Health Dept says SA carries cost of treating foreign nationals, while upholding Constitution

JOHANNESBURG - The Health Department says South Africa is left to shoulder the burden of treating foreign nationals without any financial assistance from their home countries, insisting there are no agreements to recover costs, even as pressure on the system mounts.

This comes as Operation Dudula has intensified its campaign at public clinics in Johannesburg and Durban, illegally demanding identification from patients and turning away migrants in defiance of the constitution and health laws.

The department has warned that while the healthcare system is strained, scapegoating migrants and blocking them from accessing care not only breaks the law but also undermines public health for everyone.

The department confirmed that there are no formal bilateral or multilateral agreements to recover the costs of care from other governments, and that foreign patients are billed like anyone else according to public tariffs or means‑tested if they cannot pay.

It said this leaves South Africa to carry the full cost of treating thousands of migrants each year, despite its own limited resources, while upholding the constitution’s guarantee that “everyone has the right to have access to healthcare services”.

Officials also dismissed social media claims that patient numbers have dropped because of vigilante “screening”, saying no such trend has been recorded, and warning communities not to take the law into their own hands.

“But the challenge is that the majority of foreigners who are here are here illegally meaning even their own governments and embassies are not aware of their whereabouts. So, we cannot even engage them on issues of cost.”

With an already overburdened system, the department has urged communities to respect the law and to leave decisions about patient eligibility and screening to trained health professionals, not political or vigilante groups.

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