At a clinic in the north of Pretoria, a pregnant woman tried to register as a patient in the facility’s antenatal care using a South African identity document (ID) with a photo that didn’t match her face.
It further emerged that the woman had recently been turned away from another clinic due to inappropriate documentation.
The clinic matron called the police to resolve the dispute and to assess the authenticity of the ID.
But prior to that, the woman received care. “The staff ensured that the patient’s vitals were taken, before handing her over to SAPS, which resonates with the Batho Pele Principle,” the matron tells Health-e News.
Healthcare workers must verify identity
“As healthcare providers, we are expected to record patient identifiers, including name, ID/passport number, date of birth, contact details to register files,” the matron tells Health-e News, “to ensure reasonable efforts to verify identity for medical records, billing/medical schemes, continuity of care, prescriptions, and medico-legal documentation.”
She says that this obligation arises from the National Health Act, the Health Professions Council of South Africa’s ethical rules and accurate patient records, and the Protection of Personal Information Act.
“However, healthcare workers are not law-enforcement officers and we are not expected to authenticate documents like Home Affairs or SAPS.”
She explains there’s no national clinical protocol, but standard practice is to not confront or accuse the patient, but to record the discrepancy factually in clinical notes. “The nurse and admin clerk did well to inform me as a facility and operational manager”, she says.
“The goal was not to scare the patient but to keep her calm and not alert her that something was up. The nurses’response was to follow internal facility policy, which included escalation to SAPS. If there’s a need, the police will further escalate it to the home affairs department.”
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Dr Angelique Coetzee, Vice-Chairperson of the Unity Forum of Family Practitioners (UFFP), tells Health-e News that clinicians should never detain a patient or seize documents. “No law obliges clinicians to perform immigration or identity enforcement.”
“Healthcare workers are protected if they act in good faith, follow internal policy, escalate via management channels, and do not breach confidentiality unnecessarily. They should avoid public disclosure, social media, and personal communication with police,” she says, emphasising that legal protection may arise from HPCSA ethical protection, including whistleblower principles and POPIA compliance.
Confidentiality is key
The most important principle in healthcare services is the need to balance confidentiality and legal duties.
“Healthcare comes first. Law enforcement comes second. Therefore, clinicians must provide care regardless of nationality or documentation (emergency and primary care). Maintain confidentiality. Only disclose information when required by law, ordered by court, or where there is a serious public risk,” she says, adding that routine identity fraud does not override the duty of care.
Gauteng SAPS spokesperson Colonel Dimakatso Nevhuhulwi says the relevant police station responded to the incident. “There is no record of any arrest of a pregnant foreign national woman; however, the matter was escalated to the Department of Home Affairs for further investigations.”
The Department of Home Affairs did not respond to our query. – Health-e News
*The name of the facility and the matron are being withheld as the matron spoke to Heath-e News on the condition of anonymity.
