Budget 2025: R28,9bn allocated to keep 9,300 healthcare workers employed, NHI gets 9,9bn

Finance Minister Enoch Godongwana announced that R941,5 billion over the medium-term expenditure framework (MTEF) period to support the equitable provision of public health services, including free primary healthcare.

Godongwana said that the budgets for basic education, health and the police are projected to grow in nominal annual average terms at 5,9 per cent, 5,9 per cent and 5,2% respectively over the MTEF period - this is the three-year spending plans of national and provincial governments.

Godongwana explained that about 44,7% of the R941,5 billion allocation for health is directed to funding district health services, particularly primary healthcare facilities such as clinics and community health centres, which also provide outreach services.

"This level of care is recognised as the most efficient and effective due to its focus on disease prevention and proximity to communities. Almost 98% of the budget for this function is allocated to provinces, amounting to about R922,7 billion," he said.

For the 2025/26 budget, this is R298,9 billion which will be divvied up with R132,1bn going towards district health services, R58,3bn going to central hospital services, R49bn being allocated provincial health services, R47,5bn gong towards other health services, and R11,9bn going towards facilities management and maintenance.

The minister said that mainly to keep 9,300 healthcare workers in hospitals and clinics, they have added R28,9 billion to the health budget. He added that it will also be used to employ 800 post-community service doctors and to ensure that pharmacies don't run out of medicines.

"To maintain an adequate number of healthcare personnel, especially doctors and nurses, the sector plans to focus on stricter enforcement of existing policies such as overtime work and remuneration for work performed outside the public sector."

Godongwana explained that as part of strengthening the health system and preparing for the national health insurance (NHI) policy, the Department of Health will fund the development of a patient information system, a centralised chronic medicine dispensing and distribution system, and a facility medicine stock surveillance system.

"Over the MTEF period, the indirect and direct conditional grants for NHI are allocated R8,5 billion and R1,4 billion respectively. Sustained allocations for direct and indirect infrastructure grants, including potential additional funding through the BFI (Budget Facility for Infrastructure), as outlined in the 2024 MTBPS, will focus on new or replacement buildings, upgrades, rehabilitation and maintenance.

"The total infrastructure allocation is R37,4 billion over the MTEF period, including provisional allocations from the BFI and new allocations for Siloam District Hospital and Tygerberg Hospital equipment through a public-private partnership in 2027/28. It remains important to improve efficiency in expenditure, including in the areas of commuted overtime, public procurement and price benchmarking," he said.

Meanwhile, medical benefits expenditure for former government employees is projected to rise from R5,4 billion in 2024/25 to R7,6 billion in 2027/28, growing at 12% per year.

This rise is mainly driven by increased premiums and a growing number of retired employees. An additional R2,7 billion will be allocated to account for expected premium increases and membership growth.

In regard to the withdrawal of the (U.S President's Emergency Plan for AIDS Relief (Pepfar), the minister said that Pepfar "is too heavy on the administration to take on", and that they have instructed an audit firm to do an evaluation and assessment on what is needed and what isn't.

He said that the audit firm will submit their evaluation at the end of the month.

theolin.tembo@inl.co.za