Gauteng Budget 2025: Health funding crisis looms amid political tensions

 MEC for Finance and Economic Development, Lebogang Maile.

MEC for Finance and Economic Development, Lebogang Maile.

Published 9h ago

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As Gauteng prepares for the unveiling of its 2025 provincial budget, all eyes are on MEC for Finance and Economic Development, Lebogang Maile. 

The budget, set to be delivered amid calls from the National Treasury for stricter financial discipline, comes at a critical juncture for the province's governance and public services.

Anticipated Increases in Health Funding

Among the key developments, the Gauteng health department is projected to see a 6.3% increase in its budget from the previous year, potentially totaling R45.1 billion. 

This budget is expected to include R28.9 billion in conditional grants aimed at healthcare, with a notable R1.6 billion allocated for the health facility revitalization grant—reflecting a 14.3% increase intended for upgrading hospital infrastructure.

However, the withdrawal of USAID funding, which previously contributed around R1.4 billion, raises concerns about the sustainability of healthcare services in the province. 

Health MEC Nomantu Nkomo-Ralehoko addressed these challenges in the provincial legislature, stating, “We communicated with the national health department, and they said we must just do our own budget. Now we have to look into the budget ourselves.”

Opposition Calls for Accountability

The Democratic Alliance (DA) has been vocal in its criticism of the provincial government's fiscal management.

The party recently highlighted the late adoption of the adjustment budget for November 2024, which was passed on March 11, 2025—just three weeks before the end of the current financial year. Ruhan Robinson, DA Shadow MEC for Finance, expressed deep concern over the implications of such delays. 

“The GPL has a constitutional and legislative duty to approve budgets and oversee spending. When adjustments are voted on after most of the funds have already been disbursed, it raises serious questions about accountability,” he stated.

Robinson pointed to alarming financial strains across various departments, noting that the Gauteng Department of Health is projected to overspend by R4.3 billion this year, while the Department of Education anticipates R1.1 billion in accruals. “This is indicative of inadequate budget planning,” he added.

ANC’s Commitment to Key Priorities

In contrast, the ANC plans to focus on how the budget will address pressing government priorities, including health, education, crime prevention, and economic growth. Maile is expected to emphasize the importance of these sectors during the budget announcement, aiming to reassure residents that the provincial government is responsive to their needs.

Civil Society and Labor Union Expectations

Civil society organizations and labor unions are also keenly interested in the budget’s implications. 

Many are advocating for increased funding for public services, particularly in healthcare and education. 

Labor unions including the National Association of South Africa demanded budget allocations that support job creation and skills development, emphasising that these investments are crucial for addressing the province's high unemployment rates. 

“We need a budget that reflects the real needs of our communities,” Mpho Morulane the Secretary general. “Investment in education and job creation is essential for our future development and for ensuring that young people contribute to a great province.”

With pressing demands for accountability, transparency, and effective resource allocation, the upcoming budget is poised to have significant implications for service delivery and public trust as the country gears for the 2026 local government elections.

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