Health Budget 2026/27: Care, Dignity and Delivery - Investing in a Healthier Western Cape

Honourable Speaker 

Members of the Western Cape Provincial Parliament 

Special guests 

Most importantly, residents of the Western Cape

Good afternoon,

It is a privilege to table the Western Cape Department of Health and Wellness’s R34.47 billion budget for the 2026/27 financial year.

Since becoming Minister, I have witnessed both the hidden and frontline challenges created by the long-term effects of the COVID-19 pandemic, fiscal austerity, national policies that restricted workforce growth, and the withdrawal of donor funding.

Despite these obstacles, our more than 33 000 dedicated staff delivered more than 20 million patient contacts last year, holding the line with extraordinary resilience and commitment. 

But, Speaker, since the main appropriation budget last year, we have started to see genuine green shoots of recovery. Like the rooibos plant that thrives in our province, our system has adapted, endured, and is now regenerating. Through disciplined financial management, a culture of innovation, and a shared commitment to compassionate care, we are shifting from crisis response to long‑term rebuilding.

This budget balances immediate relief for our staff and patients with strategic investments that will strengthen healthcare in the Western Cape for the next decade and beyond. At its core, this budget is about stabilising the system today while driving reforms that will secure a stronger, more sustainable healthcare future for all our residents.

Strategic Direction of the Department and the Annual Performance Plan

Western Cape Government has set its vision for the province over the next five years through the Provincial Strategic Plan.

It is about enabling every resident to access opportunities and to live a life they value.

We recognise that the lived experience of our residents is shaped by many interconnected factors, and that government plays a role across every aspect of daily life. 

For the Department of Health and Wellness, our five-year strategic plan aligns directly with this vision. 

At its core is a simple but powerful commitment: to walk the life journey with every resident of the Western Cape.

This means ensuring that our children start well, that our communities are supported to live well, and that our residents are able to age well with dignity and care.

This life-course approach reflects our understanding that a person’s health and wellness is not defined by a single moment but built over time. It requires targeted interventions at every stage of life, supported by a well-run system that is responsive, integrated and sustainable.

This budget gives effect to our plans. It translates vision into services, strategy into delivery, and commitment into real outcomes for residents.

A Snapshot of the Provincial Health System and Budget

Over the Medium-Term Expenditure Framework, we are investing more than R106 billion (R106 817 647 000) to achieve a healthier Western Cape and a healthcare system that works better for everyone, everywhere.

For the 2026/27 financial year, the department’s budget is R34.47 billion (R34 470 319 000). This increases to R35.65 billion (R35 647 020 000) in 2027/28, and to R36.73 billion (R36 730 308 000) in the outer year of 2028/29.

The 2026/27 budget represents a 7.6% increase on the 2025/26 main appropriation. This is a meaningful allocation above inflation, giving the department the resources needed to respond to immediate pressures while also investing in the long-term sustainability of the health system.

It enables us to continue investing in critical infrastructure, while also addressing persistent pressures within our goods and services budget, which increases by 5.76% compared to last year’s adjusted appropriation.

These investments support the full continuum of care, from prevention and health promotion, to treatment, rehabilitation and palliative care, delivered across more than 550 service points in the province. It allows the department to stabilise specific service points that have experienced the most pressures over the past 2-3 years, like emergency centres.  

I would like to take a moment to recognise the work of our Chief Financial Officer and DDG, Mr Simon Kaye.

Over the past few years, he has had to navigate an exceptionally constrained and complex fiscal environment, making difficult decisions to ensure that every Rand is used responsibly and where it matters most.

In moments of crisis, Simon has been a steady, disciplined and deeply trusted hand, providing guidance and insight that have added value to every decision and every cent spent. He has embodied a selfless style of leadership that has rippled across our department and government.

Mr Kaye, Rhodes University’s gain is certainly our loss. Thank you for your service, your wisdom, humanity and, of course, every brightly coloured shirt.

Speaker,

A critical part of strengthening our system is investing in our people.

I am therefore pleased to announce that the budget for compensation of employees has increased by 5.54%, including an additional R105 million to expand our workforce. This will enable the department to appoint up to 825 additional staff members across service points in the province, strengthening capacity across the system.

These appointments include:

• 316 nurses
• 124 doctors
• 38 allied health professionals, including occupational therapists, dietitians and physiotherapists
• 80 emergency medical services personnel
• 278 support, administrative and management staff, who play a vital role in enabling our clinical teams to focus on patient care

While it will certainly take time to fill these posts, it will mean more care for our patients, and greater support for our existing staff.

Speaker,

Let me now turn to the programme-level allocations in greater detail.

Programme 1: Administration

Programme 1, Administration, sees an increase of 11.62%.

A significant portion of this investment is directed towards information and communication technology. The Western Cape is on a deliberate journey to digitise the health system, improving the patient experience, supporting clinical decision-making, and ensuring that our system operates more efficiently.

A key priority in the coming year is making our systems work better for both patients and clinicians. We are advancing the rollout of a single sign-on functionality, which will allow clinicians to access multiple clinical systems through one platform. This will improve efficiency and allow more time to focus on patient care.

At the same time, we are piloting the first phase of a patient-facing digital platform.

This will allow patients to view aspects of their health information and begin to interact more directly with the health system, strengthening their ability to manage their own care journey.

We are also upgrading our core patient administration systems to enable more efficient appointment scheduling, with the future ability for patients to book, change or cancel appointments electronically. This will reduce congestion at facilities and improve the overall patient experience.

In partnership with the Gates Foundation, we have also secured additional resources to pilot AI-enabled solutions that reduce the administrative burden on clinical staff in primary care facilities, allowing them to spend more time where it matters most- with patients.

Programme 2: District Health Services

Programme 2, District Health Services, continues to receive focused investment as part of our deliberate shift from a predominantly curative system to one that places far greater emphasis on prevention.

Clinics and community health centres will see increases of 7.97% and 7.63% respectively, strengthening primary healthcare as the very foundation of our health system. This includes shifting appropriate resources closer to where care is delivered, enabling local stewardship and allowing delivery systems to respond to context-specific needs while remaining aligned to our broader strategic priorities.

Through our medicine delivery programme, eligible patients are now able to receive their medication directly at home. In the past 12 months alone, more than 87 000 medication parcels have been delivered.

That is a grandmother who no longer needs to travel long distances to collect her diabetes medication. Or a resident with mobility challenges that simply takes their blood pressure medication without worrying about how they will collect it. It is practical, everyday relief that makes it easier for people to take control of their health.

Speaker, we are steadily making progress towards achieving our 95-95-95 HIV targets: 95% of people living with HIV know their status, 95% of those who know their status are on treatment, and 95% of those on treatment are virally suppressed. To enable this work, the department has allocated R2 billion (R2 089 532 0000) to HIV programmes.

Tools such as PrEP and PEP continue to play a critical role, particularly for young people and those at higher risk. At the same time, by integrating HIV and TB services at every point of care, we are strengthening our ability to respond to one of the most significant health challenges facing our country.

Looking ahead, we are preparing for an important advancement in HIV prevention.

In the coming months, we expect the introduction of Lenacapavir, a long-acting HIV prevention option, to transform how we prevent new infections. A twice-yearly injection offers a powerful alternative to daily medication which supports adherence and reduces stigma. 

But none of this progress happens in isolation. It is made possible through strong partnerships with civil society and communities across the province. The Provincial Council on AIDS and TB continues to play a vital role in bringing these partners together, enabling a coordinated and collaborative response to HIV and TB.

I want to thank all those who continue to stand with us in this work, driven by a shared commitment to reducing infections and building a healthier Western Cape.

Speaker,

In the 2026/27 financial year, a total of R5.18 billion (R5 178 278 000) has been allocated to our district hospitals such as Khayelitsha and Mitchells Plain. One of our busiest hospitals in the province, Mitchells Plain and its staff consistently manage high patient volumes and runs at a 97% occupation rate. 

We recently received an email from a patient who came to the Mitchells Plain Emergency Centre needing hospitalisation just days before Christmas. 

She shared her experience. 

“From the security at the entrance to the security at emergency and the ward floors, I was met with a helpful greeting. Admin staff, nurses and cleaners was courteous and friendly making one feel so much better. 

The above would sound like I was at a private facility maybe even alone in a ward, instead, I was part of a full emergency ward following every needed process, from bloods to examination to x-ray. I was a patient who met each person with respect for the role they play in the hospital system and I was met with the same.”

This is the standard of care we strive for across every facility in our province, care that sees the person, not just the patient, even under the greatest pressure.

Before I move on, I would like to acknowledge the late Dr Gio Perez, the former Head of Metro Health Services who passed away last week.

He was a dedicated leader who played a critical role in strengthening primary healthcare and ensuring that services reached communities where they were needed most. But more than that, he was deeply loved by the people who knew him.

He leaves behind a legacy of service, compassion and leadership that continues to shape the work we do today.

We honour Dr Perez for a contribution that words cannot fully capture, and we extend our sincere condolences to his family, his colleagues and his loved ones.

Programme 3: Emergency Medical Services

Programme 3, Emergency Medical Services, is allocated a total of R1.53 billion (R1 528 807 000) for the 2026/27 financial year. This represents 4.4% of the department’s total budget, with R1.4 billion (R1 396 868 000) allocated to prehospital support and emergency transport, and R132 million (R131 939 000) to planned patient transport, also known as Healthnet.

Our EMS services continue to operate under significant pressure.

They are impacted by a complex set of challenges, including safety risks, long travel distances in rural areas, and the unfortunate inappropriate use of EMS services. These pressures contribute to longer waiting times and place those with genuine emergencies at risk.

That is why I am particularly pleased to announce that 30 additional Emergency Care Officers will be deployed from April in rural areas where the need is greatest.

With an investment of just over R11.17 million, these officers will focus specifically on interfacility transfers. This intervention will ensure that in areas such as Ceres, Bredasdorp, Knysna, Oudtshoorn, Gansbaai and Beaufort West, there are dedicated teams to manage these transfers, keeping more ambulances available for critical cases.

In the metro, the West Coast and the Garden Route, the department has also partnered with the private sector to support low acuity interfacility transfers.

By improving patient flow into, out of and between facilities, we can free up beds sooner, reduce waiting times, and improve overall efficiency. Since its inception in December 2025, this partnership has already enabled more than 2 400 patient transfers.

Programme 4: Provincial Hospital Services

Within Programme 4, Provincial and Specialised Hospital Services, 15.85% of the total departmental budget has been allocated to provide care at facilities such as George Hospital, Brooklyn Chest Hospital and Alexandra Hospital.

A total of R5.46 billion (R5 464 528 000) has been allocated to this programme, including a notable 5% increase for psychiatric and rehabilitation services.

Since the COVID-19 pandemic, demand for mental health services has increased significantly. Mental health is now one of the fastest-growing pressures on our healthcare system.

We are responding by strengthening acute psychiatric services.

This includes a R24 million (R24 470 000) investment to upgrade 72-hour observation facilities at Stikland Hospital. Additionally, three Acute Psychiatric Units at Eerste River, Khayelitsha and New Somerset Hospitals will be opened and operationalised at a cost of R36.25 million (R36 254 000), adding 90 new psychiatric beds.  

But while these facilities are essential for those requiring intensive care, our broader goal is to make mental health support more accessible, earlier.

That is why we are launching a new pilot initiative, the Tele Mental Health Centre.

Mental health needs are widespread, but specialists are limited and often concentrated in urban areas. Telehealth gives us a way to bridge that gap, and by using our existing digital platforms, we will enable virtual support between specialists and frontline clinicians and where needed, direct patient consultations. 

This pilot centre -with an investment of R4 million over the MTEF- will operate as a small, dedicated team focused on testing and refining new models of care, identifying what works, and tackling practical challenges needed for future scale. 

Programme 5: Central Hospital Services

For our most specialised services, caring for the most complex cases, our central and tertiary hospitals, Tygerberg and Groote Schuur, as well as Red Cross War Memorial Children’s Hospital, will receive R9.26 billion (R9 259 970 000). Out of millions of patient interactions across our system each year, it is these three hospitals that carry the most complex, high-risk and specialised care.

This includes a 6.31% increase in the budget for the Red Cross War Memorial Children’s Hospital.

Speaker,

It is often said that our children are our future. But they are also a reflection of our society and our values.

We are currently seeing isolated outbreaks of measles and diphtheria in the Western Cape, both preventable diseases for which safe and effective vaccines exist. These are serious illnesses, and they remind us that prevention must remain at the centre of our health system.

Vaccines are among the most impactful, cost-effective and life-saving innovations in human history. They quietly protect families and communities every single day.

Our immunisation programme focuses on improving access, strengthening routine coverage, and addressing vaccine hesitancy through targeted, community-based interventions.

We are also strengthening our communication efforts, using platforms such as Facebook, Instagram and TikTok to encourage parents and caregivers to vaccinate, while actively addressing misinformation.

At the same time, our surveillance systems continue to monitor vaccine-preventable diseases closely, enabling early detection and rapid response.

Looking ahead, we will participate in Africa Vaccination Week in April, with a focus on reaching un- and under-immunised children in priority districts, supported by partnerships across the public and private sectors.

Speaker,

The HPV vaccination campaign remains a cornerstone of our prevention efforts. In the past financial year, we visited all public and special schools. Of the 50 474 eligible learners, 36 900 girls were vaccinated, achieving 73% coverage. While this is encouraging progress, we know there is more work to be done.

And this is not work that government can do alone.

I want to call on all members of this House to support our efforts to build trust in vaccines within our communities, to use your voices, your platforms and your leadership to encourage parents and caregivers to protect their children. Because trust is the foundation of any successful immunisation programme.

Through this budget, we are investing in prevention not only to save lives today, but to reduce pressure on our health system in the future.

This is what it means to deliver growth with discipline and care: investing early, acting responsibly, and ensuring that every child has a fair chance at a healthy future.

Programme 6: Health Sciences and Training

Programme 6, Health Sciences and Training, will receive R465 million to train and prepare the next generation of healthcare workers in the Western Cape.

These institutions are centres of excellence and set national benchmarks in health education.

The College of Emergency Care, in 2022, became the first college in the country to be accredited to offer an NQF Level 6 Diploma in Emergency Medical Care, and it is now progressing towards accreditation for a Bachelor’s degree.

Last year, at the Western Cape College of Nursing, the first cohort of postgraduate diploma students graduated as specialist nurses in areas such as critical care, emergency nursing, mental health, midwifery and primary care.

But training does not only happen in lecture halls. Across the department, we are investing a further R47.5 million to upskill staff within our services, ensuring continuous learning and development. In total, 1 500 bursaries will be awarded, strengthening our pipeline of skilled healthcare professionals for the future.

Programme 7: Health Care Support Services

Programme 7, Health Care Support Services, increases by 6.02% to a total allocation of R744.9 million (R744 978 000).

These are the essential services behind the scenes that keep our health system running, from engineering and laundry services to medical depots, orthotic and prosthetic services, and forensic pathology.

An additional R27.21 million (R27 213 000) has been allocated to strengthen this capability, including investments that will make forensic investigations faster, more accurate and more effective.

Our Forensic Toxicology Unit has recently achieved a major milestone.

It is now the first provincial public forensic toxicology laboratory in South Africa to be accredited for advanced drug testing methods, which means that the results produced by this unit meet international standards of accuracy, reliability and credibility.

And that matters deeply, because behind every forensic case is a family seeking answers, and a justice system that relies on credible evidence.

By strengthening our forensic services, we are supporting the work of law enforcement and the courts, ensuring that investigations are backed by high-quality, science-based evidence.

Speaker,

This is also what care looks like.

Care is not only what happens at the bedside. It is ensuring that every life is treated with dignity, that every case is handled with integrity, and that every family can trust the system to find answers.

In this way, even beyond our hospitals and clinics, this budget reflects our commitment to deliver growth with discipline and care.

Programme 8: Health Facilities Management

Programme 8, Health Facilities Management, reflects an increase of 22.09% to a total budget of R1.72 billion (R1 717 241 000).

This increase is largely driven by Budget Facility for Infrastructure (BFI) funding, which supports several of the province’s major healthcare infrastructure projects. While much of this work happens behind the scenes, it is critical in laying the foundation for the next generation of health facilities in the Western Cape.

The design and planning for the redevelopment of the Tygerberg Hospital and the new Metro East (Belhar) and Metro West (Klipfontein) regional hospitals are underway. These are once in a generation facilities that require deeply technical planning and engineering. Behind the scenes preparation taking place to make these possible and change the health landscape in the Western Cape. 

And Speaker, while this work is ongoing, our investment in healthcare facilities continues.

In the 2026/27 financial year, we will have 22 projects in planning, 57 in design or tender phase, and 42 projects either under construction or being handed over to our clinical teams to begin serving patients.

These include refurbishments at Amalienstein and Calitzdorp Clinics; new and replacement clinics in Diazville, Mossel Bay, Hanover Park and Weltevreden; and major rehabilitation projects at Montagu Hospital, Paarl Hospital recently damaged by fire, Alexandra Hospital and New Somerset Hospital.

We will also open the doors of the new Ravensmead Community Day Centre, Hornlee Clinic, and the upgraded Emergency Centre at Groote Schuur Hospital in this financial year.

Speaker,

Infrastructure is not only about buildings, it is also about creating environments that support better care. That is why, over the next three financial years, the department will invest R57.54 million (R57 539 000) in photovoltaic systems across our facilities to improve energy resilience, reduce costs over time, and help ensure that our services can continue uninterrupted.

Speaker,

Together, each programme forms a public healthcare ecosystem that is far greater than the sum of its parts.

And these are only some of the ways in which this budget will be put to work. Other initiatives, such as Khulisa Care and Planet Youth, will continue this year, gathering the evidence, building partnerships, and doing the hard work needed to shift the needle on stunting, violence prevention and the wellbeing of our most vulnerable residents.

Conclusion

Speaker,

Underpinning every programme and every budget line are thousands of dedicated public servants.

And I want to take a moment to recognise our senior management team, under the stewardship of Dr Keith Cloete - for their leadership, discipline and unwavering commitment create the conditions that enable this system to function and to grow and support our staff in their work. Thank you for the dedication and passion, professionalism and care which are changing lives daily. 

I also wish to thank my excellent team in the Ministry who work so incredibly hard each and every day to make a difference. I am so enormously grateful. 

Speaker,

We have committed to walking a lifelong journey with our residents. From the moment a child is born, to the care we provide in times of illness, to the dignity we uphold at the most vulnerable moments of life.

Like the rooibos plant that grows in the soil of this province, our health system has endured difficult conditions. It has been tested by crisis, shaped by constraint, and strengthened through resilience.

Today we are building a system that is more responsive, more sustainable, and better able to meet the needs of the people we serve, not only today, but for generations to come. This budget allows us to provide targeted, non-recurrent seed funding to test and scale innovative interventions, developing new models of care and redesigning existing services to improve how we deliver care to our residents.

This budget reflects our commitment to invest with discipline, to grow responsibly, and to place care at the centre of everything we do.

A strong health system is built not only through budgets and policies, but through partnership, trust and shared responsibility. And it requires all of us to recognise that health is not something we deliver, it is something we build together.

I thank you.