Gauteng Health Seeks to Recover R4.6bn in Patient Fees, Citizens React to Foreigners Owing Billions
- The Gauteng Department of Health confirmed that it is owed R4.6 billion in unpaid fees from various patients, including foreign nationals
- The department has since implemented measures to recoup the money, which is also owed by other State departments
- Social media users weighed in on the department's plans, with some bringing up the looting at the Tembisa Hospital

Source: Getty Images
Byron Pillay, a Briefly News journalist, has dedicated a decade to reporting on the South African political landscape, crime, and social issues. He worked as a newspaper journalist for 10 years before transitioning to online.
GAUTENG – Foreign nationals are among the numerous patients who owe the Gauteng Department of Health billions in unpaid fees.
During a recent appearance before the Portfolio Committee, the department noted that it was taking steps to recover R4.6 billion in outstanding patient fees.
At least R2.4 billion is owed by self-paying patients, which includes foreign nationals, while the remainder of the debt is made up of intergovernmental obligations and outstanding payments from medical schemes.
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Chief Director details how the debt accumulated
Addressing the current issue, Siyabonga Jikwana, the Chief Director of Health Economics and Finance at the Gauteng Department of Health, explained why the debt was so high.
Jikwana said that one of the reasons was that some patients didn’t have any form of identification when they showed up at public institutions. He explained that when the department reached out for the payment, they didn’t have any legal recourse to be able to do so.
He explained that the second part of the problem was that a lot of patients were coming from neighbouring countries, like Zimbabwe and Mozambique. He added that they just showed up at healthcare institutions, and the healthcare department did not invest in systems where they could identify patients which patients were locals, and which were foreigners when they entered the institutions.

Source: Getty Images
What steps has the department taken to recoup the funds?

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Jikwana also confirmed that the department has since appointed five debt collectors to help recoup the unpaid fees.
“Our job is to ensure that we recover as much as possible by all means. We started working with them (debt collectors) five months ago, and during this period, they have managed to collect more than R20 million, which is a significant improvement in our revenue collection,” he added.
He further stated that processes were also underway to recover intergovernmental debt owed by entities such as the Road Accident Fund, the Department of Justice, the South African Police Service and Correctional Services, as well as by other provinces.
South Africans weigh in on department’s debt
Social media users weighed in on the amount of money outstanding, and while some questioned how they would recover it, others brought up the billions looted from the Tembisa Hospital.
Mmaleshoane Mokgoatjana asked:
“Where will they get the foreign nationals, because they are untraceable? Oh, konje, South Africans will have their hard-earned money deducted to pay for the foreigners.”
Madala F Hlatshwayo suggested:
“Start with those who stole money at Tembisa Hospital, and leave the innocent patients.”
Leslie-anne Malissa Leeuwschut asked:
“How do you give free services and expect them to pay afterwards. With no correct names, addresses or contact details.”
Nkosazana Radebe suggested:
“Send the invoices to their countries.”
Mushavhi Ishe exclaimed:
“Foreign nationals must pay. Citizens must pay.”
Ann Wylie asked:
“Why not concentrate on getting the billions that seemed to have found their way to Ramaphosa’s nephew, plus the many other people who benefited from the financial looting of Tembisa hospital?”
Salongok Mkulu agreed:
“They should first recover those billions that were looted by a few individuals from Tembisa Hospital.”
SAHRC declares that foreigners have the right to medical care
Briefly News reported that the South African Human Rights Commission (SAHRC) defended the rights of foreign nationals to free healthcare.
The SAHRC stated that the Constitution made it clear that everyone had access to healthcare services.
implemented Dudula and March and March made headlines when they attempted to prevent foreign nationals from accessing clinics.
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Source: Briefly News


