By localnew 
Gauteng Health Struggles to Recover R2.6 Billion in Unpaid Medical Bills
The Gauteng Department of Health says it is owed about R2.6 billion in unpaid patient fees, including amounts owed by patients from neighbouring countries such as Zimbabwe and Mozambique, as part of a broader outstanding medical debt issue.
According to officials, a significant portion of this debt comes from self‑paying patients — both South African citizens and foreign nationals — who received medical treatment but have not settled their bills. In many cases, those who owe money lack proper identification or are difficult to trace, making recovery particularly challenging.
The total outstanding patient fees for the province are even higher, with the department working to recover around R4.6 billion in unpaid fees overall. This includes other unpaid amounts owed by medical schemes, government departments and intergovernmental entities.
To address the growing debt problem, the health department has appointed debt‑collection agencies, tightened billing and claims processes, and introduced measures requiring upfront payments for patients who do not qualify for free healthcare services. Officials say these steps are aimed at improving billing accuracy and increasing the chances of recovering outstanding fees.
The debt burden poses a financial challenge for the provincial health system, which relies on patient fees to support services and maintain facilities. Authorities have highlighted the importance of improving patient verification systems and exploring bilateral approaches to facilitate cost recovery where possible.