Business Day reported on 14 June that the outstanding debt of the National Health Laboratory Service laboratory (NHLS) had reached about R11bn in March 2026. Gauteng reportedly owed about R3.3bn and KwaZulu-Natal about R3.94bn, including debt from previous years.
The amount includes debts for critical services already provided to the public health system and reflects failure in financial governance, weak coordination and poor accountability across parts of government.
“Unpaid laboratory bills can contribute to delayed diagnoses, disrupted care and weaker disease surveillance. Rural and under-resourced communities are often the most exposed when public health systems come under pressure.”
The NHLS warned Parliament that delayed provincial payments are undermining its ability to replace ageing equipment, fill critical vacancies, strengthen disease surveillance and modernise IT systems.
A financially weakened NHLS could struggle to detect outbreaks, monitor antimicrobial resistance and respond to emerging health threats.
The Portfolio Committee on Health said oversight must shift to action, with provinces required to submit repayment plans and face consequences for non-payment. National Treasury intervention, including ring-fenced or direct funding, may be considered. The committee will seek quarterly reports, stressing that reliable laboratory services are essential to protect patients and public health.