CLAIM: South Africa has free public healthcare; all immigrants, ill/legal (sic) benefit.
SOURCE: Account on X
VERDICT: Misleading
Zimbabwean, Hopewell Chin’ono, wrote on X encouraging those in South Africa ‘to organise yourselves so that we can assist you by negotiating with specific medical centres in your local communities’.
He said he had ‘spoken on the phone with a few Zimbabwean doctors in South Africa and some Zimbabweans living and working in South Africa, and they explained that most of these people die alone because they can’t access medical facilities for fear of vigilante attacks’.
The post had over 120,000 views and 251 comments.
The responses ranged from disbelief that this was happening to outrage that this was a lie.
In one of the responses, an account expressed outrage, claiming that, ‘🤪 that is a lie! Your compatriots are feeding you lies. South Africa has free public healthcare; all immigrants, ill/legal benefit. “Vigilante attacks?” From whom? Nurses and Doctors? You leeches need to fix your country and stop being a burden’.
Another responded that, ‘Health care isn’t free ,I’m personally a South African and I have a chronic illness which I pay at Baragwath for my treatments , Foreigners are also subjected to pay now as they were a burden to our healthcare I work for Department of health’.
A Zimbabwean also responded to the post with, ‘its not free to illegal foreigners. They pay same fees as they should pay to private doctors for consultation, which is R469. now imagine someone going weekly. if its an operation, they have to pay 50% of the amount before operation and the other 50% before they are discharged’.
So, what is the correct position?
There are a number of laws in South Africa which deal with the right to health care.
Constitution
The Constitution states that all people in South Africa, regardless of status or nationality, have the right to have access to health care services, and that ‘no one’ may be refused emergency medical treatment.
Section 4(3) of the National Health Act provides for certain free health care services for people who don’t have medical aid. It does not limit access to these services based on nationality or immigration status, meaning that these services are available to all, South African and not; documented and not.
It says:
- All women are entitled to free abortion at government facilities.
- All pregnant and breastfeeding women and children under the age of six are eligible for free health care services at public clinics or hospitals.
A 2007 national health department directive also guarantees free HIV and TB care and treatment to anyone regardless of status.
The Refugees Act
Refugees in South Africa have the same right to access healthcare as South African citizens, as set out in the Constitution. This right is also considered to include asylum-seekers.
The Immigration Act
This act is different: it states that staff at clinics and hospitals must find out the legal status of patients before providing care (except in an emergency).
The Uniform Patient Fee Schedule sets out who must pay for certain services at a South African health facility, which is explained in the Classification of Patients for the Determination of Fees. Fees are not payable for “free services”.
The following foreign nationals should be means-tested (in the same way as South African citizens) at the hospital:
- Foreign nationals who have permanent or temporary residency in a passport, and
- Anyone from the Southern African Development Community (SADC) region who is undocumented.
The hospital should look at what they earn and decide what fee they should pay. Refugees and asylum seekers are subject to the same test. The hospital decides what fee they must pay, depending on their income.
Undocumented immigrants from Zimbabwe have the same rights as South African citizens. They get free health services for pregnant/breastfeeding women and children under 7. The free services also extend to termination of pregnancy, services required according to the criminal procedure act, psychiatric care and certain infectious diseases including HIV and TB.
For emergency and primary healthcare and hospital treatment, a charge is incurred. The bill is determined by one’s income. This is called the ‘means test’ which is also applied to Sourh African citizens.
Specialised healthcare for undocumented immigrants is generally not available, unless if it is an emergency.
Legal expert, Kholofelo Mphahlele, writes in a 2022 article that though the South African Constitution says the most basic forms of healthcare should be made accessible to all who reside in South Africa, ‘this is not the lived experience of so many’.
‘Some migrants and refugees are denied access to healthcare simply because they are foreign nationals. There have been several instances of migrants and refugees being denied treatment solely based on their nationality. This has been coined ‘medical xenophobia,’ he writes.
Conclusion
The claim that ‘South Africa has free public healthcare; all immigrants, ill/legal (sic) benefit’ has been rated as misleading. There are various acts that deal with healthcare in South Africa, including the Constitution. While there are free services, these are limited to pregnant/breastfeeding women; children under six; psychiatric care; and infectious diseases including HIV and TB. For emergency and primary healthcare and hospital treatment, a charge is incurred. The bill is determined by one’s income. This is called the ‘means test’ which is also applied to South African citizens.
Although this is the official position, practice has been reported to be different.
