Health Minister Dr Aaron Motsoaledi addressed Parliament on the complexities of providing healthcare to foreign nationals.
Image: Leon Lestrade / Independent Newspapers
Health Minister Dr Aaron Motsoaledi has shed light on the challenges faced by South African hospitals and clinics in accommodating patients from other provinces and neighbouring countries.
Responding to oral questions in Parliament on Wednesday, the minister admitted that the Department of Health helps foreign nationals with the limited resources it has, stressing that South Africa’s constitutional right to emergency medical treatment overrides immediate concerns about nationality or payment.
He clarified that hospital patients arrive via two main avenues. Firstly, patients can be officially referred from another province or a neighbouring country. In these cases, the receiving hospital bills the referring authority, regardless of whether the admission is an emergency or planned.
Secondly, some walk-ins come independently. These patients are billed using the Uniform Patient Fee Schedule (UPFS), a means test determining if and how much they must pay.
“This is a very tricky situation, because many patients who come on their own from neighbouring countries, the countries argue that they never sent anybody, and so you can’t hold them liable because they are not even aware that the person has crossed the border.
“The patients themselves must settle the bill, but you also have Section 27(3) of the Constitution. That says no one may be refused emergency medical treatment. And it’s only a doctor who can determine whether the person is an emergency or not. And if they determine that it’s not an emergency, the patient must pay,” Motsoaledi said.
“Unfortunately, this is just theoretical because most of the time, they give the wrong names. They give wrong addresses; they can never be traced.
“And the problem is exacerbated by the fact that, unfortunately, the truth is that many people from our neighbouring countries believe everything is free in South Africa at all levels of care at every hospital, perhaps except in private.”
Motsoaledi said clinics differ: primary health care is free, so people arrive, and there is no means test.
On how the department assists people from neighbouring countries, Motsoaledi said: “We accommodate them with the little we have because the Health Department cannot increase its own budget… But we tend to deal with what we have to help everybody. Whatever we have, whatever amount of medicines we have, we share with them in the way we can.”
He pointed out that many lack documentation, frequently change their names (sometimes to South African names), and possess fraudulent identity documents.
“Our solution to this problem is a new system which has been designed for the past eight years by the Centre for Scientific and Industrial Research, which is called the Health Patient Record Registration System, which is linked to Home Affairs, which is going to register all of you. Every South African, as I am speaking, millions are already registered on that,” Motsoaledi said.
Questioned on what steps are being taken to ensure foreign nationals accessing the country’s healthcare system are handed over to Home Affairs for repatriation and cost recovery, Motsoaledi said: “You can’t hand over a person and say this one is illegal. This one is not. It’s not our job. It’s not the job of health workers because where will human beings go when they’re in trouble?”
Then, on the possibility of individuals and families from neighbouring countries using Section 27(3) of the Constitution to access free emergency medical treatment in South Africa, Motsoaledi said emergencies are emergencies. A person cannot be left in the middle of the road bleeding because they are not from South Africa.
“No doctor can do that, and in fact, before you even find out who they are, you would’ve helped them,” Motsoaledi said.
“Anybody who has an emergency, we will help them, and you ask the questions later. I think that is what ubuntu is all about. It’s not necessarily the Constitution. It is ubuntu. That a human being who’s dying needs help.”
thobeka.ngema@inl.co.za