Gauteng Health Set to Underspend R725 Million in 2025-26 Budget

• The Gauteng Department of Health is expected to return R725 million of its 2025-26 budget
• National Treasury warned of financial administration risks in Gauteng's health sector
• The Gauteng Health's woes are linked to leadership instability and corruption allegations

Justin Williams, a journalist at Briefly News since 2024, covers South Africa’s current affairs. Before joining Briefly News, he served as a writer and chief editor at Right for Education Africa’s South African chapter.

GAUTENG - The Gauteng Department of Health is set to underspend R725 million in the 2025-26 financial year, despite chronic challenges in hospitals, staff shortages, unpaid suppliers, and a lack of essential equipment.

Underspend R725 million in the 2025-26 financial year

According to a response from the Gauteng finance and economic development department to the provincial legislature, National Treasury has approved only a conditional rollover of R261 million, meaning R463.5 million of the unspent funds will be returned to the national fiscus. According to The Citizen, the department has attributed the underspending to delays in project completion, late invoice submissions by contractors, and slow delivery of medical equipment.

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In December 2025, National Treasury reportedly warned Gauteng Health MEC Nomantu Nkomo-Ralehoko and three other provincial health ministers about the risk of administration. Treasury highlighted risks including late payments to service providers, overspending on salaries, high doctor and nurse vacancy rates, budget overruns, and neglected infrastructure maintenance.

Absence of permanent chief financial officer

Gauteng Health’s financial problems were made worse by not having a permanent chief financial officer for more than three years. The auditor-general has also found the department to be the only provincial health department to fail all nine key areas of governance, including procurement, spending control, planning and the use of conditional grants.

The situation worsened after the suspension of department head Lesiba Malotana, who was flagged as “high risk” in a lifestyle audit by the Special Investigating Unit. Corruption allegations have continued, with more than R2 billion reportedly looted from Tembisa Hospital. The DA said it would step up pressure on Premier Panyaza Lesufi to remove Health MEC Nomantu Nkomo-Ralehoko, arguing that the department needs competent and ethical leadership. The party said proper use of the department’s R67 billion budget could greatly improve health services in Gauteng.

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In previous years, Gauteng had returned over R1 billion in unspent funds from the health and education departments in 2024-25 and incurred R4.2 billion in new irregular expenditure, while major infrastructure projects such as the Johannesburg Forensic Laboratory and the Boitumelo Community Health Centre remain incomplete after years of spending.

3 More stories about Gauteng

• Briefly News also reported that the SAHRC criticised the Gauteng Education Department over unplaced learners as the school term began.
• Deputy Health Minister Joe Phaahla admitted that the health system was at breaking point in Gauteng. Due to a clause in the National Health Act, free basic medical care is given to anyone, even foreign nationals.
• The Gauteng health department has called out incidents of robbery and hijacking of vaccination equipment in the province.

Source: Briefly News