Provinces underspend health budgets by over R3bn

Health Minister Joe Phaahla said only KwaZulu-Natal fully spent its budget during the financial year. Picture: Timothy Bernard / Independent Newspapers.

Health Minister Joe Phaahla said only KwaZulu-Natal fully spent its budget during the financial year. Picture: Timothy Bernard / Independent Newspapers.

Published Mar 5, 2024


Provincial Departments of Health have underspent their budgets by more than R3 billion in the 2022-23 financial year.

Less than R1bn in unspent funds was rolled over to the affected provinces.

Only KwaZulu-Natal fully spent its budget during the financial year.

This was revealed by Health Minister Joe Phaahla, responding in writing to parliamentary questions from EFF MP Reneiloe Mashabela.

Phaahla’s response showed that Gauteng led the pack, having underspent its total allocated budget with R2.7bn, of which R937 million was for provincial equitable share and R1.7bn for conditional grants.

The breakdown of underspent budgets in other provinces is:

  • The Western Cape did not spend R180 million.
  • Northern Cape R141m.
  • Limpopo R103m.
  • The Free State R85m.
  • The Eastern Cape R62.2m.
  • Mpumalanga R25.3m.
  • North West R200.6m.

Phaahla said some of the reasons for the failure to spend budgets were late receipt of invoices, slow construction, and delays in delivery of equipment and reconciliation of payments.

He said Gauteng attributed its under spending of R2.7bn to late receipt of invoices and claims from suppliers, shortage of condoms, the reduced number of nursing students enrolled for the academic year and delays in the submission of non-profit institution’s claims.

Phaala said claims for the South African Cuban Doctor Programme could not be processed for payment as they were subjected to reconciliation.

He said the underspending on conditional grants was due to the unavailability of contracts, price reductions of antiretroviral drugs, non-contracting of general practitioners performing voluntary medical male circumcision and a shortage of condoms in the country.

He said Gauteng submitted a rollover application of R582.2m.

Phaahla said the Western Cape recorded savings due to delays in filling of funded vacancies, and training could not be implemented due to delays in implementation of contracts with training providers.

There was also use of Covid-19 rapid antigen tests instead of the more expensive laboratory-based PCR tests, and a decrease in audit fees and legal fees.

In the Eastern Cape, there were delays in the payment of medico-legal settlements due to trust registration delays by plaintiff attorneys.

“The roll-overs amount to R24.8m for the National Tertiary Services Conditional Grant and R6.1m for the District Health Programme Conditional Grant (Comprehensive HIV Component) has been approved.”

Phaahla said the Free State’s underspending was R85m on the conditional grant as a result of reconciliation for payment at year-end not being finalised.

“The roll-over amount of R84m on Health Revitalisation Grant was requested and approved to be spent in 2023/2024,” he said.

Phaahla said Limpopo attributed R103m to underspending – R49.3m in conditional grant and R54.2 voted funds – to delayed deliveries of medical equipment.

“The department successfully secured R78m through roll-over requests to be paid during the 2023/2024 financial year.”

The minister said Mpumalanga experienced delays in the procurement of equipment due to revised public procurement regulations.

The Northern Cape underspent funds due to delay in the supply, delivery, installation and commissioning of the linear accelerator.

“National Health Insurance grant roll-over amount was requested and R47 484m was approved to be spent in the 2023/24 financial year. National Health Revitalisation Grant underspent by R82 211m, attributed to the delay in the monitoring and implementation of infrastructure projects.”

In the North West, there were delays in submission of invoices by service providers and late delivery of medical equipment.

“Roll-overs were requested and approved.”

Cape Times