The Gauteng department of health needs alternative funding to deal with high volumes of foreigners who are treated in the province's hospitals, straining its already tight budget.

Tomorrow, finance MEC Barbara Creecy is expected to deliver her provincial budget after giving the health department the biggest slice of the cake for the first time last year.

The troubled department received R46.4bn, about 38% of the total budget for the 2018/2019 financial year.

The budget represented an increase of R4.4bn, followed by education at R3.4bn. It was the first time in Gauteng history that the biggest allocation did not go to education. The department also faces medical negligence litigation, which was about R20bn last year.

Gauteng health MEC Gwen Ramokgopa said there was no additional funding available for treating foreigners.

"The important thing is . where is the funding going to come from? In our equitable share, there is no allocation for the additional huge numbers. From our national grants there is no allocation.

"I am happy that the minister of health [Aaron Motsoaledi] has begun to look at this matter since the National Council of Provinces visited Gauteng and verified that indeed there is a huge need for resources to be allocated to the huge numbers. We are waiting for the national minister to give us guidance on this matter."

Yesterday, the Sunday Times reported that a circular was sent to heads of department saying "all non-South Africans citizens should be classified as full-paying patients, except refugees with valid documents".