A new, state-of-the-art haematology unit at the Port Elizabeth Provincial Hospital is standing idle because it cannot employ nurses to ensure care for patients with blood cancers.

This is the latest example of how the Eastern Cape health department's budget problems are affecting service delivery.

It follows complaints by the South African Medical Association that doctors have not been paid, and a warning from health activists that rural facilities in the province are teetering on the brink of collapse.

The R20m unit was launched by the Eastern Cape's head of health, Siva Pillay, on May 9, supposedly heralding an end to the arduous journeys patients with blood disorders have had to make to get life-saving treatment in other provinces. But without nurses, who are appointed by the provincial health department, it cannot open its doors.

The Eastern Cape has one of the country's highest incidences of bone marrow and blood cancers, yet until now has been unable to provide the highly specialised care the sickest require, said the hospital's head of haematology, Neil Littleton.

Patients needing stem-cell transplants or high-dose chemotherapy need to be admitted to isolation units, as the treatment virtually destroys immune systems, making them vulnerable to the slightest infection.

Aloe Igazi, a nongovernmental organisation, raised funds for six isolation units, a six-bed general ward, and an outpatients unit with a chemotherapy pharmacy.

The department promised the haematology unit 22 nurses, but despite having advertised and recruited staff, it had yet to appoint them, Dr Littleton said.

"Bhisho will not employ them because there is a moratorium (on hiring) . because there is no money. The unit is standing empty, and I refuse to move in until they employ the right staff ," he said.

Attempts to obtain comment from the department yesterday were unsuccessful.

Daygan Eagar, a researcher with advocacy group Section27, said the main problem was the province's ballooning costs for healthcare personnel, many of whom held administrative posts.