In 2018, the national government placed the North West Province under Section 100(1)(b) of the Constitution — the most severe form of national intervention, effectively taking over provincial functions. The trigger was the catastrophic collapse of the Health Department, where billions in irregular expenditure had been documented, critical medicine stocks had run out, and hospital infrastructure was crumbling.
The intervention was supposed to stabilise the province. Instead, it exposed the limits of national oversight when systemic corruption is entrenched. Years after the intervention began, the AG continued to flag billions in irregular expenditure at the NW Health Department. Supply chain processes remained compromised. Medico-legal claims mounted as patients harmed by negligent care sued the department. Hospital equipment went unrepaired.
The Section 100 intervention — constitutionally the most powerful tool the national government has to address provincial failure — proved insufficient when the underlying patronage networks remained intact. Staff appointed through cadre deployment continued to occupy key positions. The procurement systems that enabled looting were not fundamentally reformed. The NW Health crisis became a case study in why governance failures cannot be fixed by simply replacing one set of administrators with another.