Health policy on migrant pregnant women challenged
Hospitals insist on payment
Civil society organisation Section27 has approached the Johannesburg high court in a bid to get the Gauteng department of health policy which prevents migrant pregnant women and children under the age of six from accessing services for free nullified.
When the policy was introduced in May 2020, the department wanted to create uniformity in the revenue management and strengthen its internal controls.
In the policy, the department defines which patients should pay for services they get in hospitals in full, which ones are subsidised and which ones receive services for free.
It says that free health services must be provided to pregnant and lactating women commencing from the time of pregnancy, to children under the age of six and to refugees with valid documents who develop a health problem while in SA.
Patients who are on ARV treatment and do not belong to a medical aid are also exempted from paying.
But Section27 says this policy is being used by hospitals to require all pregnant migrant women and children under the age of six, who are not refugees, to pay for health services, which ought to be free.
She said the policy is also used to compel other types of migrants such as asylum seekers, stateless persons and undocumented person (which can include South Africans with no identity documents or birth certificates) to pay for services that the National Health Act stipulates are free.
“Hospitals in Gauteng are alleging that asylum seekers, undocumented persons are not entitled to free health services because they are not mentioned in the policy as being eligible,” said Section27 attorney Sibusisiwe Ndlela.
She said since the introduction of the policy, people have been coming to the organisation complaining that they were being turned away as they were not documented refugees.
“Once this policy was introduced in 2020, there was an influx of migrant clients who were being denied services. When we write letters on their behalf, hospitals would then say the policy only allows refugees to access free health services. This essentially means that the policy is being used in a way that excludes other types of migrant people,” Ndlela said.
In the organisation’s court papers, Section27 argues that preventing migrants from having access to free health services is inconsistent with the National Health Act and it is accordingly unlawful.
Section27 argues that the act states that the state must provide pregnant and lactating women and children below the age of six, who are not members of a medical aid, free health services.
The organisation also wants the court to direct the department of health to publish a circular and display posters in all public health facilities which state that “all pregnant women, all women who are lactating and all children below the age of six are entitled to free health services”.
In the court papers, lawyers mention a case of a Lesotho national who was pregnant in June 2020 and suffered from high blood pressure.
She was attending Zola Clinic in Soweto for antenatal care until she was referred to Charlotte Maxeke Johannesburg Academic Hospital where she started to receive treatment in July.
According to the document, on September 11 she was made to sign an admission of liability and undertaking to pay a debt agreement which said she owed R2,437.
She was told that she would not receive any further treatment unless the document was signed. She then approached Section27 for help and the hospital referred the organisation to the policy.
The department’s spokesperson, Kwara Kekana said the application has been referred to the state attorney who will appoint counsel who will advise the department on how to respond to the matter.