South Africa's health sector continues to be plagued by economic inequalities, as private providers, which service only 15% of the population, have more resources.

The struggling public sector, which has fewer resources, is responsible for the remainder of the population.

The Financial and Fiscal Commission (FFC) revealed this in its report on the national health department's 2023/24 budget and annual performance plan.

Among the health issues the FFC highlighted was the high burden of communicable and non-communicable diseases, which require dedicated targeted preventative and preventative programmes.

Furthermore, the FFC noted that Stats SA estimated in 2021 that the HIV prevalence rate was about 13.7% of the South African population (about 8.2-million).

The FFC reported, "It was indicated that inequality in healthcare resources requires an acceleration and speedy implementation of health reforms, such as the implementation of the National Health Insurance. The FFC informed the [health portfolio] committee that the private sector, which has more resources, provides health services to only about 15-16% of the population, while the public sector, with less resources, is responsible for the remainder of the population."

In addition, it said there was a shortage of doctors and specialists in South Africa in comparison to the situation in other countries. According to the FFC, South Africa has the lowest number of doctors per 1 000 patients and the highest number of patients per doctor.

It was indicated that the situation was worsening in the country, because it had 0.79 doctors per patient in 2019.

"The FFC indicated that the Department of Health's budget for the 2023/24 financial year is R60.1-billion, down from R64.6-billion for the 2022/23 adjusted appropriation and that the total expenditure is projected to increase at an annual average rate of 0.4%. On the entities, it was highlighted that the Compensation Commissioner for Occupational Diseases' expenditure is expected to total R1.5-billion over the medium-term expenditure framework (MTEF), increasing at an annual average rate of 6.5%," the report read.

The FFC also noted that the Council for Medical Scheme's total expenditure was expected to increase at an average annual rate of 4.7% from R193.4-million in 2022/23, to R221.9-million in 2025/26.

"The council is further expected to generate 95.2% (R616.4-million) of its revenue over the medium term through the collection of levies from medical schemes and 3.2% through transfers from the department," it said.

Regarding the SA Health Products Regulatory Authority (Sahpra), the FFC reported that the total revenue expenditure was expected to increase at an annual average rate of 7% to a total of R1.2-billion over the MTEF and a deficit of R13.9-million was projected for 2023/24, after which the budget would remain balanced.