The Gauteng legislature warned that prolonged waits for surgery can have serious consequences for children
Children needing surgery at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) are waiting up to 30 months for procedures, with more than 200 young patients currently on the hospital’s paediatric surgery waiting list.
The figures were revealed in Gauteng Health MEC Faith Mazibuko’s written response to questions submitted in the Gauteng Provincial Legislature.
The reply outlines the extent of the backlog, the reasons behind lengthy waiting times and the department’s proposals to reduce delays.
The response shows that 217 children are currently waiting for surgery across various categories, with some expected to wait more than a year before receiving treatment.
According to the legislature reply, the largest group on the waiting list comprises 100 children awaiting surgery for undescended testis (orchidopexy), with an average waiting time of 14.8 months.
Another 35 children are waiting for inguinal hernia or hydrocele surgery, where the average wait is 10.2 months, while 28 children requiring umbilical, ventral or epigastric hernia procedures face waits of 10.6 months.
Children needing hypospadias, penile reconstruction or penoplasty are expected to wait 13.4 months, while those awaiting circumcision or treatment for phimosis face average waits of 11.3 months.
The shortest average waiting period is 8.1 months for other paediatric surgical procedures.
The department also disclosed that the longest individual wait over the past three years involves a child awaiting a left inguinal hernia repair.
“The patient was born on 25 February 2023, was booked on 27 November 2023 for surgery but has not been operated on to date,” the response states.
The department said the backlog is caused by several pressures on the health system.
“The reasons for long waits are multifactorial: limited elective paediatric theatre capacity, emergency and neonatal surgical load, anaesthetic constraints, availability of subspecialist expertise and cancellation of elective lists when urgent cases require theatre access.”
It also noted that emergency surgical cases increasingly consume operating theatre time.
According to the response, emergency surgeries increased from 521 in 2023 to 758 in 2025, resulting in elective operations being postponed.
“Emergencies take theatre time, cancel elective lists, and use ICU beds. As emergencies go up electives get bumped.”
The department added that shortages of theatre staff, anaesthetists and post-operative beds have further reduced the number of elective procedures that can be performed.
It warned that lengthy waiting lists can also result in children initially booked for elective surgery deteriorating and eventually requiring emergency treatment.
The legislature’s response warns that prolonged waits can have serious consequences for young patients.
It lists “physical deterioration”, developmental delays, psychological distress and poorer surgical outcomes among the risks associated with delayed treatment.
According to the Gauteng Health Department, conditions such as hernias can worsen while children wait for surgery, while delayed procedures may increase the risk of emergency admissions and reduce treatment success rates.
The response also highlights the impact on families, including parental stress, financial pressure, missed school and disruption to family life.
Despite the growing waiting list, the number of paediatric surgeries performed at CMJAH has remained relatively consistent.
The hospital completed 2 078 surgeries in 2022, 2 032 in 2023, 2 120 in 2024 and 2 077 in 2025. Between January and the end of May this year, 740 procedures had been performed.
The department said total surgeries remained stable between 2 032 and 2 120 cases annually from 2022 to 2025, although elective operations peaked in 2023 before declining in subsequent years.
The MEC said one of the key interventions needed is a dedicated emergency paediatric surgical theatre with dedicated anaesthetic and nursing support.
“A protected emergency paediatric theatre list would improve access for urgent cases, reduce cancellations of elective paediatric surgery, protect elective operating time and help prevent further growth of the waiting list.”
It cautioned that “without additional protected paediatric surgical theatre time, adequate anaesthetic cover, and reliable access to staffed operating lists, the waiting list is unlikely to decrease meaningfully despite the best efforts of the paediatric surgical team.”
Meanwhile, DA Gauteng health spokesperson Madeleine Hicklin said the legislature reply revealed “a widening crisis of delayed care” at Charlotte Maxeke Hospital, where patients are left “in prolonged pain and uncertainty while essential treatment is delayed”.
The party said it would table follow-up questions to Gauteng Health MEC Faith Mazibuko to establish why recommendations for a dedicated emergency paediatric surgical theatre, together with dedicated anaesthetic and nursing support, have not yet been implemented.
According to Hicklin, while the department’s explanations for the delays may be understandable, “it is difficult to accept that a child should be left for almost three years with a condition that could become critical or life-threatening”.
The DA warned that untreated hernias can become life-threatening if complications develop.
“If a hernia becomes incarcerated, part of the intestine can become trapped, causing severe pain and obstruction. If it becomes strangulated, blood flow is cut off and the tissue dies. Without urgent surgery, this can lead to perforation, sepsis and death,” Hicklin said.
The party argued that delayed treatment is not isolated to Charlotte Maxeke Hospital, citing the case of a patient at Tambo Memorial Hospital who has reportedly been waiting for more than a year for hip surgery while renovations continue at the facility.
“The DA condemns the neglect of essential surgical care and calls for urgent intervention and accountability to relieve the suffering of patients across Gauteng hospitals,” Hicklin said.
