The Medium-Term Budget Policy Statement (MTBPS) by Finance Minister Enoch Godongwana, marked a critical test of the Government of National Unity’s (GNU) commitment to turning campaign promises into life-changing reality. Despite campaign promises for human rights realisation by the coalition partners, the MTBPS presented underscores the government’s commitment to maintaining the status quo, leaving the health and education sectors underfunded.
South African Schools and Healthcare Facilities Will Remain Understaffed
The proposed R11-billion expenditure to encourage early retirement among public sector employees aims to reduce the wage bill and make room for younger talent. However, concerns linger that this move won’t sufficiently address understaffing in education and healthcare. In fact, this proposal juxtaposes with provinces’ efforts to redress staff shortages and backlogs caused by austerity budgeting. Just last month, Gauteng Health announced that it would rehire retired staff to address hospital backlogs. In our work on access to women’s health services in Eastern Cape and Limpopo, we have seen that women rely on experienced nurses to provide specialised women’s health services. The early retirement proposal cuts off skills transfer, leaving junior nurses to rely solely on textbook knowledge to meet patients’ needs.
The education sector faces significant challenges, including low replacement rates for retiring teachers due to the MTBPS’s failure to reverse the R397.9-million cut to the Funza Lushaka bursary. Furthermore, the Western Cape education department’s decision to freeze 2,400 teaching posts in 2025 will exacerbate overcrowding in underserved schools. The Department of Basic Education estimates a staggering R176-billion shortfall by 2027/28, threatening the success of education reforms.
The healthcare sector also grapples with staffing shortages. Clinic committees reported to us in a budget training this year about worsening healthcare quality due to overworked staff and unfilled nurse positions. Earlier this year, unemployed newly qualified doctors’ protests further highlighted the public health care system’s staffing crisis.
The government must recognise public sector wage spending as an investment in delivering on its constitutional obligations, rather than a burden.
Austerity in the Classroom
We are concerned about the government’s commitment to education reforms. Despite minor adjustments to address flood damage in the Western Cape, the Basic Education budget remains largely unchanged, perpetuating nominal and real budget cuts proposed earlier in the year. This 0.4% cut, equivalent to a R1.2-billion reduction from R324.5 billion to R323.3 billion, will likely continue to constrain provincial education department’s ability to provide essential resources such as scholar transport, stationery, and learning materials.
The government’s progress report is alarming, with only one new school built against a target of 30 and none provided with water facilities out of a target of 100. The Cabinet-approved budget cuts to the School Infrastructure Backlogs Grant (SIBG) have been cited as the reason for this poor performance. Although we have lamented the SIBG’s poor performance compared to the Education Infrastructure Grant (EIG), its poor performance does not reflect the lack of need or demand for these facilities. True to the commitment to building a capable state, as highlighted in Minister Godongwana’s tribute to the late Minister Pravin Gordhan, we urge the government to fulfill its duty to ensure transparent, cost-effective, and accountable public procurement. Reducing spending without addressing the root causes of inefficiency only highlights the state’s failure to provide adequate oversight.
Effective solutions lie in capacity building, targeted interventions, and robust oversight mechanisms, not draconian budget cuts that exacerbate existing problems. By adopting a more nuanced approach, we can safeguard the rights to healthcare and education, upholding the government’s responsibilities to its people.
Furthermore, the state of school infrastructure is dire, with:
• 3,932 schools having undignified and life-threatening pit toilets, with 728 relying solely on pit toilets, primarily in the Eastern Cape, KwaZulu-Natal, and Limpopo (according to the DBE’s Education Facility Management Report from August 2023).
• 74.2% of schools lacking libraries.
• 82.6% of schools without science, technology, and life sciences laboratories.
Despite freezing teacher posts, the Western Cape will receive R251-million for infrastructure projects. While an improvement to school infrastructure is to be welcomed, it is notable that it is not the reality across provinces. Provincial funding disparities exacerbate inequality. Well-resourced provinces are able to secure more resources, while under-resourced ones struggle. The 2022 floods highlighted this issue, with KwaZulu-Natal and Eastern Cape failing to secure repair funds for health facilities. Urgent intervention is needed to capacitate under-resourced provinces and prevent further entrenchment of inequality.
The Unmet Promise of Universal Healthcare
South Africa’s healthcare funding has increased by 0.8% to R274-billion, mainly to repair flood-damaged infrastructure. However, this marginal boost won’t keep pace with rising costs and growing demand, perpetuating unconstitutional austerity measures. The public healthcare system remains under-resourced, with overcrowded and dilapidated facilities, despite commitments to universal coverage.
Other budget cuts tabled in the Main Budget that undermine the commitment to providing quality healthcare services have not been reversed in the MTBPS. This includes the R1-billion cut to the HIV/AIDS grant owing to cost savings in procuring Antiretroviral Treatment (ART). Indeed, this is a missed opportunity to position our health system to scale up ART uptake, develop robust health information systems and provide comprehensive support for patients on ART to bolster retention and achieve our 95-95-95 targets: targets that Botswana, Eswatini, Rwanda, and Tanzania have already met.
The proposed R500,000 shift from Women’s Maternal and Reproductive Health allocation is a significant setback for the realisation of women’s constitutional rights and further undermines South Africa’s commitment to Sustainable Development Goals (SDGs) on women’s health. This is particularly concerning as provinces continue to face persistent stockouts of contraceptives that are attributed to budget cuts.
Inclusive Growth Begins with Gender Equity in Budgeting
The National Treasury’s delay in implementing Gender Responsive Budgeting (GRB) since the 2022/23 budget is a concerning setback for addressing gender inequalities in South Africa. GRB is vital for promoting economic empowerment, strengthening public services, and combating gender-based violence.
Despite commitments, the MTBPS lacks consideration for gender implications, particularly in its efforts to reduce the public sector wage bill. This oversight is alarming, given women comprise 70% of educators and over 90% of nurses, driving inclusive growth and job creation.
Austerity Isn’t the Only Option
South Africa’s government faces international criticism for not using fiscal policy to tackle inequality, poverty, and unemployment. The latest MTBPS reinforces these concerns. To make progress, the government must prioritise fiscal expansion alongside expenditure cuts. We applaud the Minister’s commitment to an Africa-focused agenda during South Africa’s G20 Presidency, a chance to address debt and tax reform.
The MTBPS highlights rising debt servicing costs squeezing education and healthcare funding and underscoring the need for debt reform. We continue to urge the government to prioritise rights realisation and ensure that budgets reflect this. It is time for South Africa’s government to harness fiscal and budgetary policy to build a state that prioritises the progressive realisation of human rights.
The European Union funding supports SECTION27 and the Centre for Child Law’s work in enhancing accountability in health and education in South Africa.
For media enquiries contact:
Pearl Nicodemus | nicodemus@section27.org.za | 082 298 2636
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