Gauteng health pushes back on underspending claims, says budget strain tells a different story

A familiar argument resurfaces in Gauteng health

The Gauteng Department of Health has moved quickly to shut down reports suggesting it failed to spend hundreds of millions of rands from its budget, calling the claims misleading and out of context.

According to the department, official in-year monitoring reports compiled under the Public Finance Management Act (PFMA) for the 2025–26 financial year paint a very different picture. Rather than underspending, the department says it is projecting an overspend of R1.2 billion on its adjusted budget.

In a statement issued yesterday, the department stressed that current financial pressures should not be confused with underspending recorded in the previous financial year.

Why the numbers don’t tell the same story

The response follows a report by The Citizen, which cited a Gauteng finance and economic development department reply to the provincial legislature indicating a projected underspend of R725 million by the end of March 2026.

Health officials argue that comparing figures across financial years without context creates a distorted narrative. They insist that pressures in the current year stem largely from historical accruals, unpaid bills that have followed the department for years, particularly for medicines, medical supplies and consumables.

In plain terms, today’s budget is being squeezed by yesterday’s debt.

More patients, higher costs, thinner margins

Beyond old debts, the department points to a steady rise in patient numbers at public hospitals and clinics across the province. Gauteng remains a healthcare magnet, serving not only its own residents but patients from neighbouring provinces and beyond.

This growing demand, officials say, is placing additional strain on already stretched facilities. At the same time, the cost of medical consumables and services has increased faster than inflation assumptions built into the 2025–26 budget.

For frontline workers and patients, these pressures are visible daily, from overcrowded waiting rooms to delayed maintenance and staffing shortages, all of which have fuelled public frustration online.

Efforts to tighten the purse strings

The department says it has rolled out what it describes as “significant corrective measures” to stabilise its finances and improve compliance. These include tighter expenditure controls and closer oversight of payment processes.

There has been some progress on a long-standing sore point: paying suppliers on time. The department reports that 79% of service providers were paid within 30 days in the second quarter of the financial year, increasing slightly to 80% in the third quarter.

While critics argue this still falls short, health officials see it as a step in the right direction.

Trust, transparency and tired hospitals

The debate around underspending versus overspending highlights a deeper issue a public health system under sustained pressure, and a trust gap between government and residents who rely on it.

The department says it remains committed to restoring financial discipline, strengthening accountability and ensuring that resources are channelled where they matter most: patient care, infrastructure upgrades and support for healthcare workers.

For now, the argument over the books continues, but on the ground in Gauteng’s hospitals, the demand for functional services remains constant, regardless of how the numbers are interpreted.

{Source: The Citizen}

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