Public Hospitals in South Africa
South Africa has a network of public hospitals providing care to all residents. Patients who earn below a certain income threshold receive care for free. Understanding how the fee system works and what your rights are will help you access the care you need.
Who Provides Public Hospital Care
Public hospitals are funded and managed by provincial departments of health. There are district hospitals, regional hospitals, tertiary hospitals, and central hospitals, each offering increasing levels of specialised care.
The Department of Health, under Minister Dr Aaron Motsoaledi, oversees national health policy while provinces run day-to-day operations.
Primary health care at public clinics and community health centres is free for everyone, regardless of income. Bring your ID and any previous health records when you attend.
Are Public Hospitals Free?
Care at public hospitals is free for patients who earn below the means test threshold. This is determined by your income and household size. If you earn above the threshold, you are charged according to a uniform patient fee schedule.
Children under six and pregnant women receiving antenatal care receive free care regardless of income. Patients with certain conditions, including TB and HIV, also receive free treatment.
The Uniform Patient Fee Schedule
Patients who earn above the free care threshold are classified into fee classes. The class determines how much you pay per visit.
| Class | Criteria | Approximate Fee |
|---|---|---|
| Class 0 | No income or below threshold | Free |
| Class 1 | Low income | Small co-payment |
| Class 2-4 | Moderate income | Scaled fees |
| Class 5-7 | Higher income, no medical aid | Higher fees |
| Full cost | Has medical aid | Billed to scheme |
Documents to Bring
- South African ID document or passport
- Medical aid card (if applicable)
- Referral letter from a clinic or doctor (for specialist or hospital care)
- Previous medical records, test results, or prescription history
- Proof of income (if applying for Class 0 exemption)
Types of Public Hospitals
The public hospital system is structured in levels of care. You should generally start at the lowest appropriate level and be referred upward.
- District hospitals: First-level hospital care, handle most common conditions
- Regional hospitals: More specialised care, serve several districts
- Tertiary hospitals: Advanced specialist care, require referral
- Central hospitals: Highly specialised, national referral centres (e.g., Groote Schuur, Chris Hani Baragwanath)
Finding a Public Hospital
To find your nearest public hospital or clinic, use the following resources.
- Website: www.health.gov.za
- National Health Hotline: 0800 029 999 (free call)
- Contact your provincial department of health
- Ask at your nearest public clinic for a referral letter