The department of defence’s presidential medical unit spent R472.7m on emergency and non-emergency medical care for current and former presidents, deputy presidents and the minister of defence from the 2019/20 financial year to the end of July 2024.
This was funded by taxpayers since the unit’s budget is allocated from the department of defence.
DA spokesperson for defence Chris Hattingh criticised the expenditure as “excessive”, especially considering the department’s critical underfunding, which has resulted in SA soldiers facing dangerous conditions and inadequate support.
“The red carpet treatment, which is now even extended to the minister, is a kick in the face for our suffering soldiers,” Hattingh said in an interview with Business Day.
A spending breakdown shows that in 2019/20, expenditure totalled R80m, followed by R67m in 2020/21, R88m in 2021/22, R92m in 2022/23, and R97m in 2023/24. Starting from April 1 2024, the budget was set at R49m.
During this period, Cyril Ramaphosa was the serving president, supported by two deputy presidents, David Mabuza and Paul Mashatile. Mabuza faced health challenges that required him to travel to Russia for medical consultations, which he claimed were at his own expense.
Mashatile collapsed from the heat while delivering an address in Limpopo in September and was taken to hospital.
Former presidents include Jacob Zuma and Thabo Mbeki, and past deputy presidents Phumzile Mlambo-Ngcuka, Baleka Mbete, Kgalema Motlanthe and Mabuza.
The cost of the presidential medical care was disclosed in a written responses from defence minister Angie Motshekga to questions posed by Hattingh in parliament.
Hattingh raised concerns about the coverage of both emergency and non-emergency medical care. He highlighted that the presidential medical unit did not recover the funds from Parmed, the medical aid for MPs, members of provincial legislatures and judges.
Motshekga stated that the unit provided medical assistance to current and former heads of state and deputy presidents, as well as the serving minister of defence and visiting heads of state as directed by the department of international relations & co-operation.
“The provision and cost of medical services are not categorised based on whether they are emergency or non-emergency,” Motshekga said, adding that the SA Military Health Service, under which the presidential medical unit falls, did not claim from the medical aid of the principal for costs incurred.
The unit had 65 members — including one commanding officer, 12 medical officers, four nursing officers, 34 operational emergency care practitioners, three human resource practitioners and five logistical personnel — and operated from four provinces, Motshekga said.
Hattingh said the unit had about 45 luxury vehicles designated for exclusive presidential use. In the past these vehicles were reserved solely for emergency medical situations involving presidents, past presidents and their families. The benefit had now been extended to the minister of defence, who, Hattingh noted, was a member of Parmed and was no different from any other minister.
“It is very necessary to have such a unit available for emergencies but it appears that this has now been extended to the full and comprehensive medical care, including, for example, a hip replacement. There is no reason why the presidential medical unit should be providing comprehensive medical care to all these people when they have medical aid coverage.”
In the rest of the world only emergency medical care was provided.
“I don’t think it was ever the intention that the presidential medical unit should be providing comprehensive medical care at taxpayers’ expense,” Hattingh said.
“Why should a former president or deputy president and all their wives and children be supported by the presidential medical unit while they belong to a medical aid?
“What was originally intended — for the presidential medical unit to be for emergency medical care — has migrated to comprehensive medical care and now the minister of defence has been included although she is a Parmed member.”
Hattingh noted that the unit was involved, for example, whenever former Zuma travelled with his blue-light brigade.
The spending on medical costs should be seen in the context of the declining budget of the department of defence, which has struggled to pay its personnel. This led to unauthorised expenditure of R3.37bn in the 2023/24 financial year.
The department has for many years voiced concerns about its inadequate budget, stating that it lacked sufficient funds to maintain and upgrade its equipment, among other needs.
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