The KwaZulu-Natal Department of Health (KZN DoH) is under intense scrutiny after revealing it owes suppliers more than R1.7 billion — a financial crisis that opposition leaders and unions warn is already affecting healthcare service delivery across the province.
In a written reply to a parliamentary question posed by the Democratic Alliance (DA), Health MEC Nomagugu Simelane confirmed that the department’s outstanding payments total R1,740,624,847.03. She attributed the delay to “cash flow challenges” and said the backlog would be addressed in the first quarter of the new financial year, which began on April 1.
While Simelane noted that the department aims to pay suppliers within 30 days, the reality paints a different picture. Of the R1.7 billion owed, over R1.33 billion is tied to invoices within the 60 to 90-day payment period. A further 1,519 unpaid invoices, totaling more than R71 million, are now overdue by more than 90 days.
DA spokesperson on health, Dr. Imran Keeka, expressed concern that the delays are particularly harming small and medium-sized enterprises (SMEs) — many of which are critical suppliers of medical goods and services. “This situation should never have escalated to a point where service delivery is affected,” Keeka said. “It is also worrying that some suppliers, while paid, reportedly failed to pay their own staff, sparking protest action in some cases.”
Keeka added that a recent protest outside the department’s Pietermaritzburg head office underscores the growing frustration among affected vendors. “The department has effectively adopted a ‘take from Peter to pay Paul’ approach,” he said, warning that such reactive financial management only deepens inequalities among suppliers.
The Public Servants Association (PSA) also weighed in, calling the department’s failure to honour its obligations “negligent and unsustainable.” PSA KZN manager Mlungisi Ndlovu said the crisis threatens not only the provincial health system’s stability but also public confidence in its leadership.
“Suppliers — many of them essential to healthcare delivery — are being financially suffocated,” Ndlovu said. “This is a direct result of poor fiscal oversight, and it is unacceptable that mismanagement of this scale continues with no apparent accountability.”
MEC Simelane acknowledged in previous portfolio committee meetings that the department faces persistent financial pressure. However, with the withdrawal of the national Division of Revenue Bill in March and provincial budgets expected to be tabled by late May, there is cautious optimism that the province’s finances may stabilise.
Still, critics insist that real consequences and reforms are needed. “This isn’t just about numbers,” Ndlovu said. “It’s about lives, and the ability of the healthcare system to deliver in a time of need.”