Honourable Speaker, Hon Newrene Klaaste;

 

Deputy Speaker, Hon. Sharifa Ferris;

 

Honourable Premier, Dr. Zamani Saul;

 

Chief Whip of the Majority Party, Hon. Norman Shushu;

 

Leader of the Opposition, Hon. Harold McGluwa;

 

Chairperson of the Portfolio Committee on Health, Hon. Lebogang Motlhaping;

 

Members of the Executive Council;

 

Members of the Provincial Legislature;

 

Our distinguished guests and media houses present and our online community.

Let me take this opportunity to present to you the 2025/26 Northern Cape Department of Health budget vote, and to outline our achievements for the past financial year, as well as plans that we are having in shaping up the health care system in the province.Honourable Speaker, I am proud to present the Northern Cape Department of Health Budget Vote 10 for the 2025/26 financial year to this august House. The total departmental budget for the current financial year is R6.869 billion.As I present this budget to this house today, I am mindful of the journey that it has taken for us to finally have the 2025/26 appropriation bill passed by Parliament last week. This bill has seen National Treasury allocating additional R6,7 billion towards the Healthcare sector as a mechanism to try and cushion the health sector which is overburdened by the challenges regarding staffing, Infrastructure and ageing medical equipment amongst others.The additional allocation will be allocated in line with the provincial equitable share formula as prescribed by National Treasury and the budget will be available to provinces during the budget adjustment period. The indicative allocation for the

Northern Cape Department of Health is R161 Million for 2025/26. The additional allocation will be focusing on the following areas as agreed and adopted by the National Health Council (NHC).

• Employment of Doctors, Nurses and other health professionals.

• Procurement of beds, mattresses and linen.

• Payment of accruals

 

Honourable Speaker, shifting global geopolitical dynamics are particularly relevant given the recent policy shifts under the Trump administration, which have direct implications for South Africa's healthcare sector and broader economic stability. The announced cuts to foreign aid programs have already begun affecting health initiatives across the African continent, with South Africa potentially losing critical funding for HIV/AIDS programs, tuberculosis interventions, and maternal health projects that have been supported by PEPFAR and other US-backed health initiatives.Madam Speaker, healthcare planning cannot occur in isolation from global political and economic realities that directly affect resource availability and implementation capacity.It is imperative to acknowledge that our public health system serves 87% of the province's uninsured population, creating unprecedented demand pressures on our healthcare infrastructure. This substantial burden underscores our critical dependence on strategic partnerships to maintain healthcare delivery resilience and ensure adequate resource mobilization and implementation capacity.It is for this reason that we need to have a combined model of leverage that includes the role of private sector both in the corporative space and private health care as we strive towards building a financially sustainable health care system. It is for this reason that we have partnered with the private sector on key initiatives such as delivery of assistive devices such as (wheelchairs, hearing aids, walking aids), delivery of health care infrastructure and surgical interventions that is aimed at addressing the backlogs.Madam Speaker, sitting in our gallery today is a young lady called Susan Pholo who is one of our patients who received medical treatment at Robert Mangaliso Sobukwe

Hospital (RMSH). Susan is one of two patients to receive a pioneering Bone Bridge implant (hearing device) surgery at RMSH, this was the first of its kind in the Province and it just demonstrates the capacity of our joint partnership with our private sector and the capability of our healthcare system despite all challenges we are faced with as a province.In the 2024/25 financial year we performed a total number of 6926 surgeries in the province against the total backlog of 7906. This translates into 88 percent success rate, though this is a moving target we will be placing additional resources this year that will include amongst others the resuscitation of our outreach program to perform surgical marathons at some of our District Hospitals and Regional Hospital with much emphasis on orthopaedic cases as well as urology.Recruitment and retention of medical specialist and theatre trained nurses remains a critical challenge for the department despite all attempts to fill these vacancies. It is against this backdrop that we are now looking at options of partnering with private health care providers. Additionally, we have intensified our registrar program as a mechanism to allow opportunity to those medical practitioners that would like to specialize with an intention to retain them post the completion of their studies.

 

Honourable Speaker, as part of decanting overburdened facilities to reduce the volume of patients visiting our healthcare facilities, we recently introduced the Smart Locker Technology in the John Taolo Gaetsewe (JTG) and ZF Mgcawu District. These innovative lockers allow patients to collect their medication quickly, conveniently, and privately – without long queues or waiting times. Using a simple security code sent to their mobile phones, patients can access their pre-packaged medication at a time that is convenient to them.Madam Speaker, this is healthcare innovation that is responsive and patient centric as it promotes respects, human dignity, privacy and time spent at our health care facilities. We will expand the deployment of this technology on an incremental basis.Madam Speaker, the Honourable Premier Dr. Zamani Saul in his State of the Province Address earlier this year shared with us the plans that we have as a province that included infrastructure investment. Allow me to give progress thereof:

The following health care facilities were completed during the 2024/25 financial year:

• Heuningvlei Clinic

• Boegoeberg clinic

• Bankhara bodulong clinnic

 

Additionally, it should be noted that the following facilities are undergoing a process of revitalization and will be completed by the end of the current financial year:

• Griekwastad Community Health Centres (CHC)

• Keimoes CHC

• Legobate CHC

• Dr Arthur Letele Medical Depot

 

In the 2024/25 reporting period the Honourable Premier unveiled plans to build the new Schmitsdrift Clinic, I am delighted to announce to this house that the facility will be completed by the end of this calendar year. Additional to this Vedanta Zinc International recently announced a multi-million investment into an Oncology Chemotherapy Centre at Dr. Van Niekerk Hospital in Springbok as outlined by the Premier in his State of the Province Address 2025/2026, representing one of the mining companies largest Corporate Social Investments (CSI). The construction of the Oncology centre spanning 366m2 is underway and expected to be completed in December.

Madam Speaker, I have taken note of the recent incident that took place in Kuruman Hospital that may have perceived to have an impact on human rights. Coincidentally when the matter emanated plans were already underway to revitalize the hospital, which started with the walkways, fencing around the hospital, replacement of beds and lined. This plans were soon to be followed by the refurbishment of the accident and emergency unit.

 

Secondly, it is important to note that the condition based assessment performed by the department in the last reporting period highlighted infrastructural challenges as one of the major factors affecting access to our hospital. It is also worth mentioning that majority of our health care facilities where build for limited number of population

size and with limited services, what we are experiencing now is the results of us improving and expanding access to health care services to serve the 87% ensured population across our province.Honourable members, it is important to note that this is an area that has experienced a growth in the population size due to the economic activities around the mining sector.We are in a process of installing the temporary structures as part of decanting the congestion around accident and emergency and we have also looked at the long term solution that will see the Accident and Emergency and some wards revitalised in the next 18 months. All these are the initiatives and responses of the government in action.Emergency Medical Services (EMS) remains one of the most challenging factors in the department, despite the annual investments made in the net replacement of our Ambulances and Planned Patient Transport. Annually we plan for the procurement of 30 ambulances as part of improving our EMS services and response time. We are currently sitting at 91 percent coverage rate when compared with the national norm as the province has a total number of 128 ambulances as opposed to the desired number of 140 ambulances.Despite the challenge the province response time for both urban and rural is sitting on an average of 65% which is 5% above the National norm this achieved despite the vastness of the province and distances between referral facilities.

 

Madam Speaker, in consultation with our Provincial Counterpart Treasury, together with the office of the Premier and the Northern Cape Fleet entity we are exploring a model that will support the function of accelerating the procurement of ambulances in the most cost effective and efficient manner. The process also seeks to address the maintenance of our fleet management given the challenges we are experiencing in the current dispensation.

 

The legislature Portfolio Committee on Health earlier this year released a report they termed Pre-Oversight Visits to health facilities; amongst others the report states: “the austerity measures implemented last year negatively impacted service delivery and budgets at regional health and social development facilities. Delays in filling and

abolishing vacant posts due to budget constraints have placed enormous strain on existing staff…” We may add that austerity on health budgets has been a recurring theme. In spite of this we continue to provide health services and extend the basket of services.Madam Speaker, before presenting our budget vote, allow me to address the narrative that dismisses the remarkable health transformation occurring in our province.The Human Development Index (HDI) for the Northern Cape has risen substantially from 0.618 in 2005 to 0.705 in 2025, with our department's contribution reflected most powerfully in the dramatic improvement of life expectancy across our communities. Women in our province now live an average of 66 years, compared to 54 years in 2021– precious additional years spent with families, nurturing communities, and fulfilling dreams.This progress extends beyond longevity to maternal safety, with maternal mortality declining significantly from 115.8 to 90.4 deaths per 100,000 births. Put simply, 25 fewer mothers are lost for every 100,000 babies born – each representing a family kept whole.For men, life expectancy has increased from 50 years in 2021 to nearly 60 years today. Madam Speaker, these are not mere statistics – they represent grandparents meeting grandchildren, parents witnessing graduations, and communities retaining their wisdom and institutional memory.This evidence unequivocally demonstrates that healthcare in our province is on an upward trajectory, not in decline as some would suggest. While we acknowledge the persistent challenges we face – the historical burden of disease, systemic healthcare inequities, and current fiscal constraints – these obstacles have not deterred our commitment to preserving and extending life Madam Speaker, this is a new era for our department, we embrace accountability as a non-negotiable and commit to ensuring that public resources are protected through transparent governance and decisive action against financial misconduct.

 

 

This clearly demonstrated by our ability not to incur any unauthorised expenditure in the last three reporting periods.

Honourable Speaker, our medico-legal case management demonstrates both encouraging progress and ongoing financial challenges that require urgent attention.

On the positive side, we have achieved significant gains through effective case settlement strategies. Over the past three years, we successfully settled 18 cases, saving the department R184.9 million by negotiating settlements of R122 million against original claims totalling R306.9 million - representing a 60% cost reduction through strong legal defence.Additionally, our overall medico-legal liability has decreased from R1.564 billion in 2022/23 to R1.361 billion in 2024/25, reflecting a R203 million reduction in our exposure.However, Madam Speaker, the remaining R1.36 billion liability continues to pose a substantial burden on our financial health, representing approximately 20% of our entire departmental budget.This unfunded obligation significantly constrains our ability to invest in service delivery improvements that are directed towards patient care.Madam Speaker, the signing into law of the National Health Insurance Bill by His Excellency, President Ramaphosa on 15 May 2024 will remain a transformative milestone towards Universal Health Coverage. This was a much more needed reform given the imbalances currently experienced in our country in accessing health care system, therefore a single healthcare system is the future that all of us should jointly support.This historic legislation directly confronts the moral injustice of our current two-tiered healthcare system, where quality care remains the privilege of the few while the majority depend on an overburdened public health system.Therefore, it is in this context, Madam Speaker, that we welcome both the National Dialogue announced by the President in the State of the Nation Address and the all-inclusive Provincial nation-building and social cohesion dialogue announced by Premier Dr. Zamani Saul in the State of the Province Address.In the Northern Cape, where geographic isolation compounds healthcare access challenges, the NHI represents hope for our rural communities who have been systemically disadvantaged by distance and economic barriers. This legislation transforms our healthcare system from a market-driven commodity into a public good that serves all South Africans with dignity and equity.

Madam Speaker, beyond policy, we are actively pioneering NHI implementation on the ground. In my last budget vote, I reported on our agreement with the National Department of Health to establish Contracting Units for Primary Healthcare in Phokwane Local Municipality. Today, I am proud to announce that this pilot is operational and yielding critical insights for national NHI rollout.

 

The Northern Cape forms part of the nationwide testing of this revolutionary healthcare financing model, positioning us as pioneers in South Africa's healthcare transformation. Our Phokwane Contracting Unit encompasses Hartswater and surrounding areas, integrating the district hospital, primary healthcare clinics, ward-based outreach teams, and accredited private providers under a single funding and management structure.Honourable Speaker, allow me to take the public into confidence today by unveiling our 'Ideal Health Facilities Realisation and Maintenance Programme' - a comprehensive intervention designed to transform the physical state and operational standards of our healthcare facilities in alignment with the regulatory framework established by the Office of Health Standards Compliance (OHSC). This programme through the National Department of Health comes as part of our broader efforts to strengthen healthcare systems.Honourable Speaker, in my 2024/25 budget presentation, I comprehensively addressed the quadruple burden of diseases confronting our healthcare system. This burden - encompassing HIV/AIDS, tuberculosis, non-communicable diseases, and injuries from violence and accidents - continues to define our epidemiological landscape, with HIV/AIDS and tuberculosis remaining the primary drivers of mortality in South Africa.Madam Speaker, in my 2024/25 budget presentation, we outlined our mitigating strategies to reduce HIV prevalence and morbidity through accelerating testing, initiation, and maintaining patients on treatment - the HIV Cascade program known as 95-95-95.On this scale of the cascade we are now setting at 94-79-92 across these critical targets. Our focus is now to trace the 15% of the HIV positive patient that we have tested and are known to be HIV positive but not on ARVs. This initiative is part of the1.1 Million ART Close the Gap Campaign that was launched by the National Minister of Health, Dr Aron Motsoaledi earlier this year.

Madam Speaker, leadership and governance is one of the fundamental areas that we should focus on to ensure a financially sustainable health care system. Last week I met with the Office of the Auditor General (AG) in quest towards our journey of renewing our commitment of receiving an unqualified audit as mandated by the Honourable Premier.The AG highlighted to culture shift approach that they have observed over the past two reporting periods on the improved financial management discipline and reaffirmed that we are on the right track towards the finishing line which seemed to be a long journey for the department, Premier your leadership and support in advocating for clean administration will soon be rewarded by an unqualified audit for the department in the next two years as confirmed by the AG if we maintain the same consistency.

 

Honourable Speaker, I extend my sincere gratitude to Premier Dr Zamani Saul, my Executive Council colleagues, and the Portfolio Committee on Health for their unwavering support and strategic leadership.I also acknowledge Acting Head of Department Mr Mxolisi Mlatha, our Executive Management Team, departmental staff, and Ministry team for their steadfast dedication to achieving our vision of "A modern health system delivering quality care to a growing Province." This moment calls for unified action to deliver meaningfulpublic value. United in purpose, we will achieve greater impact in our shared pursuit of "a better life for all."

 

Thank you.