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Gauteng’s public healthcare system is experiencing substantial financial strain due to the high costs of treating foreign national oncology patients.
This is according to researcher Dr. MD Mokonoto, who presented a report on oncology services before the Gauteng legislature’s Health and Wellness Committee on Thursday.
The total amount owed to Charlotte Maxeke Academic Johannesburg and Steve Biko Academic hospitals for funding foreign nationals on oncology services was found to be R700 million and R400 million, respectively.
Mokonoto highlighted four prevalent factors contributing to the budgetary strangulation for cancer treatment: the cost of foreign nationals and walk-in patients over time, and consignment, among other issues.
The reason Gauteng has a significant burden of oncology patients is because it serves as a hub for cancer treatment, draining resources from the entire country and neighbouring regions.
Mokonoto stated that many Southern African Development Community (Sadc) countries have failed to comply with paying medical bills for their citizens seeking cancer treatment in South Africa.
“In Steve Biko Academic Hospital, they reported that Angolan patients won’t be accepted anymore because when public funds are depleted, they go to private hospitals,” Mokonoto said.
Mokonoto emphasised that the burden of treating foreign national oncology patients contributed to the budgetary strangulation faced by Gauteng’s central hospitals.
Following extensive engagements with managers and clinicians with the committee, Mokonoto suggested the Department of Health prioritise enforcing payment by foreign countries, as outlined in the Uniform Patient Fund Regulation 2024.
“Since the Uniform Patient Fund (UPF) Regulation 2024 is stating that foreign nationals fall under full-paying patients, the department should prioritise enforcing payment by their countries.”
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He said the cost of an oncology regimen in a public hospital was approximately R75,000, while in the private sector, it could range up to R150,000.
Some patients trick the system by filling in false or incorrect addresses. Due to the expensiveness of the oncology costs, patients refer themselves to the public health oncology services, some of them coming as far as other provinces.
“Worryingly, these patients tend to register incorrect addresses in Gauteng and return home. When the hospital phones them to fetch medication, they disclose that they are in another province, e.g., Eastern Cape, which warrants transportation of medication at the cost of the hospital, particularly Charlotte Maxeke Academic Hospital,” Mokonot added.
To combat self-referral and improve patient tracking, the Committee suggests strengthening the Health Information System (HIS) through biometric implementation.
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According to Mokonoto’s presentation, to address the backlog in oncology services, the Gauteng Department of Health (GDoH) has taken several measures.
These include outsourcing radiotherapy services to private sector partners, streamlining patient flow, expanding radiotherapy capacity, enhancing human resources, and implementing continuous monitoring and evaluation.
However, these efforts are ongoing, and the province continues to face challenges in managing the significant burden of oncology patients.
Watch: Assessing the impact of the programmatic scope on oncologyservices in Gauteng hospitals
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