“The Health Minister never said that anyone should be attacked… To say we are xenophobic is going too far,” deputy director general for the National Health Insurance (NHI) and the NDoH Dr Anban Pillay told Health-e News.

Earlier this week Pillay had said that no other provincial health department other than Gauteng had acted on a bogus directive issued by a junior official from the NDoH sent almost two months ago.

But a second circular came to light later in the week, this time from KwaZulu-Natal instructing non-citizens to pay for services including “emergency treatments”, which many have pointed out is unconstitutional.

Ramifications beyond health

“Whilst the NDoH claims that this circular was released in error, such actions have serious ramifications including furthering anti-foreigner sentiments within, and beyond, the public healthcare system,” Professor Jo Vearey from the African Centre for Migration and Society at Wits University.

Towards the end of last year Health Minister Aaron Motsoaledi came under fire for comments he made regarding the burden foreign nationals are placing on the health system.

According to Vearey, non-citizens make up only between five and eight percent of provincial populations and are not the root cause of the crippling health system.

“The NDoH has a worrying track record of scapegoating foreign nationals for the poor performance of the South African national healthcare system. Denying access to foreign nationals is a public health disaster, with negative public health implications for all in South Africa and the SADC region,” said Vearey.

Similar sentiment for NHI

Section27’s Sasha Stevenson said that the KZN circular had been withdrawn as of Thursday night, five weeks after it had been sent.

Writing in public health magazine Spotlight, Stevenson asked how a junior official would have come up with the content contained in the national communique sent mid-January in the first place.

“The sentiment didn’t come from nowhere.”

According to Stevenson, the South African Constitution and National Health Act give everyone, regardless of documentation, the right to free primary health care, antenatal care and HIV and tuberculosis treatment. Neither can anyone be denied access to emergency care.

She told Health-e News that this “move to exclude foreign nationals from the health system is not without precedent” and the “NHI Bill envisages drastic reductions in access to care for foreign nationals and so the war is far from won when it comes to unconstitutional regression in access to care”. – Health-e News

An edited version of this story was published by the Saturday Star