Billions owed as debt collection efforts intensify
The Gauteng Department of Health is confronting a mounting financial burden, with approximately R4.6 billion in outstanding patient fees remaining uncollected. A substantial share of this debt — roughly R2.4 billion — is attributed to self-paying patients, a category that includes undocumented foreign nationals who are particularly difficult to trace.
The crisis has prompted the department to adopt a more aggressive and structured approach to revenue recovery, though significant hurdles remain. Departmental spokesperson Kealeboga Mohajane acknowledged that while strides have been made through focused collection drives and upgraded internal systems, locating patients without proper documentation continues to hamper efforts.
Mohajane indicated that the department is actively exploring additional avenues for cost recovery, including bilateral discussions where deemed appropriate, to address the challenge posed by untraceable debtors.
"As part of these efforts, the department has strengthened its revenue collection capacity by participating in the transversal contract RT27-2024 for the provision of debt collection services to the state for the period from 1 April 2024 to 31 March 2029 which is managed by the national treasury."
Since five debt collectors were appointed in June last year, the initiative has yielded approximately R28.8 million in recovered funds. A particular focus has been placed on recouping money owed by self-paying individuals, including foreign nationals residing in the province.
Government entities and medical schemes also in arrears
Beyond individual patient debt, the department is also pursuing outstanding amounts owed by various government bodies. Recovery efforts are being directed at entities including the Road Accident Fund, the Department of Justice, the South African Police Service, correctional services and other provincial authorities, according to Mohajane.
The department has simultaneously moved to overhaul its dealings with medical schemes, where unpaid and disputed claims form another significant portion of the outstanding balance. New interventions include tighter billing controls, streamlined claims submission processes and the removal of longstanding administrative bottlenecks that have historically resulted in delayed or rejected payments from medical aid providers.
Looking ahead, the department confirmed it will implement prepayment protocols for patients who do not qualify for free healthcare services. The measure is designed to prevent further accumulation of bad debt and ensure that revenue is secured before treatment is rendered, rather than pursued after the fact.
