South Africa’s Health Sector Fights Back: R11.8 Million Recovered, R6 Billion in Fraud Prevented

Medico-legal scams, overpriced multivitamins, ghost tenders, how officials are finally fighting corruption in the health system.

It’s no secret that South Africa’s public healthcare system has long been weighed down by corruption, but new figures suggest that the tide may finally be turning.

At the end of June 2025, the Health Sector Anti-Corruption Forum (HSACF) revealed that it had recovered R11.8 million in cash and assets and prevented over R6 billion in potential losses. The announcement was made following its quarterly meeting, where key players from government, law enforcement, civil society and the private health sector came together to track progress and align on next steps.

Fraud Busts and Court Dockets

Led by the Special Investigating Unit (SIU), the forum’s work has dug deep into more than 100 open cases. According to SIU spokesperson Kaizer Kganyago, some 54 fraudulent medico-legal claims have been identified and stopped in their tracks — a huge relief for a system already struggling to fund essential services.

The SIU’s latest referrals total hundreds of millions in suspected fraud:

• R689 million referred to the Legal Practice Council

• R279 million flagged to the Legal Practitioners’ Fidelity Fund

• R412 million submitted to the National Prosecuting Authority (NPA)

Meanwhile, the Hawks (Directorate for Priority Crime Investigation) confirmed that out of 106 active cases:

• 21 are still under investigation

• 2 have already reached the courts

• 69 are awaiting direction from prosecutors

These cases collectively involve an estimated R3 billion in suspected losses.

Legal Sector Under the Microscope

The fallout from COVID-19-era procurement continues, with the NPA reporting steady progress on cases tied to Proclamation 23 of 2020. A total of 125 cases have been enrolled, 83 finalised, and 32 remain on the court roll.

This focus on accountability comes at a time when public trust in both legal and healthcare institutions is fragile — with many South Africans having witnessed first-hand the cost of dysfunction, from overburdened hospitals to delayed surgeries and chronic medicine shortages.

Medical Schemes Flagged for Irregularities

The Council for Medical Schemes (CMS) didn’t mince words either. It’s currently probing governance failures and regulatory breaches across several well-known providers:

• Foodmed Medical Scheme – governance and compliance issues

• GEMS and Polmed – possible irregularities in vitamin procurement

• Optivest Health Services – accused of overcharging

• Sizwe Hosmed Medical Scheme – ongoing compliance investigation

These findings are particularly concerning for public servants and vulnerable members of society who rely on these schemes for essential cover.

More Than Just Recovering Cash

Beyond the numbers, the HSACF insists this is about restoring integrity in one of the most vital sectors of the country.

“This is a whole-of-society battle,” said Kganyago. “Civil society, private healthcare, and public institutions must continue working together to build transparency and eliminate waste.”

The forum emphasised that its fight isn’t only about catching criminals, but also about putting systems in place to prevent fraud before it happens. That includes stricter compliance checks, stronger reporting mechanisms, and faster court proceedings.

While the progress is promising, public commentary online has been mixed. Many South Africans have praised the recoveries but remain skeptical about whether high-profile culprits will actually see jail time.

“Every time I hear about recovered money, I think: but will anyone actually serve time?” one X user commented. Another wrote, “This is a step in the right direction. We’ve been waiting for action, not talk.”

The HSACF meets again in a few months and its future progress will be closely watched by those who’ve long borne the brunt of a broken system.

For now, South Africa’s health corruption watchdog has delivered a clear message: if you steal from the sick, expect a reckoning.

Need to know:

• Fraudulent medico-legal claims are among the top concerns

• Several medical schemes are under formal investigation

• COVID-19-related graft is still unfolding in courtrooms across SA

• Public trust remains shaky, but enforcement is gaining momentum

If you’re concerned about health sector corruption or want to report suspicious activity, visit www.siu.org.za or contact the National Anti-Corruption Hotline: 0800 701 701.

{Source: IOL}

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