The Democratic Alliance (DA) calls on provincial departments of health to urgently settle the more than R11 billion owed to the National Health Laboratory Service (NHLS), as mounting debt and governance failures continue to undermine critical diagnostic services relied upon by millions of South Africans.
The NHLS provides essential public health laboratory testing, including HIV and TB diagnostics, cancer pathology services, and forensic toxicology testing linked to medico-legal investigations. When the system fails, it has devastating consequences for patients and families.
A recent case highlighted by the Sunday Times revealed that an 18-month delay in a toxicology report has left the family of Midesh Singh unable to obtain a death certificate, prolonging their trauma and preventing closure.
Financial pressures on the NHLS continue to escalate due to unpaid provincial accounts. The NHLS previously told Parliament that provinces owed R8.9 billion in March 2025, while the 2024/25 NHLS annual report recorded R9.2 billion owed as of 31 March 2025. According to reports, the debt has now risen to R11.3 billion as of 31 January 2026.
The 2024/25 annual report shows major outstanding debts from several provinces, including:
- KwaZulu-Natal: R4.02 billion
- Gauteng: R1.9 billion
- Eastern Cape: R1.33 billion
- Free State: R523 million
- Northern Cape: R475 million
Notably, according to the annual report the Western Cape does not owe the NHLS.
While financial instability is a major concern, governance failures also persist. The Auditor-General has flagged irregular expenditure and failures by NHLS management to investigate financial misconduct or discipline responsible officials, with procurement processes frequently bypassed.
Last year, the DA also lodged a complaint with the South African Human Rights Commission (SAHRC) after cancer patients in Gauteng were forced to wait up to three months for test results, while private laboratories deliver results within approximately 48 hours.
In August 2025, the NHLS announced the procurement of high-output analytical instruments for laboratories in Pretoria, Johannesburg and Cape Town, alongside the hiring of additional technical staff to help reduce backlogs.
The DA will submit parliamentary questions to determine:
- the current backlog in forensic toxicology and cancer testing,
- whether the new equipment and staff have reduced delays,
- the status of the NHLS partnership with PathCare, and
- the updated provincial debt owed to the NHLS.
Provincial governments must pay what they owe. The continued underfunding of the NHLS places patient care, forensic investigations, and public health surveillance at risk. South Africans deserve a laboratory system that is properly funded, efficiently managed, and capable of delivering timely results.