The Gauteng Department of Health says it will move within the next two months to fill nearly all vacant hospital CEO posts, as pressure mounts over a leadership crisis that has left 13 of the province’s 37 public hospitals without permanent heads.
Speaking with The Star, the department acknowledged the scale of the problem but said the delays stem from a long-standing shift in hiring policy, aimed at improving stability and retaining skilled leadership.
“The Gauteng Department of Health has been exploring approaches to convert hospital CEO positions from contract appointments to permanent positions. This has been the Gauteng Department of Health's position since 2015 and has affected the retention of skilled hospital CEOs,” the department said.
It added that the move towards permanent posts is intended to strengthen institutional stability, arguing that contract-based roles have discouraged experienced candidates.
“This post-convention aims to create stability for the institutions, as contract positions have deterred skilled hospital CEOs due to the nature of the job.”
Despite the widespread reliance on acting leadership, the department maintains that hospital performance has not been compromised.
“Public servants in acting positions perform functions like those of an incumbent in a permanent position. They are provided with delegated powers to perform these functions under the Public Finance Management Act (PFMA). Therefore, standard care protocols, patient care, patient planning, and clinical guidelines are applied consistently, irrespective of position,” it said.
The department further pointed to improvements in key performance indicators, stating that outcomes have strengthened under the current structure.
“As reflected in our annual report, the Department of Health's performance has improved across a vast number of key performance indicators, utilising the current workforce.”
However, the situation has drawn sharp criticism from the Democratic Alliance (DA) Gauteng Shadow MEC for Health, Jack Bloom, who described the vacancies as a serious failure of leadership.
“One in three Gauteng public hospitals lack firm leadership as they do not have a permanent CEO,” Bloom said.
The issue, he noted, was confirmed in a written reply by Gauteng Health MEC Faith Mazibuko in the provincial legislature.
According to Bloom, some hospitals have been operating without stable leadership for years, with Pholosong Hospital standing out as the worst case, having gone nearly five years without a permanent CEO.
“It is unacceptable that the Gauteng Health Department has failed to appoint permanent CEOs to so many hospitals. Acting CEOs, no matter how capable, cannot provide the long-term leadership to turn around struggling institutions,” he said.
Bloom also criticised what he described as a broken promise by Gauteng Premier Panyaza Lesufi, who had previously committed to filling all CEO posts by December 2021.
The vacancies, he said, have been driven by a combination of resignations, transfers, promotions and deaths, but warned that the continued reliance on acting appointments is affecting service delivery.
“Meanwhile, patients endure long waiting times and deteriorating care,” he said.
At Tembisa Hospital, for example, the CEO position has remained unfilled since August 2022 following the suspension of former CEO Ashley Mthunzi over corruption allegations. He later died in April 2024, yet the post remains vacant.
In response to mounting pressure, the department has now committed to fast-tracking appointments.
“In the next two months, the department will advertise, shortlist and fill almost all these vacant positions to create stability in hospitals and administration. Filling these key positions is the department's priority for achieving stability,” it said.
“These positions will be advertised as permanent as part of the new retention strategy.”
The Star
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