Gauteng Health defends handling of negligence and misconduct cases amid scrutiny

The Gauteng Department of Health has defended its handling of disciplinary cases involving medical negligence and financial misconduct, saying it acted “in all matters where sufficient evidence existed to proceed” as it faces growing scrutiny over accountability and consequence management.

Why the department is under pressure

Pressure intensified after ActionSA announced it would escalate complaints against the department to the Health Professions Council of South Africa (HPCSA), the South African Nursing Council (SANC) and the Public Protector. The party’s Gauteng MPL on the province’s Health Committee, Emma More, told the legislature that 10 healthcare professionals were disciplined for negligence during the 2024/25 and 2025/26 financial years.

Disciplinary outcomes and regulator referrals

According to More, of those disciplined, two employees resigned and two were dismissed. She said none were referred to the HPCSA or SANC. The department’s written reply from Gauteng Health MEC Nomantu Nkomo-Ralehoko had acknowledged that no healthcare workers disciplined for medical negligence during those two financial years had been reported to their respective professional regulatory bodies.

More warned that failing to notify professional regulators could allow practitioners found guilty of serious misconduct to continue working elsewhere without their disciplinary records being considered. In response, Gauteng Health spokesperson Steve Mabona said the department was “currently reviewing matters involving healthcare professionals, including former employees, to determine whether referral to the relevant professional councils for further investigation is warranted.”

Allegations over financial misconduct

ActionSA also flagged concerns about the department’s handling of financial misconduct. Figures provided by More showed nearly R20 million lost across nine reported cases involving 74 officials, with less than R500,000 of that amount considered recoverable.

More said none of the implicated officials were dismissed during the three-year review period. Instead, 20 employees were allowed to resign or retire, and 14 officials who received final written warnings remain employed by the department. Gauteng Health said criminal cases had been opened and investigations were continuing, and that it “continues to explore all lawful mechanisms available for the recovery of losses suffered by the State where supported by evidence.”

Acknowledged need to strengthen accountability

The department acknowledged public concern over its disciplinary processes and said all outcomes had been implemented “in accordance with labour legislation, public service prescripts and applicable legal frameworks.” It also said it “recognises the need to continuously strengthen accountability mechanisms and consequence management processes.”

Mabona added that the department remained committed to “protecting public resources, upholding patient safety and maintaining the highest standards of governance and professional conduct,” and pledged continued cooperation with law enforcement agencies, professional councils and oversight bodies.

Broader governance and financial context

The scrutiny comes amid wider financial and governance difficulties in Gauteng’s public health system. The Auditor-General’s latest audit found that Gauteng Health failed all nine governance areas assessed, including procurement, revenue and expenditure management, strategic planning and consequence management. The department has also operated without a permanent chief financial officer for more than three years.

The Democratic Alliance warned that Gauteng Health was projected to underspend its 2025/26 budget by R725 million, with R463.5 million expected to be returned to National Treasury after only a partial rollover was approved.

Medico-legal claims and court finding

Provincial officials previously told Parliament that outstanding medico-legal claims had been reduced from R29 billion to below R16 billion through inspections and mediation. Despite reductions, Gauteng remains one of the country’s most litigated health departments. Earlier this year, the Johannesburg High Court ordered Gauteng Health to pay R1.6 million in damages after finding it had failed to honour a settlement agreement to provide ongoing medical care and assistive devices to a child with cerebral palsy.

The department’s response and the escalations by political parties and oversight bodies signal continued attention on how Gauteng Health manages disciplinary, financial and governance failures.