Deputy Minister of Health Dr Joe Phaahla (left) with health MEC Sello Lehari (center) during an oversight visit at Mafikeng Provincial Hospital. (Photo: North West Department of Health/X)News & Features
12th November 2025 | Nthusang Lefafa
Mafikeng Provincial Hospital, a critical public healthcare facility in the North West, is facing a slew of challenges from broken and faulty medical equipment, long waiting times for surgeries, to chronic shortages of skilled nursing staff. Nthusang Lefafa reports on efforts underway to get the hospital up to scratch.
Mafikeng Provincial Hospital is ensnared in a web of systematic failures, according to a research report commissioned by the North West Provincial Legislature that was released earlier this year. The challenges gripping the hospital appear to stem from management weaknesses, financial pressures, poor planning and delays in procurement processes. Together, these factors combine to contribute to a perfect storm of recurring healthcare service disruptions.
“These persistent challenges highlight the need for strengthened oversight and accountability to ensure improved healthcare service delivery. These are not just statistics or policy concerns; they are everyday realities affecting people, patients, nurses, doctors, and the families who rely on this hospital for care,” stated the report from March 2025.
The Mafikeng Provincial Hospital is a regional, specialised hospital. It must, on a 24-hour basis, provide among others, health services in the fields of internal medicine, paediatrics, obstetrics and gynecology, and general surgery, trauma and emergency services, and short term ventilation in a critical care unit.
MEC Sello Lehari today welcomed the Deputy Minister of Health Dr Joe Phaahla as he conducted a health care facilities oversight in Mahikeng Provincial Hospital, Bophelong Psychiatric Hospital and Lonely Park Clinic. pic.twitter.com/XFHkf5uTyt
— North West Health (@NorthWestDOH) October 31, 2025
With a budget of R824 million for the current financial year, Mafikeng Provincial Hospital is meant to take care of a growing population at a time when all South Africa’s provincial health departments are grappling with having to deliver health services with very tight budgets.
A business case study by the provincial health department that was presented in the Provincial Legislature in September 2024 points out that the North West province has 7.1% of the national population but receives only 6.2% of the national provincial health budget. Consequently, the provincial budget for a patient that does not have medical insurance is 13% lower than the national average.
Even when conditional grants have been excluded and only the equitable share allocation is considered, the North West Department of Health still receives 11% less than the national average budget per person, according to the case study.
“Over the years, the department has been raising the same concerns that the budget allocation is not in line with the department’s needs and the baselines should be reviewed,” the document produced by the department’s acting chief financial officer stressed. It added that the budget allocation does not increase in line with inflation nor does it consider the historical spending patterns of the department.
The document warned that budget constraints will result in substandard or deferred care, causing poorer outcomes, and this will mean poor patient satisfaction.
Unsatisfied patients
One such patient is Gopolang Moopeloa. He told Spotlight he spent more than six days at Mafikeng Provincial Hospital in 2019 without seeing a doctor after being admitted for two fractures on his left leg. “I was only given pain killers,” he claimed. “When I asked a nurse about the prospect of seeing a doctor, I was told that they did not know anything about his whereabouts,” Moopeloa alleged.
When the wound on his fractured left leg began to fester, he said he requested to be transferred to a nearby private health facility. “I could not lay in a hospital bed and watch my entire leg rot,” Moopeloa said.
Moopeloa said he racked up more than R260 000 in medical fees at the private hospital. This included costs for admission, a private ambulance, and emergency surgery. He has filed a case of clinical mismanagement against Mafikeng Provincial Hospital, which is currently being reviewed by the health ombud, according to correspondence dated June 2025 and seen by Spotlight.
Earlier this year, Reneilwe Moeti said she spent three months in Ward 3 at Mafikeng Provincial Hospital due to pregnancy related complications. Moeti told Spotlight that there was no hot water reticulation in the ward and hospital staff had to bring hot water in buckets so that patients could clean themselves in washing basins.
She also described the treatment from nurses as “very bad”. Moeti added: “In some instances, breakfast would come at 10:30. Sometimes we had to clean other patient’s vomit on toilet seats even though there were cleaners at the facility. Tissue paper would frequently run out in the toilets and one evening I slept on dirty linen.”
A lack of cleaning equipment was also identified in the Provincial Legislature research report. “Poor hygiene standards increase the risk of infections and undermine healthcare quality,” stated the report.
Provincial health spokesperson Tebogo Lekgethwane told Spotlight that Mafikeng Provincial Hospital has a cleaning schedule for all areas, including the ablution facilities and a cleaning checklist that is used daily to monitor routine cleanliness. The department denied that the hospital has ever run out of toilet paper.
Filling posts
In a bid to stabilise hospital management, the North West health department has moved to make key appointments during the current financial year, said Lekgethwane.
The hospital has employed various assistant nursing managers, a nursing service manager, and a corporate service manager. 104 posts for staff nurses have been filled while there are still six vacant posts. 15 vacant posts for professional nurses have been reserved for nurses who are currently at nursing college.
A position for a senior clinical manager was advertised, and recruitment is underway. Interviews for a deputy-director for quality assurance have been conducted.
A crucial senior post to be filled is that of CEO. Lekgethwane said this job post will be advertised soon, but could not confirm a clear timeframe. In the interim, Mafikeng Provincial Hospital has an acting CEO.
Lekgethwane also said that Mafikeng Provincial Hospital has developed a plan to deal with infrastructure challenges. “The infrastructure unit has developed a comprehensive master plan to address the infrastructure challenges.” These, he said, include upgrading of the kitchen, laundry, mortuary, renal unit, hot water reticulation of wards 7, 8 and 9 and renovating ward 3. Lekgethwane was unable to give clear timeframes on when these projects would be completed.
To deal with ageing and broken medical equipment, he said that there is a costed equipment plan. “There is a fully functional health care technology department, supported by provincial offices, with technicians that are dealing with maintenance of equipment daily.”
In terms of surgical backlogs Lekgethwane said the hospital was experiencing pressure because the Gelukspan and General De La Rey district hospitals were upgrading their theatres. “The department is implementing a catchup plan on weekends and paying specialists for overtime,” he said.
The way forward
Karabo Magagane, the chairperson of the North West Legislature Portfolio Committee on Health and Social Development, told Spotlight that the problems plaguing Mafikeng Provincial Hospital “are a serious concern for the health committee”. More so because many of these issues have been flagged repeatedly during previous oversight visits and in past quarterly reports, she said.
“The committee is of the view that until the department strengthens its management systems, holds officials and to a great extent project contractors accountable for underperformance, the hospital will continue to experience recurring operational and service delivery challenges,” said Magagane.
She reckoned that turning the situation around at Mafikeng Provincial Hospital will require a multi-pronged approach. This must be “anchored in accountability, effective planning, and targeted resource allocation,” Magagane added.
Beth Engelbrecht, adjunct professor and leadership and governance lead of the North-West University School of Medicine, told Spotlight that efficient district health services would help ease the strain on Mafikeng Provincial Hospital.
She said it is surrounded by level 1 hospitals and community health centres that struggle with infrastructure and capacity constraints, which limits their ability to perform optimally.
“Patients therefore flock from across the 5 sub-districts to the Mafikeng regional hospital. Its resources are therefore further stretched in an already limited resource environment. The recommendation in this regard is that District Health services should be optimised to buffer inappropriate load onto the hospital. This should include theatre capacity,” said Engelbrecht.
Regarding staffing challenges, she said that while every hospital in the country would indicate a need for more staff, the question to be answered is to what extent every staff member is focusing on their role and purpose and is creating an environment where people want to work and be happy and feel free to innovate and bring improvement. “A culture of fear and playing politics reduce motivation and creativity,” she said.
Regarding leadership and governance challenges, she said it is heartening to hear several key managerial positions have now been filled or are in the process of being filled. “A recommendation is to invest in leadership development across all levels in the hospital, both clinical and administrative support components towards a new culture of care and optimising resources with concomitant accountability,” said Engelbrecht.
To ensure leadership stability at the top, she said leadership across all levels in the hospital must take ownership for a changed culture that is patient centered.
Engelbrecht added that organised labour must see its role as a partner for quality and support efforts for order and improvement.
Community steps up
Tumo Mmolawa, chairperson of a community-based group representing healthcare users who visit Mafikeng Provincial Hospital, told Spotlight that a community desk was set up so that there is a direct relationship between the hospital, patients and the health department.
“We have a large number of negligence cases where patients are left with pain, trauma, depression and more,” he claimed.
Mmolawa said the group will be pushing for a round table discussion with various stakeholders, including the provincial health department, and the office of health MEC Sello Lehari to come up with solutions for some of the problems facing Mafikeng Provincial Hospital.
Mmolawa said he was hoping to speak to Deputy Minister of Health Dr Joe Phaahla during his oversight visit of Mafikeng Provincial hospital on 31 October. He claimed he was told by the hospital’s leadership that the deputy minister did not come to meet the community but was on an official visit.
Speaking to the SABC about Mafikeng Provincial Hospital, Phaala said: “There are a number of areas which need urgent maintenance and improvement. We have been discussing how we will accommodate patients whilst we do renovations on the wards. We have decided to erect temporary structures in the meantime.”
Phaahla’s oversight visit of health facilities in Mafikeng forms part of his programme to monitor the state of healthcare delivery across the country.
