Health Minister Dr Aaron Motsoaledi says the government’s push to overhaul hospital procurement systems was already in motion before the Public Protector weighed in.
However, the Charlotte Maxeke crisis has sharpened the urgency.
Five years after a devastating fire crippled one of South Africa’s largest academic hospitals, the national government has stepped in following a damning Public Protector report that found systemic failures, maladministration and budget underspending behind the prolonged repair delays.
Motsoaledi and Finance Minister Enoch Godongwana conducted a joint site visit to Charlotte Maxeke Johannesburg Academic Hospital on Tuesday.
They were accompanied by Gauteng Premier Panyaza Lesufi and the relevant provincial MECs for Health and Infrastructure.
The visit came directly in response to the Public Protector’s investigation report, which found that systemic failures and maladministration had caused and prolonged delays in repairing the section of the hospital destroyed in the April 2021 fire.
Charlotte Maxeke Hospital, which serves patients not only from Gauteng but from neighbouring provinces including the North West, has been operating under significant strain since the blaze.
Discussions underway
With pressure mounting over whether the fire-damaged unit will be ready in time, Motsoaledi pointed to a commitment already secured from the Public Servants Association.
“That is the promise that the PSA has given us. We have no reason not to trust them,” he said, adding that progress would be tracked rigorously.
“That is what will be assessed every Tuesday when the committee chaired by the premier meets.”
Lesufi confirmed the weekly structure and indicated his intention to broaden its scope beyond Charlotte Maxeke.
“I don’t want to deal with Charlotte Maxeke tomorrow, [then deal with] Steve Biko the following day. So we’ll bring all the potential hospitals that have a problem, bring them under one roof when we have these kinds of discussions,” he said.
Who is accountable and who can act?
The Public Protector’s report triggered calls from civil society organisations for disciplinary action against those responsible for the delays.
Asked directly whether officials would face consequences, Motsoaledi explained that the lines of accountability follow employment, not just oversight.
“If you go through it again, you will pick up that she is actually instructing on accountability steps which must be undertaken by each,” he said, referring to the Public Protector’s remedial directives.
He noted that his own role was clearly defined: ensuring remedial actions are implemented, while the premier carried a distinct and specific mandate.
“With the premier, they are actually outlining the steps that he must take in terms of the accountability that we are talking about, because, by and large, the employees that are involved are employed by Gauteng. They can’t be charged by any other person because no employer can charge the person they are not employed by.”
Lesufi did not shy away from the directive.
“The Public Protector does not beat about the bush. She’s very straight on it – that all those functionaries that were responsible for this situation must be attended to appropriately,” he said, confirming that the Tuesday meetings would be used to follow up on those accountability steps.
Procurement failures and the case for consequence management
Beyond the specific failures at Charlotte Maxeke, the visit opened a broader conversation about what consistently goes wrong with procurement on public infrastructure projects.
For Godongwana, the problem is rarely the regulations themselves.
Drawing on the findings of the Special Investigating Unit’s report into Tembisa Hospital, he illustrated how officials circumvent controls rather than being let down by absent ones.
“People knew that they didn’t have, they had the delegation up to 500 000. What they would do is to split tenders up to, even if it’s for two million, to split up into 499 000, 499 000 in order to bypass the regulations,” he said.
The minister argued that tightening procurement rules in isolation solves nothing without the political will to act on findings.
“You can pass as many regulations as you can. As long as we do not have consequence management, we are not going to avoid people bypassing the system.
“So the key question is, when people are found, is there scope? Is there willingness to deal with consequence management of people who are trying to bypass the system? That’s what we’re trying to encourage accounting officers to be doing,” said Godongwana.
Digital procurement and decentralised oversight on the horizon
Motsoaledi outlined two structural interventions already underway in the health department that he believes will make it significantly harder for procurement irregularities to go undetected.
The first is a nationwide shift toward electronic procurement systems across all public hospitals, moving away from the manual processes that enabled the Tembisa irregularities.
“The manual procurement is what made it easy for people to do what they wanted in Tembisa. But once you do it in a programme – and we are busy with it, not only for Tembisa or for here, for all the hospitals in the country – we have discussed it at the National Health Council so that we can actually follow up who is doing what,” he said.
The second intervention involves restructuring where procurement personnel are physically based.
Motsoaledi said that placing procurement officials in provincial offices, far removed from the hospitals that use the goods and services, has long been a vulnerability.
“Where the people who do procurement sit in provincial offices, but the people who want to use whatever is being procured are inside the hospital, and that is what they are going to use, they surely must have a say and sit in those rooms. It will be very difficult for any corruption that involves so many people,” he said, noting the initiative predates the Public Protector’s report.
“It has nothing to do with the public protector’s office. We started it long after the Tembisa report was read.”
