While some small upward adjustments will support school and health infrastructure rehabilitation and the much needed employment of medical interns and community service doctors, Finance Minister Enoch Gogongwana’s 2022 Budget continued to cut health and education budgets overall in real terms and fails to acknowledge the impact of Covid-19 on access to these fundamental rights.
SECTION27 is highly concerned that the 2022 budget continues an austerity path and fails to live up to government’s constitutional obligations by cutting basic education and health care funding. This budget seems oblivious to the adverse impacts of Covid-19 on access to quality basic education and healthcare services, and does not do enough to address increased inequality, backlogs in delivery of services and infrastructure, as well as worsened health and education outcomes since the pandemic. More is needed from Treasury to address the challenges caused by Covid-19 and move forward on targets towards human rights realisation.
While some small upward adjustments that will support school and health infrastructure delivery and employment of medical interns, community service doctors and educational assistants are welcomed, this budget continues trends of real term reductions in health and education budgets. But with chronic understaffing problems in both healthcare and education, we note that this year’s budget does not address permanent or sustainable solutions to human resource constraints in both sectors, particularly when future retirement waves and post shortages are considered.
Despite government’s constitutional duties to promote human rights, especially those of children, even in times of fiscal constraint, the 2022 budget sees a continued deprioritisation of healthcare and basic education funding in real terms. According to this budget, Treasury is steadfastly committed to prioritising debt-servicing over human rights, with debt-service costs a larger share of national expenditure than spending in either health or basic education.
While both basic education and healthcare sectors will see nominal increases in allocations over the Medium Term Expenditure Framework (MTEF), in real terms after accounting for inflation and population growth, spending in both these crucial areas will decline. This will have negative and lasting impacts on basic education and health outcomes, worsen inequality and jeopardise government’s ability to fulfil its human rights obligations. We note that budgeting for human rights realisation, over and above the intrinsic and Constitutional significance, acts as important multipliers for economic growth and development.
Around R1 billion has been allocated every year for the medium term for the provision of medical intern and community service doctor posts, which SECTION27 welcomes. We also note the encouraging allocations for the continuation of Covid-19 vaccination and outreach, which, given relatively low levels of vaccination in our society, requires sustained work going forward.
But despite these promising developments, with CPI inflation averaging 4.5% over this period, the public health sector will face a 4.3% reduction in funding in real terms on average each year for the next three years. This means that government will have less money over the medium term to spend on healthcare worker posts, the revitalisation of health infrastructure, or even providing testing and treatment for HIV to name just a few problems. This will limit health departments’ abilities to provide catch-up and recovery of routine health services in the post-pandemic context, but also jeopardises future targets crucial to health.
- Broader compensation funding is capped by this budget, which will result in hiring freezes for crucial healthcare worker posts on the frontline.
- The HIV/AIDS component of a new conditional grant is reduced over the medium term, with Treasury admitting it is “unlikely” South Africa will be able to meet its targets for initiation and retention of people on anti-retroviral treatment.
- Oncology and mental health services are once again side-lined in this budget, with funding for these services allocated to the broader National Health Insurance grant. Government has not indicated how money specific for these crucial and currently under-supported services will be protected.
- Despite increased strain on health infrastructure following Covid-19, real allocations to health revitalisation programmes does not keep up with inflation.
All these concerns will negatively impact the quality of care given to the 50 million people who rely on public health facilities when they are sick.
Reductions in spending on basic education of -2.5% in real terms over the next three years will have detrimental effects on the basic education sector and its ability to provide equal and quality education for all learners. Failing to allocate funding for basic education in line with learner enrolment growth and inflation will jeopardise the provision of schooling essentials like educators, textbooks, furniture, and safe infrastructure, and delay the immediate realisation of basic education.
We welcome the fact that the national school nutrition grant is expected to grow consistently over the next 3 years. Furthermore, the long-awaited transition of early childhood development (ECD) from the Department of Social Development to be integrated into the basic education sector is a positive step towards tackling inequality and poverty. However, serious challenges remain:
- While the ECD’s integration into the basic education sector is welcome, this budget does not adequately allocate funding for the provision of these services over the next three years.
- While the employment of educational assistants has shown some early promise in terms of learning outcomes, these posts are temporary and do not address structural issues surrounding understaffing at schools and classroom overcrowding. With employee compensation growing slowly over the medium term, and with a wave of teacher retirements looming, the basic education sector is going to face unprecedented human resource constraints. This will have adverse impacts on learning outcomes due to classroom overcrowding. Worryingly, too few teaching bursaries are budgeted for to compensate for anticipated teacher retirements and growing class sizes.
- Infrastructure funding allocations seem set to grow slowly, but the budget does not indicate how backlogs of suspended infrastructure projects owing to Covid-19 will be addressed and how this may affect infrastructure delivery more generally.
- Holding teachers accountable for sexual violence or corporal punishment will be made even more challenging with budget reprioritisations away from the South African Council of Educators (SACE).
We believe that by cutting real basic education and health care funding over the medium term, government is failing to put forward a coherent agenda for socio-economic development as well as undermining its human rights obligations. Learners and public health sector patients deserve better.
For full analysis of spending on basic education and healthcare according to the 2022 budget, visit this link: