' Bloom says. 'They could better use this money to fill the vacancies for 13 professional nurses, as Tara Hospital cannot use 50 of its 137 beds because of staff shortages. It is a clear example of excessive security costs squeezing out service delivery,' he says. 'The numbers simply don't add up,' Bloom says. He points out that the written responses provided in the Gauteng Legislature – signed off by MEC for Health and Wellness, Nomantu Nkomo-Ralehoko – cite an internal security assessment and compliance with Private Security Industry Regulatory Authority (PSIRA) salary increases for guards as reasons for the higher costs. However, the internal assessment has not been shared with either Bloom or Spotlight, despite requests from both. The PSIRA-approved annual increase is 7.38%. In contrast, the department's security spending rose by more than 100% from 2023/2024 to 2024/2025, and is projected to increase by another 40% from 2024/2025 to 2025/2026. According to a statement released by the Gauteng health department in April 2024, it had 113 security companies under contract at the time, providing a total of 6,000 guards across 37 hospitals and 370 clinics and institutions in the province. 'Very fishy' Bloom says security guarding contracts have been 'very fishy for at least the past 10 years'. He claims: 'There are certain security companies that keep popping up. These companies will get two-year contracts, then have their contracts extended for something like 10 years. Then we have these new contracts, which have soared in costs. The auditor general has said that there is irregular expenditure. Security contracts have always been suspect and have always been corruption territory.' In March this year, the DA lodged a complaint with the Public Protector over a R49-million guarding contract for five clinics in Tshwane and the MEC's offices. The contract was awarded to a company called Triotic Protection Services. The DA alleges that the company was founded by City of Tshwane's deputy executive mayor, Eugene Modise, who also previously served as its director. When the company was awarded the contract, it was allegedly in the crosshairs of the South African Revenue Service because it owed R59-million in tax over five years. This has raised concerns about the company's tax compliance status and its eligibility to tender for the contract. Spotlight approached Modise for comment through Samkelo Mgobozi, spokesperson for the office of the executive mayor, but had not received a response by the time of publication. Other security companies that have contracts with the department have also made headlines for allegedly flouting labour laws. These include not paying guards for months and withholding employees' pension and provident fund contributions. It leaves questions about due diligence and the proper vetting of companies. A review under way? In the weeks since Bloom's questions were answered in the legislature, he says Nkomo-Ralehoko conceded to a review of the security spend at the province's hospitals. However, the Gauteng health department has not announced anything formally and no further details have been provided. The department has also neither responded to Spotlight's questions nor provided supporting documentation of its assessment criteria for the security contracts, the tender requirements, tender processes and how it measures value for money and the impact of increased guarding in improving safety and security for patients, staff and visitors to its hospitals. It has also not made available a list of the companies with successful contracts and what their services entail. As Spotlight previously reported in some depth (see here and here), there are serious security problems at many health facilities in Gauteng. It ranges from cable theft disrupting hospital operations to assaults on healthcare workers. The department has also been criticised from some quarters for its plans to train healthcare workers to better handle violent situations. That steps need to be taken to better secure the province's health facilities is not controversial. But previous reporting has also shown a pattern of questionable contract management, with, for example, contracts being extended on a month-to-month basis for years after the original tenders had technically expired. It appears that the widespread use of these month-to-month security contracts came to an end when the department finally awarded a series of new security tenders in 2024, but it also seems likely that these new contracts are driving the department's ballooning security spending. 'Has to be justified' The department's massively increased security spend must be fully explained and is essential for transparency, several experts told Spotlight. 'This kind of escalation in cost has to be justified, especially when the department has no money,' says Professor Alex van den Heever, chair of social security systems administration and management studies at the University of Witwatersrand. He says the specifics of the tender process and the contracts awarded need to be publicly available to be openly scrutinised. The processes must meet Treasury's procurement guidelines and must follow the Public Finance Management Act, which regulates financial management within the national and provincial governments. Where there is wilful non-compliance, Van den Heever says criminal charges should be laid. 'This is a department that has routinely had around R3-billion a year in irregular expenditure. It means procurement procedures have been bypassed. This is not an isolated incident; it's systematic,' he adds. The latest Auditor-General report into the Gauteng health department was released in September last year for the 2023/24 financial year. It showed that of its R60-billion budget, the department underspent by R1.1-billion, including R590-million on the National Tertiary Service Grant that was meant to help fund specialist services. The report highlighted R2.7-billion in irregular expenditure, which is R400-million more than the previous year, and R17-million in fruitless and wasteful spending – an increase of R2-million from the year before. Equally damning, the report highlighted the lack of credible information provided. 'This is likely to result in substantial harm to the operations of the department as incorrect data is used for planning and budgeting and the effectiveness of oversight and monitoring are reduced as a result of unreliable reported performance information on the provision of primary healthcare services,' wrote the Auditor-General. Van den Heever says leadership and management within the health department need to be seriously questioned. Questions should be asked of why 'bad apples' are not being removed, why there are no consequences for conflicts of interests and collusions, and why webs of enablers within the department are not exposed for insulating wrongdoers, he says. Van den Heever says that over nine years of monitoring, the Gauteng Health Department's irregular and wasteful spending ranged between 3.6% and 6.6% of its total budget. In contrast, during the same period, the Western Cape's irregular spending ranged from 0% to just 0.1%. Lack of transparency The Gauteng health department's spike in security spending demands deeper investigation, says advocate Stephanie Fick. She is executive director for accountability and public governance at the Organisation Undoing Tax Abuse and serves on the Health Sector Anti-Corruption Forum. This forum was launched in 2019 as an initiative to combat corruption within the healthcare system. It falls under the Special Investigating Unit and brings together a range of stakeholders, including law enforcement agencies, government departments, regulators and the private sector. Fick says the health department's failure to provide easy access to information on tenders, contracts and contracted companies undermines transparency and accountability. She encourages more people to come forward with insider information. 'We want to see the details right down to line items and who signed off on things. We encourage people to use our protected whistle-blower platforms to share information,' Fick says. 'For civil society, there is a growing role to mount strategic challenges to things like this kind of excessive and irregular expenditure; to demand transparency and to expose people who are responsible. 'This must be done so ordinary people can better understand what's been happening with their tax money and so they choose more carefully when they go to the ballot box, starting with next year's municipal elections,' she says.
Eyewitness News
18-06-2025
- Health
- Eyewitness News
Public Protector finds some Gauteng public hospitals failed to respond to COVID-19 pandemic
JOHANNESBURG -The Public Protector has found that "administrative deficiencies" led to some of Gauteng's public hospitals failure to respond effectively to the COVID-19 pandemic. The provincial representative for Office of the Public Protector, Vusumuzi Dlamini, appeared before the Gauteng Legislature on Wednesday to release reports into some of his office investigations. In August 2020, at the height of the pandemic, the Public Protector investigated six public hospitals to determine how they were handling the influx of patients. As the country's most populated province, Gauteng had the highest number of people infected with the coronavirus. However, Dlamini said Gauteng hospitals were not prepared to effectively respond to this due to historical and present administrative challenges. Dlamini said that at the Jubilee Hospital, healthcare workers who contracted the virus were not always granted special leave as required. At the Chris Hani Baragwanath Hospital, there were delays in the distribution of personal protective equipment, poor infrastructure, and no dedicated wards for psychiatric patients with COVID-19. Dlamini has directed all six of the hospital heads to present a report of how they plan to address these administrative deficiencies for the next pandemic or similar event.
IOL News
03-06-2025
- Business
- IOL News
Maile tables revised R172. 3bn budget, vowing service delivery and fiscal discipline
Gauteng MEC for finance and economic development re-tables budget for 2025/2026, focusing on service delivery and economic growth Image: Gauteng Legislature The Gauteng Provincial Government Finance MEC Lebogang Maile has re-tabled the province's increased 2025/2026 Budget, emphasising service delivery, fiscal discipline and inclusive growth in the country's economic hub. The revised budget now amounts to R172.3 billion — an R886.6 million increase from the initially proposed R171.5 billion. Maile presented the revised Budget to the Gauteng Provincial Legislature and explained that the additional funds were made possible through the provincial allocation of unspent resources and revenue over-collections from the previous financial year. 'These resources enable us to better respond to the urgent needs of our communities and to reinforce our commitment to service delivery,' he stated. He further said that the re-tabling was a necessary response to the extraordinary delays and disagreements at the national level, where the postponement and subsequent amendments to the national budget caused ripple effects on provincial planning. 'The developments at the national level, including the postponement and withdrawal of the Division of Revenue Bill, compelled us to withdraw our initial provincial Budget and re-table it within the legal framework provided by the Public Finance Management Act,' Maile said. According to Maile, the priorities outlined in the State of the Province Address (SOPA) are comprehensively funded in this 2025 Medium-Term Expenditure Framework (MTEF) Budget within and across all budget votes. Maile said that this deliberate alignment ensures that the government's strategic objectives - such as infrastructure development, social services, safety, and economic growth - are adequately resourced to deliver tangible and measurable impacts for Gauteng residents. He expressed confidence that these investments will translate into real change, improving the lives of the people across the province and reaffirmed the commitment made during the Medium-Term Budget Policy Statement (MTBPS) tabling in November last year. 'Fiscal discipline is non-negotiable. We will continue prioritizing efficiency gains and making strategic trade-offs to fund our government's priorities. Managing our finances responsibly is fundamental to building a resilient Gauteng that can sustain growth and development, even in difficult economic times.' Video Player is loading. 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Advertisement Next Stay Close ✕ Maile stressed that fiscal discipline requires provincial and municipal governments to uphold fiscal positions that are aligned with macroeconomic stability. He argued that this is essential for maintaining investor confidence and economic resilience and for ensuring equitable and sustainable service delivery across all communities. He also highlighted that exploring alternative funding sources is crucial for long-term fiscal sustainability. 'Provincial departments and entities are actively investigating innovative financing mechanisms—such as public-private partnerships, donor funding, and blended finance models—to supplement constrained revenue streams. 'These efforts will enable the government to expand its investment capacity while maintaining prudent financial management,' said Maile. Prioritising Critical Sectors with Targeted Allocations The allocations outlined in the budget are focused on addressing the most urgent and impactful needs: The Gauteng Department of Human Settlements was allocated R332 million to improve sanitation in informal settlements (R232 million) and to secure land and structures against illegal occupations (R100 million), directly tackling the issues of land invasion and service delivery gaps highlighted in SOPA. The Department of Roads and Transport will receive R314.9 million, with R150 million targeted at 54 priority roads across the five economic corridors and R115 million for repairing traffic lights and streetlights, improving mobility and safety. Maile announced that the Departments of Agriculture, Rural Development, and Environment have been allocated R23.8 million and R18 million, respectively, to build capacity and implement environmental initiatives, including the clean and green campaign aimed at improving urban environments and public spaces. Other critical sectors include health, education, safety, sports, arts, ICT, and infrastructure. The budget ranges from R50 million for school upgrades to R1.5 billion for ICT expansion and R3.6 billion for infrastructure development. He said these investments are designed to accelerate service delivery, foster economic growth, and improve the quality of life for all residents. The Budget also prioritised social programs, with R5.4 billion allocated to Social Development to address urban poverty, homelessness, and skills development. The Department of Community Safety will receive R2.3 billion to enhance policing, community safety efforts, and law enforcement visibility, including deploying Gauteng Traffic Wardens to restore law and order. Maile announced that R1 billion is being funded for arts, culture, and sports, which supports community engagement and social cohesion and hosts major national and international events. In digital transformation, Maile said R1.5 billion is allocated to expand ICT connectivity, including Wi-Fi hotspots and CCTV installations in townships, contributing to safer and more connected communities. Maile reaffirmed that maintaining fiscal discipline remains an uncompromising priority. He said the government is committed to managing expenditures efficiently, identifying savings, and making strategic trade-offs to fund priority programs. 'Our approach is to ensure that every rand spent delivers maximum value to our people,' he said. 'This requires us to be disciplined, innovative, and unwavering in our commitment to responsible governance.'
The Citizen
03-06-2025
- Health
- The Citizen
‘I could die before surgery': Cancer patient lost in Gauteng hospitals backlog
Over 34 000 patients are waiting to undergo surgery in various Gauteng public hospitals. A man from Gauteng, who is suffering from skin cancer and living in pain, has been told he may have to wait up to eight months for surgery at the Charlotte Maxeke Johannesburg Academic Hospital. But he doesn't have eight months. He could be dead before then. There are probably many more like him who are low down on the waiting list for surgery at Gauteng's government hospitals and who may die before they are admitted to theatre. Thousands trapped in growing surgical backlog There are more than 34 000 patients waiting, said Gauteng health MEC Nomantu Nkomo-Ralehoko in a written reply to questions by the DA's shadow health MEC Jack Bloom in the Gauteng Legislature. The man has developed a lump on his cheek, making it difficult for him to eat and speak. Early this year, he was diagnosed with skin cancer known as squamous cell carcinoma which has the potential to spread all over the body if left untreated. He is one of the 3 315 patients who has been on the surgery waiting list at Charlotte Maxeke Johannesburg Academic Hospital. Patient faces starvation and suffocation risk 'The cancer has begun to spread to other body parts causing considerable pain and swelling,' said the patient in a statement. He was scheduled to have a feeding tube and stent inserted yesterday, but the appointment has been moved again to the following week. 'The hospital cannot perform the primary procedure due to a backlog of patients. The growth must be removed, along with reconstructive surgery on my jawline,' said the patient. 'We were told I might have to wait for another six to eight months.' Hospital resources stretched beyond limits Cancer Alliance director Salomé Meyer said the man was turned away from hospital yesterday morning. She said the patient requires a feeding tube and a stent to allow him to breathe and to eat. ALSO READ: Health minister defends nearly R10 million legal spend on NHI court battles 'If that is not emergency surgery then what is? He was told to come back next week as the surgeon is now attending another hospital. 'The hospital has only one operating theatre and one intensive care unit. Patients with trauma from car accidents or gunshot wounds take precedence. 'We are now actively seeking to raise funds to facilitate the removal of the growth before it spreads further and completely blocks his airways.' Meyer said the man first required emergency surgery but his surgery was cancelled. 'If he does not get this surgery as soon as possible, he will starve to death and possibly suffocate,' she said. Budget shortfalls and misused funds deepen crisis Meyer said in 2023-24, a portion of the R784 million that was made available for backlogs was also to be allocated to surgery, but 'we did not get any feedback from the department of health. What we know is that they did not use R250 million of the ringfenced cancer money and now are spending the remaining money on the cancer backlog for radiation,' she said. 'So where is the money for surgical backlogs? The problem is all of the affected hospitals have had staff cuts.' Meyer said it would not be surprising cancer patients were the majority requiring surgery as many of them can 'wait' as their operations are not regarded as emergency or life-saving. She added the budget cuts were affecting all the hospitals. 'Gauteng is particularly affected because of the backlogs. We need to realise that health in SA is in the emergency room – and we do not have blood, or even staff to attend to this crisis,' she said. Patients could wait years Nkomo-Ralehoko said the largest waiting list is 6 764 patients at the Steve Biko Hospital in Pretoria, followed by the Chris Hani Baragwanath Hospital in Soweto (6 232), Dr George Mukhari Hospital in GaRankuwa (5 354), and 3315 patients at the Charlotte Maxeke Hospital. ALSO READ: Gauteng hospital security bill soars to R2.54bn amid patient care crisis Bloom said: 'Furthermore, figures are only given for 17 out of 37 hospitals in Gauteng. 'Waiting times differ for certain types of surgery; for instance, it is only one to two months for a cataract removal at Leratong Hospital, but two years at the Mamelodi and Yusuf Dadoo hospitals. 'While patients at Kalafong Hospital in Atteridgeville wait five years for hip surgery. They will only wait three to six months at Dr George Mukhari Hospital.' He added: 'The MEC blames the long waiting times on the high turnover of patients to Gauteng and the burden of trauma that takes preference over elective cases. She also admits that load shedding and water shortages lead to cancellations and postponements of surgeries. 'In May last year, the MEC claimed that the surgical waiting lists had been reduced from 38 000 to 24 000, so this progress has been reversed. I estimate the real waiting list for all 37 hospitals is probably about 40 000 as the budget cuts and staffing shortages have worsened the situation.' Bloom said while surgical blitzes can temporarily bring the number down, the DA is pushing for effective use of the R66 billion budget to permanently reduce the waiting lists. Health department denies backlog as crisis escalates Gauteng department of health spokesperson Motalatale Modiba conceded there were 34 528 patients recorded on surgical waiting lists at public hospitals in the province, but denied there is a backlog. 'The waiting lists includes patients across key specialties such as cataract, general surgery, paediatrics and others. However, it is important to differentiate between surgical backlogs and waiting lists. 'The waiting list is a dynamic figure as it fluctuates as and when new patients are registered on the waiting list and when surgeries are performed – it is therefore a moving target.' ALSO READ: Mother accuses Mpumalanga hospital of sabotage in medical negligence case Other hospitals with long waiting lists
The Citizen
17-05-2025
- Politics
- The Citizen
Kleinfontein is not an illegal township, maintains CEO
Mayor Moya has established a committee to prevent more townships from popping up. While City of Tshwane Mayor Nasiphi Moya has declared Kleinfontein among 17 illegally established townships in city, the Afrikaner-only town's leadership says nothing could be further from the truth. Earlier this week, Moya confirmed that the city has identified 17 illegally established townships within the metro's boundaries, some established on municipal land or private property. These include: Leeuwfontein; Kleinfontein; Moshate Gardens; Marula View; Mooikloof (Tweefontein) Wallmannsthal; Haakoringboom; Onderstepoort; Elandsfontein Plots; and Moloto City. Moya said the individuals responsible for these settlements did not follow the legal framework that governs township establishment. 'In most cases, no formal township application was lodged, environmental and planning approvals were bypassed, and no bulk infrastructure was planned or installed,' she said. Moya said these illegal developments now face a host of serious challenges, including inadequate access to water, electricity, sanitation, and roads, poor spatial integration, and service delivery backlogs. Moya has established a mayoral sub-committee to prevent more townships from popping up. The High Court in Pretoria declared Kleinfontein illegal last year and ordered the city to enforce its laws and regulations in the area. The settlement's leaders said they planned to challenge this in court. Town not illegal, says CEO Kleinfontein CEO Stefan Wiese welcomed the establishment of this committee, but disputed that the town is an illegal township. 'Kleinfontein is a legally established cultural settlement in terms of section 235 of the constitution of the Republic of South Africa, which provides for the right to self-determination of cultural communities. 'This status was formally acknowledged by the Gauteng Legislature in 2013, following a visit to Kleinfontein by members of the provincial legislature, who recognised our community as a legitimate cultural expression under the constitution,' he said. Wiese said Kleinfontein is built on private land, legally bought and fully paid for by its members, and developed using funds raised entirely by the community. 'We have received no government grants or assistance in this regard. 'Kleinfontein is also not a burden on the City of Tshwane. Since our establishment more than 30 years ago, we have provided all municipal-type services internally, including water, sanitation, electricity distribution, refuse removal, and internal security. 'We do not receive or require any municipal services from the City. 'Importantly, Kleinfontein has had an active rezoning application with the City of Tshwane since 2013,' he added. Wiese said they were relieved that this matter may now finally receive the attention it deserves through the work of the committee. 'A resolution to this long-outstanding application will bring clarity and benefit all,' he said. ALSO READ: WATCH: 'Apartheid and Kleinfontein can't be mentioned in the same sentence' says Afrikaner community after MK party visit What the committee will do The committee's focus will be on reviewing the findings and legal implications of the 17 identified illegal townships, consulting with affected communities and property owners, engaging relevant departments and enforcement agencies, and recommending a consolidated approach and draft policy for the Council's consideration. The committee includes the MMC for Human Settlements Aaron Maluleka, the MMC for Economic Development and Spatial Planning Sarah Mabotsa, the MMC for Utilities Frans Boshielo, and the MMC for Community Safety Hannes Coetzee. ALSO READ: EFF to march to exclusive Afrikaner township Kleinfontein Are they paying tax? Tshwane's Democratic Alliance (DA) caucus spokesperson, Jacqui Uys, said the party hopes the outcomes of the committee's investigations will be fair towards all the ratepayers and residents of Tshwane. 'The City of Tshwane has 19 illegally established developments, like Kleinfontein, Leeufontein, and Moshate Gardens, where approximately 19 500 individuals are not charged rates and taxes. The city chose to leave some untaxed, yet charge punitive taxes on others,' she added. Uys said it is not fair to Tshwane taxpayers that these areas are exempt from paying tax. 'However, many of whom the homeowners in these developments were hoodwinked by developers when purchasing their properties and were unaware of the accompanied illegalities, thus a punitive tax is also unfair,' she concluded.
