Government Budget Cuts Will Kill A Health System Already On Its Knees


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South Africa’s health system has been in a state of collapse for many decades. The health system was dealt several blows by apartheid, which treated black people as cheap labour. After apartheid, the government adopted policies that intensified the blows on the health system. Today, more than 300 000 people die each year from preventable diseases like TB, diabetes, hypertension, malnutrion related diseases, and others.

The policies adopted by the post-apartheid government supported the growth of private health, and this was done at the expense of public health. Public health facilities are neglected; the conditions under which medical staff work are of poor quality; the public sector runs out of medicine, and thousands of important staff like community health workers are not employed fairly and permanently and are underpaid.

This weak and collapsing public health system was exposed by the Covid-19 pandemic. More than 120 000 people have been killed by the coronavirus in South Africa. Many countries with functioning health systems managed to keep their deaths very low. At the beginning of 2020, the government cut the budget of the health department. During the pandemic, the South African government refused to make additional funds available to the health system to fight the pandemic. Instead of providing more funds, the government cuts other parts of the health budget and other social services to fund the pandemic. Even the funding of the pandemic was very low and did not show the seriousness in combating the pandemic.

Now, in its budget for 2021/22, and for the 3 years from 2021 to 2023, the government has made more cuts to the health budget. In this period the budget for health will go down from R62.5billion in 2021 to R59,4billion – cuts of R3,1billion. The government says the health system is based on Primary Health Care, but the budget for PHC suffers the most, and is cut from an already small budget by almost 7%.

South Africa’s health system needs a lot of investment. We know how badly maintained and ill-equipped are out clinics and hospitals. We know that our laboratories cannot give us results in a decent time. We know that CHWs do not have decent places to shelter in their own workplaces and some have to have shelter under trees. No funds are being allocated to investing in the infrastructure of the health system.

Our clinics and hospitals are not just where we work. They are places were we serve our communities. As CHWs we are expected to serve communities with no PPEs, with no medicines, and our communities do not have enough to eat to take medication. The challenge facing CHWs is how to organise to improve our workplaces, the places of service for our communities, and how to improve the lives of our communities.

Down with budget cuts!
Forward to quality health care for our communities!

This statement was released by the Gauteng Community Health Care Forum on 20 March 2021.

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