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THE DETAILS: SA court says pregnant women, kids can access free healthcare in public hospitals despite legal status

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SECTION27 haas published the details of a court order which says pregnant women and children should access free healthcare, whatever their legal status.

We publish it below:

The Gauteng High Court, Johannesburg on Friday 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.  

The Court ordered that Gauteng regulations and a policy, introduced by the Gauteng Department of Health in 2020, that denies free health care services to pregnant and lactating women and young children who are asylum seekers, undocumented, or persons affected by statelessness are declared unlawful. The Gauteng Department of Health was ordered to amend its policy by 16 October 2023. 

The Court also declared that any other similar policies or circulars that prevent pregnant and lactating women and children under 6 from accessing free health services are declared inconsistent with the National Health Act and are invalid. 

  1. The Court included two orders that are designed to disseminate and increase the awareness of the court order:  
  2. The Court ordered that, by no later than 15 May 2023, the National Department of Health must issue a circular to all provincial departments of health recording that all pregnant and lactating women and children under 6 (who are not members or beneficiaries of medical aid schemes, and who have not come to South Africa for the specific purpose of obtaining health care) are entitled to free health services at any public health establishment. 

The National Department was ordered, by no later than 17 July 2023, to direct the preparation and display of posters or notices in all health establishments in all the provinces, which state that: 

ALL pregnant women,

ALL women who are lactating, and

ALL children below the age of six

Are entitled to free health services at any public health establishment, irrespective of their nationality and documentation status, unless: they are members or beneficiaries of medical aid schemes; or they have come to South Africa for the specific purpose of obtaining health care.

Government respondents (the MEC and Head of Department for Health, Gauteng, the Minister of Health and the CEO of Charlotte Maxeke Johannesburg Academic Hospital) are required to report to the Court on compliance with each element of the Court’s order by affidavit, and to appear in Court on 23 October 2023 to provide a comprehensive report on their compliance with the order. 

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 that was under 6 was denied free health services. Government respondents failed to respond to the litigation, other than filing a notice of intention to oppose in July 2022. 

As a result, case management of the matter by Deputy Judge President Sutherland commenced and then culminated in the withdrawal of the notice of intention to oppose, and discussions with the respondents on a proposed order, a version of which has now been made an order of Court.  

The Court’s order is a significant victory as it affirms the position already contained in our law that all pregnant and lactating women, and children under 6, are entitled to access free health services at public health facilities, including hospitals. The order will contribute to South Africa’s progress towards decreasing maternal and child morbidity and mortality. This Court order is in the interests of individual women and young children and the public health interest. For this reason, the order is warmly welcomed.

About SECTION27

SECTION27 uses a combination of law and activism and works with partners to effect systemic change in the health and education systems in South Africa. We use strategic litigation and community mobilisation to seek the realisation of the rights to access health care services and education. We conduct advocacy campaigns to educate the public on constitutionalism and participate in the public discourse on human rights. We conduct high quality research to develop an evidence base for our interventions.

SECTION27 works in partnership with social movements, civil society organisations and other partners to hold the state and private actors to account for their constitutional obligations. We aim to achieve structural change and accountability to ensure dignity and equality for all by using the following strategies:

law and litigation

advocacy

legal literacy

research

coalition building

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