Run on numbers: the devastating impact of corruption on public health services

One topic that continues to dominate in social circles is the medical aid industry. Most people, and even service providers in the industry, are constantly complaining about funds running out long before year-end. The top-end medical aid costs are only for the very wealthy, and most families can only afford the most basic plans.

In this context, it is important to consider the role of the CMS (Council for Medical Schemes). One of the main objectives of the CMS is: “Serve beneficiaries of medical schemes and the public in general by reviewing and approving changes to contributions paid by members and benefits offered by schemes. The programme analyses and approves all scheme rules to ensure consistency with the MSA (Medical Schemes Act). This ensures that the beneficiaries have access to affordable and appropriate-quality health care. By doing this, we help the CMS ensure that the rules of medical schemes are fair to beneficiaries and are consistent with the MSA. There is a total of 71 medical schemes that are regulated by CMS.”

However, concerns remain about how the organisation operates. More than 70% of all revenue is spent on salaries. This organisation exists to pay salaries rather than focus on their objectives.

This misalignment stands in stark contrast to broader national goals. According to one of the objectives of the National Development Plan (‘Vision 2030’), the strategic intent of the National Development Plan (NDP) 2030 for the health sector is the achievement of a health system that is accessible, works for everyone, and produces positive health outcomes. According to the World Health Organisation, a well-functioning and effective health system is the bedrock for attaining the envisaged health outcomes.

When we consider the importance of the work undertaken in the health care industry, it is just unacceptable what has transpired at the Tembisa Hospital. “The Special Investigating Unit (SIU) has unearthed wholesale looting at the Tembisa Hospital, following an intense investigation into allegations of corruption and maladministration at the public facility”, said the SIU head, Advocate Andy Mothibi, who led a press briefing and release of the interim report, joined by Minister of Health Dr Aaron Motsoaledi, Gauteng Premier Panyaza Lesufi, and Gauteng MEC for Health Nomantu Nkomo-Ralehok.

The Cape Times a month ago reported that Mothibi said: “We can reveal today, through the SIU investigation, that evidence has revealed a number of maldistribution and other public procurement irregularities. This indeed can be described as a devastating plunder of the public funds, which we found in our probe. The investigation has uncovered, up to date, three coordinated syndicates responsible for the loss of over R2 billion.”

Mainstream media’s daily call for accountability and consequence management goes unanswered, and nobody ever fits a new orange overall. Prison time is for small-time criminals, not for large syndicates. It is time for voters to demand that heads must roll in these institutions, starting at the ministerial level, all the way to the board level and senior managers. To be deemed innocent until proven guilty is not appropriate when R2bn goes missing. It is more appropriate that people must prove that they were qualified for the job and that they did everything humanly possible to prevent  theft and corruption.

These failures in governance are not isolated. We know up front that a very large disaster is approaching the country. A few years ago, the Guptas landed a plane at Waterkloof, a military base and a key point on our security list. Then, not long after, the president of the United Arab Emirates (UAE) and ruler of Abu Dhabi, Sheikh Mohamed bin Zayed Al Nahyan, and his family landed in the Eastern Cape. Earlier this year, we learnt that a Russian cargo aircraft, blacklisted by the United States, landed in Upington in the Northern Cape, sparking fresh concerns.

The latest and perhaps the most bizarre is the mysterious arrival of Palestinians at OR Tambo. According to Minister Lamola: “Government is still probing mysterious arrival of Palestinian group at OR Tambo.” This does create a very uncomfortable situation with the G20 taking place at the same time. Home Affairs has since said that the Palestinian group that landed at OR Tambo did not seek asylum. They’ve now been granted temporary refugee status for 90 days. President Cyril Ramaphosa said that the government made an exception due to the dire circumstances facing the travellers.

We need to find out the absolute truth about this situation, as it was most probably designed to embarrass our country. American President Donald Trump said that all two million Palestinians from Gaza should be moved to countries like Egypt and Jordan because of the devastation brought by Israel’s campaign against Hamas.

It was recently reported that the Trump administration has been working on a plan to permanently relocate up to 1 million Palestinians from the Gaza Strip to Libya. Jordan’s King Abdullah announced immediately after the October 7 attacks that Jordan and Egypt would not accept refugees from Gaza. The US has deported five people whom it described as "criminal illegal aliens" to the Southern African kingdom of Eswatini. On board the flight were five deportees from Vietnam, Jamaica, Laos, Cuba and Yemen who have been convicted of crimes ranging from child rape to murder.

Similarly, Turkey and Qatar, both state sponsors of Hamas, are refusing to take refugees even as both countries express support for the Palestinians.In South Africa, we already have serious resistance against undocumented immigrants. In September 2025, Parliament passed the Immigration Amendment Bill, designed to close loopholes in immigration law.

It strengthens enforcement, sets clearer rules for detention and deportation, and ensures magistrates oversee decisions. Children are protected under welfare laws, with detention only as a last resort. The Department of Home Affairs deported 46,898 illegal immigrants in the 2024/25 financial year, an 18% increase from the previous year. This is the highest figure in at least five years and even exceeds deportations in France and Germany combined over the same period.

South Africa has limited resources, such as health care, and undocumented immigrant inflows are hurting our health care system. Whilst this is happening, citizens must also swallow the fact that the Hawks are investigating five cases of fraud, theft and corruption in the South African Navy worth nearly R500m.

* Kruger is the independent analyst.

** The views expressed herein are not necessarily those of Personal Finance or Independent Newspapers.

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