Free State Health on Clinics and EMS
By Thobeka Makume
The Free State Department of Health has unveiled a R14.187 billion budget for the 2025/26 financial year, aimed at revolutionising healthcare services and infrastructure across the province. Delivered by Honourable Monyatso Viceroy Mahlatsi, the Member of the Executive Council (MEC) for Health, during a budget vote speech on April 25, 2025, at the Fourth Raadsaal in Bloemfontein, the plan includes the rollout of 24-hour clinics and the appointment of 280 Emergency Medical Services (EMS) staff to address critical service gaps. This bold initiative reflects the province’s commitment to ensuring accessible, high-quality healthcare for all residents, even as it tackles challenges like staff shortages, infrastructure decay, and rising medico-legal claims.
A Vision for Accessible Healthcare
MEC Mahlatsi’s speech highlighted a transformative approach to healthcare, rooted in the province’s goal of achieving Universal Health Coverage through the National Health Insurance (NHI). A key focus is the expansion of 24-hour primary healthcare (PHC) clinics, with plans to ensure every town has at least one such facility supported by standby ambulances. This move addresses long waiting times, where patients currently queue as early as 5:00 AM, and aims to enhance emergency response times, particularly in 15 towns currently without ambulance coverage.
To bolster EMS, the department will appoint approximately 280 officials, with 150 dedicated to these underserved areas and 130 to correct staffing imbalances. The Xhariep Call Centre will soon be fully operational, while the Lejweleputswa and Fezile Dabi call centres will relocate and upgrade, ensuring efficient emergency coordination. Additionally, R1 million has been allocated for household-level emergency response equipment, empowering remote communities while professional help is en route.
Strengthening Infrastructure and Services
The budget, a 2.84% increase from last year’s R13.796 billion, supports critical programmes: R6.28 billion for District Health Services, R3.386 billion for Central Hospital Services, and R995.8 million for Emergency Medical Services, among others. However, with inflation exceeding 5%, MEC Mahlatsi emphasised the need for “bold leadership, smarter spending, and stronger partnerships” to stretch limited resources.
Infrastructure remains a priority, with ongoing repairs at facilities like Pelonomi and Boitumelo hospitals, where construction delays have hampered service delivery. The department is verifying R500 million in high-value accruals, potentially lowering this figure, and launching a maintenance campaign to modernise facilities. Water security challenges, including illegal connections and ageing pipes at hospitals like Elizabeth Ross and Parys, are being tackled with support from partners like Vaal Water and the Department of Water and Sanitation.
Tackling Health Challenges Head-On
MEC Mahlatsi addressed pressing health issues with determination. The province is intensifying immunisation efforts during Africa Vaccination Week (April 24-30, 2025) and World Malaria Day (April 25, 2025), focusing on the “Big Catch-Up” campaign to protect children. Child and teenage pregnancy is being confronted with open dialogue, promoting abstinence while providing safe preventative measures to empower young people.
Vandalism of health infrastructure, including targeted theft of copper pipes, has prompted a call for community ownership and accountability for scrap metal dealers. Meanwhile, the rising demand for eye care has led to a cataract surgery waiting list extending to 2028, prompting the Free State School of Nursing (FSSON) to introduce ophthalmic nursing training in 2027. Mental health services are expanding with 10 new professionals appointed, and the Thuthuzela Care Centre at Elizabeth Ross Hospital marks the 66th nationwide facility to combat gender-based violence (GBV).
Innovation and Digital Transformation
The Free State is embracing cutting-edge technology to enhance care. The introduction of the Versius Surgical Robotics System at Universitas Academic Hospital promises safer, more precise surgeries, while nuclear medicine and tools like DEXA and PeaPod enable early detection of future health risks. Digital health initiatives, including the Hospital Management System (HMS²) and e-Impilo, have tripled patient revenue and improved data management, with plans to expand to more facilities. The Health Patient Registration System (HPRS) with biometric verification is also rolling out to curb identity theft and enhance service continuity.
Financial Management and Accountability
Despite the budget increase, financial pressures persist, with medico-legal claims reaching R6.1 billion by May 2025, largely due to maternal and neonatal care gaps like cerebral palsy cases. A six-point plan—employing more specialists, upgrading equipment, and pushing for legal reforms to reduce payouts by up to 80%—aims to prevent harm and stabilise finances. The department is also addressing audit concerns, finalising the immovable asset register, and resolving Section 42 transfers to the Department of Public Works.
Community and Partnership Focus
MEC Mahlatsi praised partnerships with entities like Masilonyana Municipality for security support and the University of the Free State for innovations like renal transplants at Universitas Hospital. The Central Chronic Medicines Distribution (CCMDD) has served 268,573 patients, with 734,500 medicine parcels distributed, and the Household Delivery programme benefits 20,000 elderly and disabled individuals. These efforts underscore a shift towards wellness, not just treatment, aligning with the Swahili proverb quoted by Mahlatsi: “To fear the powerful is futile, for will they ever be small?”
Looking Ahead
For 2025/26, the province will prioritise reducing maternal mortality in Thabo Mofutsanyana and Lejweleputswa, improving antenatal care, and boosting immunisation coverage. The NHI pilot in Thabo Mofutsanyane, with projects like the Dihlabeng CCMDD Unit, signals progress towards equitable care. With 83% of hospitals and 92% of clinics meeting quality standards, the Free State is laying a strong foundation, despite challenges like staff shortages and laundry service issues.
MEC Mahlatsi concluded with a powerful message: “This budget is not merely a financial document. It is an instrument of social justice, a plan to heal, protect, and restore dignity.” Stories like Mr Khahliso Pitso’s life-saving brain surgery and Mr Mochato Mokoena’s cancer recovery highlight the human impact of these efforts. As the Free State faces its healthcare challenges head-on, this budget promises a healthier, more resilient future for all.
