- A second video of Phophi Ramathuba admonishing a Zimbabwean patient has surfaced.
In the video, Ramathuba is seen telling a pregnant Zimbabwean woman that the bill will be sent to President Emmerson Mnangagwa.
Ramathuba says this video is old and that no patient, even undocumented foreigners, should be prevented from access to healthcare in SA.
"I would never prevent any patient coming into a hospital, especially pregnant women," says Limpopo Health MEC Dr Phophi Ramathuba, after a second video surfaced this week in which she appears to admonish another Zimbabwean patient.
Ramathuba said this video was taken so long ago that she couldn't remember the location – let alone the date.
This comes in the wake of a viral video of her confronting a Zimbabwean patient at a Bela Bela hospital.
In the latest video, the MEC can be heard telling a pregnant patient from Zimbabwe and hospital staff that she was going to start billing President Emmerson Mnangagwa for Zimbabwean patients being treated in Limpopo:
I am going to bill Mnangagwa. Let's be serious, let us [count] the cost [to our country].
She goes on to say that, on a visit to a hospital in Musina, the northern-most town in the Limpopo, which borders Zimbabwe, she found patients monitored by neonatal doctors in Zimbabwe, but booked into the hospital to deliver their babies in South Africa.
"That is what their nurses are writing [in the documents]… They are planning on giving birth in South Africa because there is nothing [in Zimbabwe]… and our midwives and doctors, we cannot turn back a mother and her child, I am sympathetic to them.
"I am asking for your bill," Ramathuba told the patient. "[Mnangagwa] must pay me."
— Pumzile🇿🇦 (@PumPum_Radebe) August 31, 2022
Ramathuba said that, when the video was taken, she had impressed upon the CEO and management at the hospital that they needed to ensure patients were paying for services at the hospital.
And, when she came across the pregnant woman, she saw it as a teaching opportunity for the staff to understand why it was so important.
The previous video was met with mixed reviews, with some calling her actions xenophobic and against her ethical oath, as a doctor, to care for the ill, regardless of who they were.
Others, especially those in Operation Dudula, have supported her.
But Ramathuba has distanced herself from this group, saying they had their own reasons for supporting her.
"Everybody deserves access to healthcare, whether they are foreigners in the country, legally or illegally. The problem is, who is going to pay for those services?
"I would never prevent any patient coming into a hospital, especially pregnant women," she said.
As she spoke, Dudula members had been stationed outside Kalafong Hospital in Atteridgeville, west of Pretoria, for two weeks, preventing people they believe are not locals from entering the building.
Ramathuba said she didn't have an issue with foreigners and that she wasn't xenophobic, "but everybody must be obliged to pay".
As a medical doctor, I am aware and I do understand my ethical obligations to patients, but there is an incorrect narrative that public hospitals are free – they are not.
She said the issue with undocumented patients was that, when it came time to pay for their healthcare, they could not be traced and the money would be lost.
The Limpopo health department has R500 million in outstanding in patient bills.
The MEC said Treasury had appointed a debt collector to recover these costs, who would be paid with the money they collected from outstanding medical bills.
"The issue is that 90% of those bills come from undocumented patients – the debt collector cannot recover their own costs [for setting up offices and hiring individuals to track down patients] because these patients technically don't exist."
Ramathuba said only half of the 10% of patients they tracked down, undertook to pay.
As a department, we have written to Treasury to cancel our debt, but Treasury wants proof that these patients can't pay. Do you see my predicament?"
She said patients who genuinely could not afford to pay needed to provide proof by means of a police affidavit or proof that they were accessing grants.
She said that, if the debt was not written off, then her office would not receive a clean audit.
The MEC said the comments that she was xenophobic at least gave her hope that citizens wanted to resolve the issue without resorting to xenophobia.
"People who were concerned over the first video said they would take me to the medical council, and I really wish they would follow that procedure because then we could deal with the context of what I was saying – which is that the system is crumbling," she said.
People are lying on the floor delivering babies because there is not enough resources.
"This is why people go to Bara (Chris Hani Baragwanath Hospital in Soweto, Gauteng) for example, to die – because the private hospitals just won't take you if you have no money."
She said it was not the fault of the patients, and that the government had put them in positions where there was overcrowding or not enough staff at hospitals.
She noted the recent statement by the Zimbabwe government, saying it was concerned over her comments to Zimbabwe patients:
The [Zimbabwe] government say their people need to go back to their country and help build it up, so they won't have to go to SA. We should do the same – we should help to fix this country.
"Anger against foreigners is unjustified."
She said the blame lay with officials who allowed undocumented people into the country.
"I was given the responsibility to look after the lives in Limpopo and I will give my all to the people in Limpopo. If each of us ran our constituency properly [there wouldn't be this problem]."