Rich get blamed for public hospitals' debt
Gauteng's health system is being put under pressure by well-off people who turn to public hospitals when their medical aid funds' benefits run out.
So the provincial health department claimed at public hearings when its representatives appeared before the Standing Committee on Public Accounts (Scopa) in the Gauteng legislature yesterday.
The department claimed that the number of well-off Gauteng residents who used public hospitals had pushed up the department's debt by almost R145-million in the 2012-2013 financial year.
The department said that, in many instances, well-off residents did not pay anything for the services they received at a public hospital.
Head of department Dr Hugh David Gosnell and chief financial officer Ndoda Biyela represented the department in the absence of MEC Hope Papo.
As of March 31, debt attributable to self-funded patients stood at R552475189. up from R407532094 in the previous financial year.
"An increase in self-funded patients' debt of R145-million can be attributed to the fact that there is an increase of unemployed-rate of patients [sic] and even those who are employed have exhausted their medical scheme benefits and resort to public facilities.
"The defaulting rate by patients has grown exponentially," the department told the Scopa committee.
The department said that foreign patients owed it millions of rands.
"Most foreign patients, who are classified as private patients, do not make upfront payments or honour their commitments when an account is presented.
"These debtors cannot be traced, especially at their country of origin," said the department.
The department said the law forbad it to refuse patients , even those without IDs or money to pay for their treatment.
"The National Health Act stipulates that no one shall be denied emergency treatment.
"Hospitals do ask patients to bring the missing documents [required for admission] but they seldom come back or send the requested information," the department said.
As a result, the department was unable to provide sufficient audit evidence for "receivables for departmental revenue amounting to R2438694000" as well as for "departmental revenue amounting to R506939000".
The department said that "incomplete and insufficient documentation furnished by patients" prevented it from furnishing evidence of its revenue.
To remedy the situation, the department said it was "procuring the services of a patient details verification system that will be used to verify patients who are without documents".
This system would be able to determine whether the patient had an income sufficient for him to pay for the services of a state hospital.