• ACTis has raised three flags for the EC DoH and placed three under monitoring.
• Whistleblowers have reported significant irregularities in human resource management, procurement, consequence management and broader governance at the EC DoH. Together with a lack of consequence management, this has created what the Auditor-General of South Africa (AGSA) identified as a ‘culture of impunity’ within the Department. This culture appears to have filtered down into hospital management and oversight structures, where accountability is undermined by failures to implement remedial actions or to investigate and adequately respond to whistleblowers’ concerns.
• Weak financial and procurement controls, outdated IT infrastructure and limited capacity among financial staff have created an environment in which financial and procurement systems can be bypassed for personal gain.
• Maladministration at the EC DoH has undermined its ability to provide primary healthcare, with reports of understaffed, ill-equipped hospitals, failure to pay pharmaceutical companies for vital medicines, and contingent liabilities of R22bn arising from medico-legal claims.
• The reinstatement of Dr Rolene Wagner – widely viewed as having contributed to stabilising the Department and improving governance – as HoD in 2024 may provide a further window of opportunity for reform, particularly to strengthen oversight and accountability.
• Ongoing investigations by the Special Investigating Unit (SIU) and Public Protector into corruption and maladministration at the EC DoH should be closely monitored.