Auditor-General flags weak accountability as health sector audit outcomes slip
Medico-legal claims stood at R50.2 billion in 2025-26, while settlements totalled R1.57 billion.
The Auditor-General has raised concerns over declining health sector audit outcomes in South Africa's 2025-26 fiscal year. Provincial departments exhibited weak accountability, lacking ownership and consequences for non-performance. The Auditor-General attributed recurring audit findings and budget strains to a reactive governance approach.
Only the Western Cape, Limpopo, and KwaZulu-Natal allocated specific funds for medico-legal claims, which totaled R50.2 billion in 2025-26, with R1.57 billion in settlements. Unauthorised expenditure reached R361 million in the Eastern Cape. Hospitals faced ongoing issues like stock control, hand hygiene, and staffing shortages.
National audits showed progress at the Council for Medical Schemes but regressed for the National Department of Health and the Mines and Works Compensation Fund. The Auditor-General urged departments to adopt robust processes for assessing and reviewing medico-legal claim valuations, emphasizing the need for consistent corrective action at executive levels.
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