The preponderance of the South African populace has no access to adequate health care. Consequently, the Government concluded a requirement subsist for a National Health Insurance (NHI) scheme analogous to the National Health Service (NHS) in the United Kingdom. The study was undertaken in Gauteng provincial hospitals in Johannesburg, South Africa. The attainment of the objective is conditional on execution of value added services. Hence, it is critical to augment quality and efficiency of effort whilst containing costs. A unique and capable methodology ascertained in health care establishments is Lean, an improvement attitude and an array of philosophies initiated by the Toyota Motor Company. The research exposed Lean as appropriate in multifaceted knowledge work environment comparable to assembly-line manufacturing. Executed decorously, Lean transmutes the manner organizations behave and initiate a voracious pursuit for improvement. The paper delineates Lean philosophies as deliberate, signifying the vital vibrancy of Lean. The fundamentals isolated were, postures on continuous improvement, value creation, and unity of purpose, reverence for employees, visual tracking, and malleable procedure. The rationale of the paper is the discussion and exposition for creating a procedure for evaluating and improving Gauteng provincial hospitals. The mechanisms encompass a structure or exemplar for gauging, assessing, analysing and improving the hospitals.