Monday 15 April

24 October 2023, Johannesburg – The Minister of Health, MEC and HoD for Gauteng Health and Charlotte Maxeke Johannesburg Academic Hospital returned to Court on 23 October to report on compliance with the court order on free health care services for all pregnant and lactating women and young children.

In April 2023, the Gauteng High Court upheld the right of all pregnant and lactating women, and children under 6, irrespective of nationality and documentation status, to access free health services at all public health establishments, including hospitals.

In a hearing in chambers before Deputy Judge President Sutherland, counsel for the government respondents reported that there had been compliance with the court order in that:

  • the Gauteng Patient Administration and Revenue Management Policy has been amended to specify that all pregnant and lactating women and children under the age of six years old are entitled to free health care services at all public health establishments, regardless of citizenship or documentation status; and
  • posters reflecting that all pregnant and lactating women and children under the age of six years old are entitled to free health care services at all public health establishments, regardless of citizenship or documentation status have been sent to all provinces and all health facilities in Gauteng. A number of health facilities in Gauteng have ensured that the posters are visible on notice boards and in wards.

There are some health facilities that government respondents admit have not displayed posters – Charlotte Maxeke Johannesburg Academic Hospital, Hillbrow Community Health Centre, Helen Joseph Hospital, South Rand Hospital, Kalafong Hospital and Thelle Mogoerane Hospital. In addition, SECTION27’s monitoring suggests that while Chris Hani Baragwanath Hospital, Steve Biko Hospital and Bertha Gxowa Hospital claim to have put up posters, those posters were not visible as of 18 October 2023.

As a result of this partial non-compliance, the respondents have been given until 6 November 2023 to report on affidavit on full compliance; and SECTION27 will have the opportunity to respond by 13 November 2023. Should compliance not be complete, Judge Sutherland will personally attend at the relevant hospitals to monitor compliance on 20 November 2023.

SECTION27 welcomes the government’s substantial compliance with the court order. We had been concerned that posters had not been put up in hospitals, following two rounds of monitoring in August and October 2023. We addressed correspondence to the respondents, and it appears that, despite not responding to us, they took steps to remedy the non-compliance.

We particularly welcome the amendments to the Policy, which not only ensure access to pregnant women and young children, as required by the court order, but also place asylum-seekers in the same position as refugees and South Africans. Previously, the position of asylum-seekers was not clear, whereas the law requires that refugees and South Africans should be means tested to determine the extent to which they need to pay for health care services (other than services for pregnant and lactating women and young children). The Gauteng Department of Health has now wisely clarified that asylum-seekers (who are awaiting determination of their refugee status) are to be treated in the same way as refugees and  South African citizens.

The order follows a Court application brought in May 2022 by SECTION27 together with two women who were denied access to free health services while pregnant and one whose child under six was denied free health services.

The European Union funding supports SECTION27 and the Centre for Child Law’s work in enhancing accountability in health and education in South Africa.

For media queries contact: Pearl Nicodemus | nicodemus@section27.org.za | 082 298 2636


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