GAUTENG premier Nomvula Mokonyane has admitted - after months of excuses - that the health department in South Africa's economic hub has lost control of its finances.
The provincial treasury will step in to clean up the mess.
The health department's struggle for years to manage its finances has resulted in patients dying while waiting for essential treatment.
Admitting the department faced "persistent challenges", Mokonyane announced yesterday that treasury officials would work with the department to build "transparent financial management".
An administrator will be appointed by the end of this month.
The National Treasury stepped in a year ago and brokered agreements with health and finance MECs to fix financial problems in the health department.
National Treasury was meant to assist with supply chain management difficulties.
Mokonyane made her announcement almost four months after the Special Investigating Unit recommended, in an interim report to parliament, that R16.5-million be recouped from corrupt former senior Gauteng health officials.
The SIU was investigating R1-billion tender fraud involving 10 transactions in the department.
In spite of the high-level interventions, problems have persisted.
Gauteng health has made headlines in the past year for failing to pay suppliers. Yesterday, Mokonyane admitted the department owed money to 883 suppliers.
The vice-chairman of the South African Medical Device Industry Association, Jeff Hampton, said suppliers were owed millions.
"Despite promises made at a meeting two weeks ago at the public service commission, subsequent meetings had not transpired.
"Some of the debts run back three or four years," he said.
Details of the implementation of the treasury rescue are yet to be finalised, but Mokonyane insisted the department was not being placed under administration.
"Health MEC Hope Papo will still be running the department.
"We are building the management capacity to run the department [with] effective, efficient financial management," she said.
The intervention is allowed under Section 18 of the Public Finance Management Act. It allows provincial treasuries to investigate financial management and internal controls.
The act allows treasuries to withhold funds to address serious breaches.
The decision to bring in "high-level expertise", said Mokonyane, had been made at an executive council meeting of the Gauteng cabinet on Wednesday.
The administrator would work with teams in the department to deal with challenges in hospital management, human resources, financial management and communication, she said.
One of the most recent scandals involving the department was a severe shortage of medical staff at Johannesburg's Charlotte Maxeke Hospital.
Understaffing - across almost the entire hospital - had been caused by frozen posts and the repeated failure by provincial officials to respond to pleas by senior doctors for more skilled medical personnel.
Papo said yesterday that his department was continuing to fill critical posts at all hospitals in Gauteng.
Finance MEC Mandla Nkomfe said the health department had sufficient funds to pay its bills.
But Section 27 researcher Daygan Eagar said it was difficult to ascertain whether this was true.
"They say that every year," said Eagar.
"What happens is each year the department of health starts out with money owed to service providers from the previous year.
"Because it has not taken old debts into account in its new budget, it has to pay previous years' debts from current funds."
Eagar said the health department needed a budget that took debt from previous years into account.
Even as Mokonyane made her bold announcement about transparency, both she and Papo avoided answering questions about the release of a forensic report on the management of the medicine supply depot in Auckland Park, Johannesburg.
"I have heard it reveals terrible corruption but they are keeping the report under wraps," said DA Gauteng spokesman on health Jack Bloom.
Papo would say only that the report had been read.
Mokonyane said Papo would this week announce disciplinary measures against officials suspected of mismanagement and fraud in the department.
Papo said treasury officials would be examining contracts to ensure the province was paying the correct prices for services and medicines.
Mokonyane and Papo said one of the ways to cut costs would be to reduce overtime paid to health staff.
"Administrators and managers will need to do their work in working hours," said Mokonyane.
Papo promised that doctors and nurses would not be affected by cuts in overtime pay.