The Gauteng Health Department faces a major legal challenge, which could have a negative impact on the care of more than 3,000 cancer patients across the province. The department has announced that it will appeal a court decision declaring the department’s inability to deal with the backlog of cancer treatments “unconstitutional” and “illegal”. The issue has been building up for years and involves delays in radiation treatment, which leaves thousands of cancer patients waiting.
The Court Ruling: A Clear Message to Gauteng Health
In March 2025, Acting Judge Stephen van Nieuwenhuizen handed down a decision that dealt a serious blow to the Gauteng Department of Health. The court ruled that the failure of the department to provide radiation treatment in a timely manner to cancer patients is unconstitutional. The court’s ruling is seen as an urgent call to action, given that there are over 3,000 cancer patients waiting for treatment. Many of them have been waiting for years.
Judge van Nieuwenhuizen said that the delays caused “irreparable damage” to patients and violated their constitutional right to health care. This decision comes after civil society groups like SECTION27 and the Cancer Alliance have been fighting for years to resolve this issue.
In the judge’s ruling, it was also revealed that the department had failed to effectively use funds despite being allocated R784 million by the Gauteng Treasury in March 2023 for the purpose of resolving the backlog. R250 million was returned to National Treasury as a result of administrative delays when awarding contracts for radiation services that were outsourced.
Gauteng Health’s Appeal: Delay in Action or Not?
The Gauteng Department of Health, in response to the court decision, has asked for leave to appeal. The decision has caused concern in both advocacy groups and patients. Many people argue that appealing this ruling will only delay the resolution of a dire situation.
Khanyisa Mapipa expressed her frustration at the continued inaction of SECTION27. The department’s inaction has already caused thousands of people untold damage. “Further delays would be a violation of their constitutional right,” she stated.
The appeal of the department is viewed as a disappointment, particularly when it should be the top priority to implement solutions that will provide cancer patients with timely care. Many patients wait years for treatment, and their health declines while they do so.
Patients who are waiting for life-saving treatment: The human cost
Backlogs have a profound impact on patients, not only in terms of legal and administrative issues but also on their personal lives. Cancer patients in Gauteng wait for radiation therapy, which is crucial to their survival and treatment. The department has not been able to eliminate the backlog, and patients are in limbo. They face uncertainty, worsening health, and are unable to receive radiation therapy.
Salome Meyer, from the Cancer Alliance, says, “Many people have died waiting for treatment, and others live in fear of not making it on time.” This backlog is more than just a health issue. It is a matter that could mean the difference between life and death for many.
These delays put pressure on the public healthcare system, since patients who could have accessed care via the private system are now forced to rely solely on a system that is already overburdened. This means that for many patients, they will have to wait months or even years before receiving essential radiation therapy.
Financial Mismanagement & Missed Opportunities
This issue stems from a mismanagement of funds. In March 2023, the Gauteng Department of Health was given R784 million by the provincial Treasury to outsource the radiation services to reduce the backlog. Nevertheless, due to inefficiency in the administration and delays in awarding contracts, a large portion of this funding wasn’t used as intended. Over R250 million was returned to the National Treasury by the end of the financial year.
The financial mismanagement led to missed chances in improving patient care and reducing the backlog. The funds were already available, and timely action would have helped alleviate the pressure placed on public health facilities that have been suffering from limited resources and staff shortages.
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The Staffing and Equipment Shortage: A Critical Barrier
The Gauteng Department of Health faces a number of challenges, including a shortage of qualified personnel and equipment. Charlotte Maxeke Hospital and Steve Biko Hospital have struggled for years with inadequate radiation equipment and a lack of staff. Both are essential in providing timely radiation therapy.
Budget constraints have also hampered the department’s ability to hire more staff and purchase much-needed equipment. The lack of resources has been a major factor in the treatment delays and growing patient backlog.
The role of civil society: advocacy and legal action
The civil society has played a major role in drawing attention to the backlog of cancer treatment in Gauteng. SECTION27 and the Treatment Action Campaign have fought for the rights of patients, held the department responsible for its failures, and pushed for quick action to clear up the backlog.
Mapipa said that “these organizations have been leading advocates for patient rights and their legal actions were crucial in forcing the government to admit the severity of the issue.” It is unlikely that, without their tireless efforts, the department would be forced to face its inability to deal with the backlog.
What Needs to be Done?
The Gauteng Department of Health needs to act quickly and decisively in order to resolve the backlog of cancer treatment. The Gauteng Department of Health will need to take a number of steps, including the hiring of additional staff, purchasing more radiation equipment and streamlining tender processes for outsourcing services.
The department also needs to commit to using the available funds efficiently. The department can start to reduce the backlog by ensuring R784 million is spent as intended on radiation services.
In order to combat systemic inefficiencies, long-term solutions are also needed. In order to ensure the sustainability of cancer treatments in Gauteng, it is important to improve coordination between the private and public sectors, increase investment in healthcare workers’ training, and make sure that patients do not have long waits for treatment.
The Key to Accountability is Urgency
The decision of the Gauteng Department of Health to appeal the court’s ruling is a concern in terms of the efforts to reduce the backlog of cancer treatments. It is still not too late to make a change and put the health and well-being of the citizens first. The time to act is now, with over 3,000 cancer sufferers waiting for treatment.
The department should focus on solving the backlog of cases by addressing issues such as financial mismanagement and equipment shortages. Only then will all South Africans be able to fully enjoy their right to effective and timely healthcare.
