Patient fees at public hospital rates will decrease by up to 70% once a new fee structure has been approved by provincial hospitals, the Department of Health said on Wednesday.
Departmental spokesperson Sibani Mngadi said the revised rates have been sent to all provincial health departments. The new rates will be implemented immediately after endorsement by provinces.
”The Department of Health is reviewing the current uniform patient fees system [UPFS] to ensure that this fee structure supports its effort to increase access to quality health care,” Mngadi said.
”The review of this fee structure is expected to result in lower hospital-fee rates that will decrease by up to 70%.”
Mngadi said the department is convinced that unless a more sustainable means of health care financing is introduced, the challenges of affordable health care will not be eliminated.
”The broadening of the medical-aid cover and the establishment of the social health insurance are key to solving the problems of health financing in this country,” he said.
The main challenge is that users of public facilities come from poor communities and are not covered by any form of health insurance or medical aid.
The most affected are people with some income, who therefore do not qualify for free health services for indigent people, Mngadi said.
These users are charged at various rates depending on their income, and they usually pay these debts out of pocket from a very limited disposable monthly income.
Public hospitals are not allowed to decline patients who cannot settle their hospital bills.
”While efforts are being made to collect outstanding debts, this has to be balanced against our constitutional responsibility to make health accessible to everyone,” Mngadi said.
The special rates for chronic patients are in place and were never revised, as stated by the Democratic Alliance — which has threatened legal action if the UPFS is not urgently reviewed, because it says that many patients cannot afford it.
Briefing the media at Parliament on Wednesday, DA MP and health spokesperson Dianne Kohler-Barnard said unaffordable fees imposed on patients at state hospitals by the Department of Health are causing a horrifying decline in the number of patients able to obtain treatment.
Using Cape Town’s Groote Schuur hospital as an example, she said there has been a 67% decrease in the number of patients at one unit. This is a microcosm of what is happening at state hospitals throughout South Africa.
”This is a gross violation of patients’ constitutional rights, and the DA calls on the minister of health to urgently review the UPFS. Should she fail to do this, we will consider legal action,” Kohler-Barnard said.
The UPFS was first introduced in 1993. Hospitals were instructed that patients should be charged a full consultation fee for every single hospital visit — even if they had to be treated several times a week over the course of several years.
Units treating chronic patients negotiated more reasonable packages, which allowed their patients to be charged for only some visits, but in January last year the department, without warning or consultation, banned these packages, said Kohler-Barnard.
No explanation or justification for this has been forthcoming, she said. — Sapa