The Gauteng Department of Health has stepped up efforts to recover billions owed in unpaid patient fees, as part of a broader push to improve financial sustainability in the province’s healthcare system.
According to a media statement released on 22 March 2026, outstanding patient debt currently stands at approximately R4.6 billion. A large portion—about R2.4 billion—is owed by self-paying patients, including both South Africans and foreign nationals, while the rest relates to unpaid claims from medical schemes and government entities. 
The department has introduced a structured recovery plan targeting debts that can be traced and legally enforced. Since appointing five debt collectors in June 2025 through a National Treasury contract, the department has already recovered close to R28.8 million.
In addition, the department is tightening billing systems, improving medical aid claims processing, and enforcing upfront payments for patients who do not qualify for free healthcare. These measures are aimed at preventing further debt accumulation while improving revenue collection.
Efforts are also underway to recover funds owed by institutions such as the Road Accident Fund, SAPS, Correctional Services, and other provinces. However, officials acknowledge that collecting debt from undocumented or untraceable patients remains a major challenge.
Despite this, the department says it remains committed to strengthening its systems, improving efficiency, and ensuring the long-term sustainability of healthcare services in Gauteng.
