Home2nd Presidential Health SummitPrivate health sector still losing billions to fraud and waste

Private health sector still losing billions to fraud and waste

South Africa’s private health sector is continuing to be bled dry by thieves and cheats, with an eye-watering R30bn lost to fraud, waste and abuse in 2025, said Health Minister Aaron Motsoaledi, linking this to corruption and deliberate manipulation of codes, as well as inefficiency and overcharging, reports Newsday.

Motsoaledi shared this information last week in response to a parliamentary question from National Assembly member Thembinkosi Mjadu (MK Party), who had asked about corruption, a lack of protection for whistle-blowers, and a failure to take decisive action against corrupt behaviour.

The Minister said the lost billions included claims for services not rendered and billing for brand-name medicines instead of cheaper generics.

There was also deliberate manipulation of billing codes, duplicate claims, and excessive charging for services, while other problems include over-servicing patients through unnecessary tests or medication, and claims submitted on behalf of non-members.

Pharmacies were also guilty of claiming for medicine while dispensing non-medical items and cash-related fraud.

Reports from Special Investigating Unit (SIU) head Leonard Lekgetho also showed corruption risks identified by the Health Sector Anti-Corruption Forum.

These included doctors doing remunerative work outside the public service while neglecting their duties in state hospitals.

“In some cases, they even took their private patients into public hospitals for treatment,” Motsoaledi said.

Other concerns were doctors deliberately referring patients for procedures in public hospitals to shield themselves from medical negligence claims.

The Minister said that other corruption risks include procurement irregularities within Health Departments and counterfeit medicines and medical devices.

 

Newsday article – South Africa’s private health sector loses R30 billion annually to fraud, waste, and abuse (Open access)

 

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