Uncertainty reigns over wide variations in how state medical facilities vary in the amount and under what circumstances they charge patients a treatment fee.
Do state hospitals charge patients a treatment fee? The Times reports that that is the question which has left patients‚ unions and healthcare workers confused after several medics raised concerns over a R65 fee which accident victims were asked to pay for treatment at Durban's Addington Hospital.
According to the KwaZulu-Natal Department of Health‚ people with the means to pay should expect a bill of R65 for treatment. The report says they pointed to a national policy document which allowed the state to charge for public healthcare at all state hospitals using a “means test”.
The test‚ which calculates a payment percentage according to annual income‚ ensures that all those who can pay do‚ according to Health Department spokesperson Sam Mkhwanazi. Pregnant women and children under 6 years old‚ the elderly and those receiving government grants are exempt from being charged.
Mkhwanazi is quoted in the report as saying that every public hospital in the country was in a position to charge an appropriate fee. “This is a national policy and is not new. It forms part of the National Health Act and falls under a test to determine payment at public facilities. That information is available to the public‚” he said.
Primary healthcare in clinics is free‚ but patients who earn less than R70‚000 a year are required to pay a percentage of total tariffs. This amount‚ Mkhwanazi said‚ was broken down into R45 for a consultation and a R20 “facility fee”. “If any South African has the ability to pay for a health service then they should pay. We determine this by conducting a means test to determine whether people should be charged when receiving care at a public hospital‚” he added.
He stressed that no one would be turned away if they could not afford “the fee”. But, the report says, Doris Thanga‚ of Manguzi in the far northern reaches of KZN‚ who travelled for several hours for oncology treatment at Addington Hospital‚ had to borrow money to pay the treatment fee. “I have to come here to get pills for my cancer. I had to pay an entrance fee to get inside and then I sat in the line to get my medication‚” she said. The 52-year-old said that as she was unemployed and had no means for generating an income‚ she had asked her brother to lend her money for what she called an “entrance fee”. “Every time I come here I need to pay. This is normal for me‚” she said‚ pointing to her printed hospital invoice.
National Education Health & Allied Workers Union (Nehawu) spokesperson Khaya Xaba said in the report that the concept of a public hospital requesting any fee was foreign to him. “This is the first time that I am hearing that. It would be disingenuous to ask anyone to pay an entrance fee‚” he said. “We will look into this practice because people should not be called to pay any amount for access to public healthcare‚ no matter who they are. People require access to free and quality healthcare‚” he said.
Nomsa Ntshangase said that in her experience all public hospitals charged for a service. “We pay R40 at Itshelejuba State hospital in Pongola. They say if you don’t want to pay you have to produce proof that you are unemployed‚” she said.
Another Facebook user‚ Juart Nakzen Bosetse‚ said he was charged R75 before seeing a doctor at the Tembisa Hospital in Gauteng. “We are used to this kind of treatment. I couldn't see the doctor until I had fork out R75 and I was told that every time I visit the hospital I have to bring R75. I think it's better if state hospital is for free because we are taxed on everything.”
KG Wa Sedumedi said that citizens should be responsible and pay if they could afford it. “Seeing a doctor for a fee at state hospitals is a national policy which applies everywhere. “Encourage citizens to take responsibility for public revenue collection so that they can find medication when they come back again‚” he added.
[link url="https://www.timeslive.co.za/news/south-africa/2017-07-04-hospital-treatment-fee-is-a-bitter-pill-to-swallow/"]The Times report[/link]