Confusion reigns as patients grapple with fees at Gauteng hospitals

It is mass confusion for many patients at Gauteng government hospitals with some expected to pay a fee for services and others knowing nothing about this.

Brian Tarbitt, a letter writer to The Citizen, yesterday queried if patients visiting Helen Joseph Hospital in Johannesburg would be charged R100 for services.

According to a patient who requested anonymity, this was a new policy by government that patients at government hospitals had to pay a fee for the service and medication provided.

‘Foreigners pay more’

She claimed at Helen Joseph, South Africans were expected to pay R90 while foreign nationals had to pay about R465.

“This is something that has been going on since January. I am not sure if the fee will now increase. But this is what people have been paying here,” she said.

“I know at Charlotte Maxeke Johannesburg Academic Hospital as well Chris Hani Baragwanath Academic Hospital, people also pay but I am not sure how much they pay.”

Another patient, James Maartens, said the paying for services at government hospitals started a long time ago and the fees were relatively reasonable.

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He claimed previously it used to be R40 for South Africans and then increased to R70 but it was now R90 and in the past, it would depend on whether one was employed or not.

“Before they wouldn’t let those who did not have money or unemployed to pay, but now everyone pays. The rules changed. You pay a small fee for the admin or seeing the specialists,” he said.

“I understand other people do not have money but this is a service. For me, it cannot be that everything is so free. The medication, the specialist you see here – it is reasonable compared to private hospitals. Honestly, the R90 fee is very reasonable.

“Those that do not have money, they will not turn them away but their bill will accumulate. And we know at local clinics, it’s free. But at hospitals, you just pay this fee which is better than what you would pay at private hospitals.”

What the constitution says

According to Section 27 in the South African constitution, “everyone has the right to have access to health care services, including reproductive health care, sufficient food and water and social security. If they are unable to support themselves and their dependants, appropriate social assistance is given.”

This meant everyone was entitled to basic health care whether they were a South African citizen or not.

Some patients said foreign nationals had the right to free basic health care and only pay when they need more than primary health care. In an emergency, everyone was entitled to free health care.

The national department of health’s spokesperson Foster Mohale said “in all public hospitals, not all services were free”.

“We use means of test to determine the fees. At any clinic, the services are free,” he said.

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Zambian national David Mubanga said he had a debt with Helen Joseph Hospital.

“I am not from South Africa and I am supposed to pay about R400 for services. I couldn’t pay the fee the first time I was here and they helped me with medication I needed. But my debt had increased and I am now owing the hospital about R800, which I don’t have,” he said.

“So, if you don’t have the money at the moment, your bill will increase the next time you visit the hospital. There is nothing we can do because this is how things are. I have heard that others get helped without having to pay anything, but I was told I need to pay this fee.”