More than a million poverty-stricken people who qualified for social security grants in Limpopo are not being paid because there is not enough money.
And a total of 112 clinics meant to serve poor rural communities do not have proper water supplies while 89 clinics do not have electricity. They rely mostly on generators and rudimentary sources of energy.
Putting parliament's ad hoc committee of health in Cape Town in the picture on Tuesday, Limpopo Health MEC Charley Sekwati said the province was too hamstrung by under-funding to help the poor to access state-sponsored pensions.
"There are slightly over a million people receiving social security grants in the province and about the same number waiting," said Sekwati.
As far as possible, his department tried to accommodate those qualifying for grants even though it meant using the health budget for welfare purposes, he said. However, it was not always possible to include everybody who qualified.
Concurring, Dr Hlamalani Manzini, head of the health and social welfare department, said: "The welfare vote is currently also under-funded. About half of the people who qualify (for social security grants) do not get them."
She said her department was one of the country's most underfunded, and this frustrated her and her team.
That they were "chronically underfunded" was evident in continuing unauthorised over-expenditure, standing at R410-million for the past four years.
Implications for the underfunding, explained Manzini, were that the province was "unable to properly clothe and provide good, nutritious food for our patients".
She made an impassioned plea for the province to be given more funding, urging portfolio chairperson James Nqulu to use his position to lobby for them.
Using a graph, she showed that in terms of the Equitable Share Formula to fund provinces, her department's share ran short by 2,5 percent in 2002/03 and 3,1 percent in the last financial year.
In terms of the medium-term expenditure framework, the department would experience a shortfall of 2,6 percent, 2,7 percent and 2,6 percent in the next three financial years.
Manzini noted that other challenges included stunted infrastructure development and stagnant service delivery. More money was spent on salaries than on the provision of service - "which is a cause for concern".
To prove the point, Manzini said that in the 1997/98 financial year the department spent 58,2 percent on personnel and 41,8 percent on service delivery. In 2003/04, 63,8 percent was spent on personnel costs and 36,2 percent on service delivery.
The portfolio committee heard that it had not been possible to increase salaries since 1997/98 and R100-million was needed for arrear payments.
Also, Limpopo received only R31,8-million of the allocated R500-million for the scarce skills and rural allowance introduced in July last year.