The African National Congress Youth League's calls for Premier David Makhura to step down are seen as part of a campaign by the provincial league to destabilise the provincial ANC leadership.
The league led by chairperson Matome Chiloane has been at loggerheads with the Provincial structure and the rift is expected to intensify ahead of the national succession battle.
On Thursday, the youth league opened a case of corruption and culpable homicide against former health MEC Qedani Mahlangu.
Mahlangu stepped down this week, just hours before the health ombudsman revealed that at least 94 patients had died after being moved from the healthcare facility to 27 non-government organisations across the province.
Qedani 'disgraceful'
The league said the findings in the report on the matter revealed a clear case of negligence and a ''massacre for profit'' by the former MEC, whom they described as disgraceful.
"Needless to say this is not the first time Qedani shows total disregard for the vulnerable, and is entangled in such a horror. As far back as 2010 new born babies died in hospitals under her watch," said the league.
"The entire leadership of the Gauteng provincial government led by Premier David Makhura allowed the MEC to arrogantly continue misleading the people of Gauteng and families of victims," said the ANCYL.
It also called for "much more" to be done than just the resignation of an MEC.
In defending the statement, Chiloane said it was unfortunate that people thought it was being done to settle political scores.
"We are not being opportunistic; we are fighting for the families,"
Chiloane said the league had wanted to wait for the final report into the tragedy to be released before sharing its views on the matter.
Angry ANC members
Chiloane said Makhura needed to appeal to his own conscience and step down.
"We will forever remind him that when he was premier 94 patients died," said Chiloane.
Some of the comments contained in the statement released on Wednesday have infuriated members of the party.
A youth league PEC member who refused to be named told News24, he agreed with Chiloane's position on Mahlangu but that speaking out against Makhura was unwarranted.
"These guys are finishing off the ANC; they are killing the party themselves with such actions," he told News24.
A member of the ANC in Gauteng who also wanted to remain anonymous questioned the lack of consistency in the league's comments.
"Why haven't they said anything about Marikana? You can't be inconsistent with your principles," he said.
Social media battle
Chiloane also got into a public spat on Facebook with economic development MEC Lebohang Maile. The MEC raised concern over the league chair's utterances on Facebook.
"This is what makes people think that the ANC is for fools," Maile wrote.
He also said the "chap" would have to explain himself to the province's PEC. This is seen as a reference to Chiloane.
Matome hit back writing that he was not bothered by "cheap views from a so-called leader on social media".
"It just demonstrates that there is a leadership vacuum in Gauteng," said Chiloane.
Maile refused to comment on the incident saying he does not want to discuss it in the media but suggested it will be raised at the party's PEC this weekend.
"I can't have an exchange with them in the media. The Facebook exchange is regrettable but I will engage with them at a formal structure of the ANC,'' said Maile.
Gauteng ANC spokesperson Nkenke Kekana said the youth league would be given an opportunity to explain itself over the weekend.
"What the EFF and the youth league are calling for is diverting attention from the real issue," said Kekana.
He said the real issue was to improve the health system in both Gauteng and SA to the benefit of the people.
He said the issue of mental health was a serious and complex one that needed both families and governments to work together.
The ANC at national level has also shared its views on the matter: It released a statement expressing concern over the league's utterances.
"ANC finds the statements of the ANCYL in Gauteng atrocious, despicable and unbefitting not only members of the ANC but humanity at large," said the party.
All structures of the movement should be focusing their energies on supporting the bereaved families, stated the statement.
The ANC said this was not the time for squabbling around leadership positions and showcasing unfortunate public displays of disunity.