“South Africa’s health sector is on the brink.”

“Provincial health budgets – where more than 95% of public health spending occurs – have been cut in real terms year after year.”

“By 2025/26, spending per capita will fall from R5,147 (2019/20) to a projected R4,508.”

“Departments are drowning in R21.7-billion in accruals, start each year in debt, and slash essential procurement and staffing just to stay afloat.”

“Massive shortages of doctors and nurses, even though production of doctors is high;”

“Medical schemes raised contributions by 8%-13% for 2025, outpacing inflation and pushing private care beyond the reach of most households.”

“The abolition of price-setting mechanisms in 2008, fee-for-service incentives that drive supplier-induced demand, and weak regulation of private hospital expansion and technology purchases.”

“Government subsidies – through medical tax credits and public-service medical aid contributions – further inflate private-sector consumption while draining public budgets.”

“Massive governance failure and policy fragmentation contribute to the crisis. Corruption, overly centralised control, weak managerial authority and performance systems detached from outcomes have eroded confidence.”

“The current financing model no longer matches national needs. South Africa faces rising costs from an ageing population, non-communicable diseases, imported medical equipment, currency depreciation and medico-legal liabilities – yet health allocations continue to shrink.”

“Securing a targeted health sector loan is a claim. Normalized: South Africa can safely borrow more for a targeted health sector loan to invest in infrastructure, staffing, and service quality.”

“Regulate the private sector to protect households and halt cost inflation. The government must publish the long-awaited block exemption regulations to enable the Multi-Lateral Negotiating Forum for price setting, and a Price Governing Body to oversee tariffs.”

“Invest aggressively in infrastructure by moving away from the slow, expensive Framework for Infrastructure Delivery and Procurement Management System and allowing health departments – not Public Works – to manage their own infrastructure and maintenance.”

“Modernise the digital backbone by accelerating the roll-out of digital information systems to link clinical services with financial data, enabling strategic purchasing, diagnosis related groups, electronic scripts, and reducing test duplication.”

“Rationalise the subsidy regime that favours the private sector. Redirect resources to public care by removing medical tax credits for earners above R750,000 to”

“Fix human resources – South Africa’s largest health asset, which is poorly managed. The government must act urgently. Enforce proper rules for remunerative work outside of public service, overtime and Occupation Specific Dispensations to stop wasteful human resource spending; fully fund and fill all professional posts within approved envelopes; formalise and expand the Community Health Worker (CHW) programme to at least 120,000 CHWs, paid at dignified levels;”

“Remove procurement waste. South Africa pays far above market value for goods, infrastructure and services.”

“To solve this crisis, we need an immediate, decisive and technically sound plan. This includes... writing off R21.7-billion (estimated in 2025) in accruals...”

“South Africa's health sector crisis is attributed to a lack of political will to implement solutions rather than a lack of solutions.”