A vote of no confidence in Gauteng Premier David Makhura failed in the provincial legislature on Tuesday.
Twenty-seven members voted for the motion, 38 against it, six members were absent, and one abstained.
The motion was brought by the DA, and the EFF voted with them.
During the debate, Makhura was accused of not taking full responsibility for the Life Esidimeni tragedy.
Makhura said the province would conform with all the recommendations by former deputy chief justice Dikgang Moseneke, who presided over an arbitration hearing into the tragedy that resulted in the death of 144 mental healthcare users.
A similar motion was brought by the Economic Freedom Fighters in 2016, but the party failed to remove Makhura.
Addressing a small crowd outside the legislature earlier, DA Gauteng leader John Moodey said that, when someone took the responsibility of public office, it was a calling.
"It is not a career. In other words: You dedicate your life to the life of service to your people. That is the responsibility you have."
Moodey said it was not about self-enrichment and titles, but rather about enriching the lives of the people.
"When you have people such as David Makhura, who has a greater responsibility than anyone else in that legislature because he is the leader of Gauteng, when he shirks in his responsibility, then we need to question his integrity."
He said Makhura had failed to carry out his responsibilities.
"We cannot allow a person such as Makhura to remain in office."
He said the victims of the Life Esidimeni tragedy did not deserve to die in such a heinous manner.
"In the post-mortem reports, many of the results say 'natural causes', but we are aware that many of them died of kidney failure and many other things related to starvation and thirst."
He said the 144 vulnerable people had been tortured.
"Where was David Makhura when he was warned about this? Where was the oversight to ensure that these people were cared for?"