Parliament, Sunday, 11 October 2026 – The Portfolio Committee on Health has called for urgent improvements in governance, financial management, service delivery and accountability within the National Department of Health.
The committee received a briefing on the department’s 2025/26 annual report as part of Parliament’s Budgetary Review and Recommendations Report (BRRR) process, wherein the committee assesses whether public funds allocated to the health sector are utilised effectively and are delivering improved healthcare services to South Africans.
The Chairperson of the committee, Ms Faith Muthambi, told the department that the committee expected it to account for its performance, governance failures, audit outcomes and service delivery challenges.
“These engagements are critical to assess not only financial performance, but also whether the department and the entities reporting to it are fulfilling their mandates effectively and contributing to improved health outcomes.”
The Chairperson emphasised that the committee’s assessment would not be based solely on expenditure levels. “We will determine whether public resources have been utilised effectively, whether value for money has been achieved, and whether governance, accountability, and performance are translating into tangible improvements in health outcomes and the quality of services provided to the public,” said Ms Muthambi.
The committee expressed concern over the fact that the department’s audit outcome have remained unchanged for over a decade despite repeated commitments to improve financial management and governance.
“There has been no movement on your audit outcome for over a period of 10 years, Minister. What is concerning is the lack of consequence management that the Auditor-General has repeatedly highlighted.”
Ms Muthambi also raised concerns regarding the 32 material irregularities identified by the Auditor-General across the health sector and stressed that Parliament’s responsibility is to safeguard the interests of citizens who rely on public healthcare services.
“Our people, particularly the rural poor, depend on these health sector services. They trust the system and use public healthcare services, and it is our responsibility to ensure that they receive the services they need,” emphasised Ms Muthambi.
Members of the committee questioned the department about the apparent disconnection between expenditure and performance. While the department reported its achievement of 33 of its 47 annual performance targets, representing an overall achievement rate of 70.2%,
Members noted that the department spent almost its entire budget allocation during the year under review. The committee questioned how the department could spend public funds while missing key targets. The committee also sought an explanation from the department for its failure to achieve the set targets despite significant expenditure.
Several Members of the committee sought clarity on persistent human resource shortages, particularly in light of the country’s growing number of unemployed healthcare professionals.
The department reported an overall vacancy rate of 15.2%, while the National Health Insurance (NHI) programme recorded the highest vacancy rate at 19.6%, with only 67 of 102 approved posts filled.
Employment equity targets for youth and persons with disabilities were also not achieved.
The committee further scrutinised financial management, audit findings and consequence management. According to the annual report, R187 million in irregular expenditure remains unresolved, with R179 million currently under investigation.
In addition, a separate R106 million connectivity contract has been referred to National Treasury and the Hawks for investigation. Members requested details on disciplinary action taken against officials implicated in cases of irregular expenditure.
Ms Muthambi called for tangible evidence that investigations were resulting in accountability and corrective action. She said: “The Auditor-General continues to identify material misstatements in the financial statements. We want to know what consequence management measures have been implemented.”
Members also expressed concern about governance challenges at the National Health Laboratory Service (NHLS). The Minister of Health, Dr Aaron Motsoaledi, acknowledged the seriousness of the situation and informed the committee that interventions were already underway. “Indeed, NHLS has got very serious problems,” said Dr Motsoaledi.
The Minister also informed the committee that following engagements with the NHLS Board and executive management, he had concluded that governance failures were at the heart of the entity’s challenges. “My diagnosis was that the problem at NHLS is one of governance.”
While welcoming the Minister’s acknowledgement of these challenges, the committee stressed that governance interventions must translate into measurable improvements and stronger accountability.
On healthcare service delivery, the committee raised concerns about medicine stock-outs, shortages of essential medicines, long waiting times for specialist procedures, deteriorating infrastructure and the impact of these challenges on patients.
Members requested an explanation of how these problems have arisen and sought assurances regarding support for patients at risk of treatment interruptions.Some committee members also focused on growing waiting lists and delays in accessing specialist care.
The department acknowledged ongoing supply chain challenges affecting medicine availability, citing manufacturing disruptions, regulatory compliance actions, congestion at the Port of Durban and broader global supply chain pressures. However, the Minister assured the Members that the country currently has sufficient antiretroviral (ARV) medicines in stock and that ARV shortages are not responsible for delays in implementing six-month dispensing models.
Members further requested updates on major health infrastructure projects and facility maintenance challenges. The committee expressed concern that poor maintenance of healthcare facilities continues to undermine patient care and staff productivity.
In response, the department acknowledged ongoing frustrations relating to provincial maintenance systems and implementation agencies, including delays at major facilities such as Charlotte Maxeke Johannesburg Academic Hospital.
The implementation of NHI also came under scrutiny. Members requested an update on activities being undertaken while litigation concerning the NHI Act remains before the courts.
The department informed the committee that although implementation of NHI-specific provisions remains subject to ongoing legal processes, efforts to strengthen the health system continue. These include investments in digital systems, electronic medical records, medicine management systems and healthcare financing reforms.
The department indicated that these activities are intended to strengthen the public health system regardless of the eventual outcome of the court process.Members also queried progress on the health sector’s digital transformation agenda, including the rollout of electronic medical record systems.
The committee received an update on the rollout of Lenacapavir, including efforts to secure local production capacity. The department reported progress in negotiations aimed at establishing local manufacturing opportunities and indicated that discussions are underway to expand future access across the Southern African region.
Ms Muthambi highlighted several areas requiring continued attention, including medicine stock-outs, audit improvements, human resource planning, forensic laboratories, emergency medical services, hospital infrastructure, medico-legal claims and the implementation of recommendations arising from previous oversight engagements.
Ms Muthambi reminded the department that Parliament would continue to monitor progress closely and that provinces identified by the Auditor-General would be called before the committee to account for their performance.
“We want the department to move from an unqualified audit opinion to a clean audit.” She stressed that addressing vacancies, strengthening governance and improving financial management must remain key priorities.
She reaffirmed the committee’s commitment to ensuring that public health resources are used effectively and that South Africans receive the healthcare services they deserve.
“It's in our interest as the committee to continue monitoring the implementation of interventions aimed at improving these important health outcomes,” concluded Ms Muthambi.
ISSUED BY PARLIAMENTARY COMMUNICATION SERVICES ON BEHALF OF THE CHAIRPERSON OF THE PORTFOLIO COMMITTEE ON HEALTH, MS FAITH MUTHAMBI.
For media enquiries or to arrange interviews with the Chairperson, please contact the committee’s Media Officer:
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Email: ylandu@parliament.gov.za
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