Healthcare provision depends on social factors, such as income levels and education, Gauteng health MEC Hope Papo said.
Papo told the Gauteng legislature that the health status of the population was not solely depended on just the health of the citizens.
"Provision of quality health care is also dependent on... income levels, educational levels, access to housing, sanitation, and nutritional status," Papo said, presenting his budget vote.
"That is why government programmes are always interwoven to address all these challenges."
About 84% of the population did not have access to medical insurance, he said. "Yet more than 80% of the resources, both financial and human, are concentrated in the private health sector, which is accessed by only 16% of the population..."
Disease burden and poverty
Papo said the public health sector was faced with a quadruple disease burden which could be traced to poverty.
These were high levels of trauma, HIV and Aids, tuberculosis, and non-communicable lifestyle diseases, such as hypertension and sugar diabetes.
When the current administration took over, the Gauteng public health system was faced with problems including poor financial management, a shortage of essential drugs, poorly maintained hospital equipment, and inadequate provision of emergency medical services.
The department last received an unqualified audit opinion in the 2006/07 financial year.
A turn-around strategy was then adopted by the Gauteng provincial executive council in July 2012 to address the problems.
He said the department was finalising the establishment of a health processing centre to ensure compliance with supplier payments within the required 30-day period.
For the financial year ending March 31, the department disclosed accruals to the value of R3.8 billion. As at January 31, accruals to the value of R4.2bn had been settled. Papo said his budget of R27.5bn was underpinned by the assumption that there would be no additional allocation over the medium-term expenditure framework.
Revenue to the tune of R61.8 million had been collected from other government departments and R94m from medical aid schemes in the 2012/13 financial year. Papo said his department was also dealing with supply chain problems.
"We have begun to negotiate prices for all new contracts with the aim of reducing prices which are not market-related and thus uncompetitive."
The department reviewed its policy on public service professionals employment conditions.
"Where we have employed health professionals we expect them to give us value for what we pay for. In simple terms, no health professionals are permitted to perform remunerated work outside of the public service during official and regular working hours," he said.