Pretoria - Section27 and other organisations have expressed concern that despite a court ruling earlier that pregnant and lactating women and children under six must receive free health services, some hospitals and clinics still insist on payment.
There are also reports of pregnant migrants being turned away from hospitals.
Since the ruling, the Sexual and Reproductive Justice Coalition and other civil society organisations have received reports of various public health facilities (administrators and individual clinicians) demanding that pregnant migrant women pay to access services.
In April, the Gauteng High Court, Johannesburg, upheld the right of these women and children to access free health services at all public health establishments, including hospitals. This ruling followed an application brought by Section27 alongside women who had been denied access to such services.
The ruling reaffirmed the rights set out in the Constitution, the National Health Act, and the Refugees Act.
Section27 said it had received complaints that several hospitals and health-care facilities were not adhering to the court order. These facilities include Charlotte Maxeke Hospital; Tambo Memorial Hospital; South Hills; Germiston City Municipal Clinic; Heidelberg Clinic; and Edenvale Clinic.
Reports of extortion in the form of requirements to pay for ultrasound scans, childbirth and postnatal care – all of which are free under existing legal frameworks – as well as women being coerced into signing acknowledgements of debt, have been received.
In some instances the hospitals withheld the children’s proof of birth forms until payment was made.
“This is not only unlawful but places children at risk of being undocumented since proof of birth is a prerequisite for birth registration with the Department of Home Affairs, which increases the vulnerability of children,” said Kayan Leung, an attorney at Lawyers for Human Rights.
Apart from being unlawful, these practices also constituted unfair discrimination and human rights abuses, she said.
Leung pointed out that South Africa had an obligation to provide adequate, affordable and accessible health services, including information, education and communication programmes, to women.
It further had an obligation to take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health-care services, including those related to family planning.
“We are deeply concerned by recent reports that Gauteng Health continues to demand payment balances, and that mothers and newborns have been detained after discharge from the postnatal ward at Oliver Tambo Memorial Hospital until they have been able to bribe the unit to let them go home,” Leung said.
She added that this extortion was a stain on OR Tambo’s legacy.
Section27 meanwhile said that to lay the blame with non-nationals who make up an estimated 6.5% of the overall population in South Africa, was to ignore the role of the state in the systematic and structural erosion of the healthcare system.
“The idea that non-nationals are draining South Africa of its resources is not only unsubstantiated but also diverts us from addressing the real issues and looking for real responses,” said Sibusisiwe Ndlela, an attorney at Section27.
She added that from the inception of our democracy, the government understood that health-care services were essential to all people, especially pregnant women, and the government accordingly promulgated laws and introduced measures to provide free maternal and child health services.
The organisations called on the Gauteng Department of Health to ensure that all facilities adhered to the prescripts of the court order and that the department took decisive disciplinary action against any facility or staff member who demanded payment for health services that should be free.
They also called on the Health Ombud to initiate an inquiry into systemic health xenophobia.