By Mapaballo Borotho
- Gauteng Health is owed approximately R4.6 billion by patients, medical schemes and government entities.
- Officials say the debt is largely due to billing failures and challenges in recovering payments, especially from untraceable patients.
- The department has appointed debt collectors and is tightening systems to recover funds and sustain healthcare services.
The Gauteng Department of Health is grappling with a growing debt burden, with approximately R4.6 billion owed to it.
The outstanding amount is owed by both South Africans and foreign nationals who have accessed medical services at public hospitals across the province.
Of this total, R2.4 billion is owed by self-paying patients, while the remainder is made up of intergovernmental debt and unpaid claims from medical schemes.
The revelation has surprised many, as a large number of South Africans are unaware that certain patients are required to pay for services at public healthcare facilities.
Chief Director for Health Economics and Finance, Siyabonga Jikwane, told Phemelo Motene on Kaya 969’s Point of View that the situation is largely due to internal failures within the department.
“It is definitely our fault because sometimes we don’t send statements or hospital bills to patients, especially those who are supposed to pay,” he said.
While the Constitution provides for access to healthcare, Jikwane clarified that free services are limited to specific groups, including children under five, pregnant women, pensioners, and those receiving social support (classified as H0).
Patients classified under H1, H2, and H3 are assessed based on their income and are required to contribute towards the cost of their care.
Jikwane explained that the debt has escalated partly because bills were not issued, and in some cases, patients are either non-residents of Gauteng or foreign nationals, making recovery more difficult.
Listen to the podcast for an in-depth discussion on the growing debt crisis…
To address the issue, the department has appointed external debt collection agencies since June 2025, recovering about R28.8 million so far.
Efforts are focused on traceable and legally enforceable debt, while also improving internal systems that allowed arrears to accumulate.
The department is also pursuing payments from government-linked entities such as the Road Accident Fund, SAPS, Correctional Services, and other provinces where intergovernmental debt has built up over time.
However, officials acknowledge ongoing challenges, particularly in recovering funds from undocumented or untraceable patients.
Jikwane emphasised that these measures are not only aimed at recovering lost revenue, but also at ensuring the long-term sustainability of public healthcare services.
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