Local government is in the midst of fundamental change and restructuring. Long before this process is completed a large chunk of provincial health services and personnel will be grafted on to the newly formed local authorities. Over 50 000 health workers will be transferred from the provincial public service to local authority staff. Overall, local authority health budgets will increase more than five fold and there will be an injection of around R5 billion for health services into local government revenue. Local government will be responsible for the running of all primary level services including 24-hour emergency services and level 1 hospitals.