SA’s private healthcare sector is losing an estimated R40bn annually to fraud, corruption and procurement irregularities, delegates heard at the Board of Healthcare Funders (BHF) conference in Cape Town. – MedicalBrief (8 July 2026)
Acting Special Investigating Unit head, Leonard Lekgetho warned that fraudulent medical scheme claims, fake healthcare providers, counterfeit medicines, procurement abuses and unethical billing practices are driving up healthcare costs while undermining public trust.
Common schemes include claims for services never rendered, duplicate billing, inflated medicine claims, unnecessary treatments and billing manipulation. The SIU is investigating several major health-related cases, including the National Health Laboratory Service, Health Professions Council of South Africa, Council for Medical Schemes, Tembisa Hospital and Life Esidimeni.
Speakers also urged collaboration to resolve tariff negotiations, modernise the Prescribed Minimum Benefits (PMB) framework and develop affordable healthcare options for the estimated eight million employed South Africans who remain outside medical schemes.