Gauteng Health Spends R612 Million on Foreign Staff

ActionSA is deeply concerned by the Gauteng Department of Health’s misplaced human resource priorities. A recently released written reply by the MEC for Health and Wellness, Faith Mazibuko, has revealed that the department spends more than R612 million annually on the salaries of foreign national healthcare professionals, while hundreds of qualified South African doctors and nurses remain unemployed.

This shocking revelation highlights a government that continues to overlook the country’s own healthcare professionals despite persistent staff shortages across public health facilities.

At a time when many South African doctors and nurses are unable to secure employment, the Gauteng Department of Health must explain why local talent is being sidelined instead of being given the opportunity to serve their communities.

The response to Legislature Question 5. HLO89 outlines a stark fiscal and operational picture:

• 551 Foreign Professionals on Payroll: The department currently employs 551 foreign nationals, with 170 on permanent terms and 186 in temporary positions.
• Concentrated in Medical Roles: Out of these, 545 are employed directly as medical staff (specialists, doctors, nurses, and clinical technicians), while only 6 hold administrative support positions.
  Massive Financial Outlay: For the 2026/2027 financial year, the department has budgeted a staggering R612,719,892.00 for the compensation of foreign employees. This follows a consistent pattern of high spending, including R617,622,852.00 in 2025/2026 and R616,309,957.00 in 2024/2025.

A Slap in the Face to Unemployed South African Graduates

This high expenditure is a direct slap in the face to the thousands of homegrown medical professionals who have been abandoned by the state.

Data from the South African Medical Association Trade Union (SAMATU) in early 2026 indicated that out of a cohort of nearly 1,900 doctors who completed their statutory community service at the end of last year, roughly 1,480 remained entirely unemployed just weeks later.

The department continuously shields its failure to hire these young, patriotic professionals under the guise of “budget constraints” and a lack of funded posts. Yet, they can comfortably find over R612 million annually to sustain foreign medical staff, many of whom occupy permanent slots that should be transitioning to qualified South African citizens.

Taxpayers fund the heavy bursaries and university training of our medical students, only for the provincial government to refuse to absorb them into a public healthcare system that is chronically understaffed and falling apart at the seams. ActionSA Demands a “South Africans First” Recruitment Audit.

While ActionSA respects the contributions of legal, specialised international skills where critical shortages exist, it cannot become the default baseline while our own graduates are forced to look for employment abroad or abandon the public service.

ActionSA will take the following steps to address this structural imbalance:

1. Demand a Phased Local Absorption Plan: I will formally request the Gauteng Health Department to provide a clear, phased strategy detailing how permanent positions currently held by foreign nationals will be prioritised for qualified, unemployed South African doctors and nurses as contracts expire.
2. Review Vetting Protocols via the Portfolio Committee: Given that the department relies on third-party digital background screening platforms like Dots360 alongside the National Department of Health (NDoH) verification process, we will demand a thorough audit of all 551 active foreign files to ensure absolute compliance with professional registries and valid immigration status.
3. Escalate to Provincial Treasury: We will engage the Provincial Treasury to demand that the R612 million compensation pool be re-evaluated, ensuring that local medical officer posts are unlocked and funded as a matter of constitutional urgency.

We cannot build a sustainable public healthcare framework, nor can the state honestly talk about the National Health Insurance (NHI), while it actively locks out the very healthcare workforce it trained.

ActionSA will continue to fight for our unemployed local professionals to ensure they are given the dignity of employment and the opportunity to serve their communities.

ActionSA Direct Democracy: Frequently uses digital polls for member input.