Health and Wellness
With reference to her reply to question 28 of 3 October 2025:
- (a) From which part of section 27 of the Constitution is the authority derived to lend state-owned medical equipment to private entities and (b) which policy or regulatory instruments authorise it;
- with reference to section 45(2) of the National Health Act, 2003 (Act 61 of 2003), (a) what wording does the Department rely on to motivate lending public equipment and (b) how does this wording authorise the transfer or loan of state assets to private entities;
- whether copies of any agreements entered into under section 45(2) between 2019 and 2025 can be provided; if so, (a) which of these agreements involve the lending of equipment and (b) what are the details of these agreements, including the (i) parties to the agreements, (ii) purpose and duration and (iii) obligations of each party?
I am informed by the Department of Health and Wellness that:
(1)(a) Section 27 of the Constitution of the Republic of South Africa, 1996 guarantees everyone the right to have access to healthcare services. In particular, section 27(3) provides that no one may be refused emergency medical treatment.
In circumstances where a patient’s life or critical health outcome may depend on access to specific medical equipment that is temporarily unavailable at a particular facility, the Western Cape Department of Health and Wellness may consider temporary compassionate use arrangements between facilities in order to safeguard patient care. Such actions are informed by the constitutional imperatives to protect life, ensure access to healthcare, and prevent the denial of emergency treatment.
(b) These decisions are not based on a single policy that authorises the routine lending of equipment. Rather, they arise from the broader legal framework governing healthcare services, including the Constitution, the National Health Act, 2003 (Act 61 of 2003), and the governance and asset-management provisions applicable to public health institutions. Where necessary, facilities apply existing governance processes and asset-management controls when considering temporary access to equipment in exceptional circumstances.
(2) (a) & (b) Section 45 of the National Health Act provides for cooperation between health establishments in order to advance healthcare delivery.
(3) The Western Cape Department of Health and Wellness does not maintain centrally aggregated agreements specifically for the lending of medical equipment to private facilities.
Where temporary equipment access has occurred, it has generally taken place on an ad hoc, clinically motivated basis, managed at institutional level to address urgent patient-care needs.
(a) The Department is not aware of formal agreements concluded specifically for the purpose of lending equipment between 2019 and 2025.
(b) Consequently, there are no agreements during this period that formally record the lending of equipment as a structured programme.
Where temporary access to equipment has occurred:
(i) the arrangements were coordinated between the relevant health establishments,
(ii) the purpose was to address an urgent clinical need affecting patient care, and
(iii) the equipment remained the property of the Western Cape Department of Health and Wellness and was returned once the clinical need had passed.
These instances are exceptional and reflect the collaborative ethos of the provincial health system.
