- About R2.4 billion is owed by self-paying patients, including South Africans and foreign nationals who don't qualify for free treatment.
- Five debt collection agencies have recovered about R28.8 million since June 2025, mostly from self-paying patients at Gauteng public hospitals.
Patients at public hospitals in Gauteng owe the provincial health department about R4.6 billion in unpaid fees. Officials shared the figure with the provincial legislature during a financial briefing.
About R2.4 billion of the total is owed by people who pay for their own care. This includes South Africans and foreign nationals who do not qualify for free government treatment.
The rest of the debt comes from unpaid claims. These include amounts owed by medical schemes and government bodies that must pay for services they received.
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The department has hired five debt collection agencies to recover the money. The agencies work under a National Treasury contract.
Since June 2025, the agencies have collected about R28.8 million. Most of that money came from self-paying patients.
Officials are also chasing outstanding payments from the Road Accident Fund. Several government departments owe money too, including the departments of justice, police and correctional services. Other provinces also owe the Gauteng health department money.
The department says it is working to fix its billing systems to cut down on mistakes and speed up payments from medical aids.
Patients who do not qualify for free care must now pay upfront. The department says this is meant to stop new debt from building up.
Officials say some patients are difficult to trace and others do not have the proper documents. The department says this makes recovery difficult, but collection efforts will continue.
