The Eastern Cape Department of Health, now effectively bankrupt, owes a staggering R269 million to municipalities across the province. This was confirmed by Premier Oscar Mabuyane in response to a parliamentary question posed by the Democratic Alliance.
This debt is not a technicality. It places an unbearable financial strain on already cash-strapped municipalities and threatens the delivery of basic services such as water, sanitation and electricity.
The Premier cited redirected budgets towards medico-legal claims as the reason for the Department’s ongoing cash flow crisis. However, this explanation offers little comfort to municipalities that are expected to continue functioning without the funds owed to them.
According to the parliamentary response, as at the end of January this year, the Department owed R48 million to Nelson Mandela Bay, R40 million to Buffalo City and R35 million to King Sabata Dalindyebo. Other significant debts include Alfred Nzo District at R20 million, OR Tambo District at R19 million, Matatiele at R18.8 million and Raymond Mhlaba at R16.8 million.
Dozens of smaller municipalities are also affected, with outstanding amounts ranging from hundreds of thousands to several million rand. Many of these municipalities are already under financial pressure and cannot afford to carry the cost of provincial mismanagement.
The effects of this mismanagement are not theoretical. On 6 May 2025, Sundays River Hospital had its electricity disconnected, allegedly due to an R4.4 million unpaid bill owed by the Department of Health to the Sundays River Valley Local Municipality.
Despite issuing a formal notice and alerting the Department of Health and the Department of Public Works, no action was taken to prevent the disconnection. It was only after the DA escalated the matter, with Shadow MEC for Health Jane Cowley MPL taking urgent action, that the Department finally made a commitment to pay and power was restored.
This incident is a clear warning that poor financial management is endangering lives. The Department’s failure to pay within the legally required 30-day period under the Public Finance Management Act is not just a breach of compliance. It is a moral failure with real-world consequences.
The DA has consistently called for the Eastern Cape Department of Health to be placed under administration. With more than R5 billion in unpaid accruals in January and growing evidence of collapse, urgent intervention is required.
We will ask our councillors in affected municipalities to check whether there are any talks happening between their municipalities and the departments that owe them money, and to push for those discussions if they aren’t already taking place. The continued mismanagement of health should not be allowed to compromise already financially vulnerable municipalities.
The DA remains committed to transparent, accountable governance. Residents of the Eastern Cape deserve better than a government that cannot pay its bills or protect public health. We are in your corner. Together, we can get the Eastern Cape working again.