Minister of Health Dr Aaron Motsoaledi revealed in a Parliamentary reply to ActionSA that the health department does not track the number of documented or undocumented foreign nationals who access public healthcare facilities, adding to ActionSA’s long-standing belief that this burdens South Africa’s healthcare system.

He further pointed out that while patients were requested to present proof of ID, services were not withheld from them if they were unable to do so. Further, health facilities did not record individuals according to nationality.

“It must be realised that on the African continent as a whole, the issue of Civil Registration and vital statistics is something that has just started in earnest recently, and the whole continent is lagging behind. At the present moment the country with the highest Civil Registration is Egypt at 98%. The second highest is South Africa at 89%. This means that 11% of South Africans are also undocumented, but cannot said to be illegal in their own country. Some countries on this continent are still between 1% and 5% registered,” Motsoaledi said in his reply.

ActionSA said this validated its concern that without appropriated data collection, the department could not account for any service delivery liabilities.

“This admission validates our longstanding concern that South Africa’s public healthcare system is burdened by an unquantified and unmanaged demand . . . We believe that this is particularly concerning given that millions of foreign nationals, many of whom are undocumented or lack any form of medical insurance, reasonably make use of taxpayer-funded public healthcare services,” ActionSA said.

The Minister defended the lack of tracking by pointing out that the right to healthcare was enshrined in Section 27 of the country’s Constitution, for citizens and non‑citizens, and that healthcare was provided based on clinical need, not on nationality or documentation status.

In May, ActionSA made submissions to amend Section 27 of the Constitution to exclude undocumented foreign nations from accessing tax-funded healthcare in South Africa.

“This situation is not mirrored in any other country, where foreign nationals are typically required to possess medical insurance as a condition of their visa applications. Yet South Africans are being gaslit into accepting this unsustainable burden as normal,” the party said.

It argued that by failing to track the number of undocumented foreign nationals in South Africa’s healthcare system, effective planning, budgeting, and policy formulation was compromised.

“In a public health system already buckling under pressure, with overcrowded hospitals, long queues, understaffing and medicine shortages, this lack of oversight is reckless and unsustainable,” ActionSA stated.

It suggested that a verification mechanism would mean that healthcare providers could verify legal status and maintain continuous patient records.

“ActionSA will continue to put South Africans first, ensuring that their access to healthcare is never compromised and that we build a system that delivers quality and affordable care,” it said.