
In Conversation With Siyabonga Jikwana- Chief Director - Health Economics and Finance (Gauteng Dept of Health)
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The Gauteng Department of Health has announced intensified efforts to recover approximately R4.6 billion in outstanding patient fees, as part of a broader strategy to improve financial sustainability in the province’s healthcare system.
According to the Department, about R2.4 billion of this debt is owed by self-paying patients, including both South African citizens and foreign nationals. The remaining balance includes unpaid claims from medical schemes as well as intergovernmental debt owed by institutions such as the Road Accident Fund, South African Police Service, the Department of Justice, Correctional Services, and other provinces.
To address this, the Department has strengthened its revenue collection systems, including working with debt collectors appointed through National Treasury’s transversal contract. Since June 2025, these efforts have recovered nearly R28.8 million.
In addition, the Department is tightening billing systems, patient classification processes, and medical aid claims management, while introducing upfront payment requirements for patients who do not qualify for free public healthcare.
According to the Department, about R2.4 billion of this debt is owed by self-paying patients, including both South African citizens and foreign nationals. The remaining balance includes unpaid claims from medical schemes as well as intergovernmental debt owed by institutions such as the Road Accident Fund, South African Police Service, the Department of Justice, Correctional Services, and other provinces.
To address this, the Department has strengthened its revenue collection systems, including working with debt collectors appointed through National Treasury’s transversal contract. Since June 2025, these efforts have recovered nearly R28.8 million.
In addition, the Department is tightening billing systems, patient classification processes, and medical aid claims management, while introducing upfront payment requirements for patients who do not qualify for free public healthcare.

