She had found instances of unprofessional conduct from staff, Madonsela told politicians and senior officials on Thursday in discussions about her unannounced visits to health care facilities.
An older woman at a clinic had told her she would consider staying home and dying, instead of being treated badly by staff.
Madonsela said staff had attitude problems at a clinic in Trompsburg, a clinic in Heidedal and the National Hospital in Bloemfontein.
Rural patients had complained about the transport ambulances which took patients to bigger hospitals for specialist attention.
Some said they got up at 3am to try and catch an ambulance, because nobody really knew when they would arrive, if at all.
Madonsela urged senior officials to monitor staff attendance, because she got the feeling patients were waiting because health care workers were arriving late for work.
Madonsela commended two senior health care workers, at two clinics, for their outstanding work and care, as attested to by patients.