World Patient Safety Day, marked annually on 17 September, reminds us that safe, respectful, and dignified healthcare is a right, not a privilege. For many LGBTQI+ South Africans, however, discrimination in clinics and hospitals continues to undermine this promise.
As part of this year’s observance, MambaOnline had the opportunity to speak to Foster Mohale, spokesperson for the National Department of Health, about what steps are being taken to ensure patient safety and equality for LGBTQI+ people across South Africa’s public health system.
Safe channels to report mistreatment
Many queer patients are unsure how to raise concerns when mistreated in healthcare settings. Mohale emphasised that there are clear channels available:
“Most public clinics and hospitals have Patient Complaints Officers or suggestion boxes, which are opened in the presence of members of the community,” he explained. “If the matter cannot be resolved at facility level, complaints can be escalated to District Health Offices for further intervention and advice.”
This system, known as the Health Facility Complaint and Compliment System, is designed to make reporting accessible and ensure that accountability follows.
Training healthcare workers for dignity and sensitivity
Discrimination in healthcare often stems from lack of understanding. Mohale said the Department has rolled out Key Population Sensitization Training for both clinical and non-clinical staff to equip them with the skills and empathy needed to support LGBTQI+ patients.
“For healthcare workers, this training focuses on improving clinical competency in HIV, STI, TB, mental health, and gender-affirming care,” he said. “It also helps them apply trauma-informed care principles, screen for risk behaviours, and provide appropriate referrals for psychosocial, legal, and harm-reduction support.”
Non-clinical staff, such as receptionists and support workers, are also trained to create a welcoming environment from first contact to exit.
“This includes confidentiality, respectful communication, and signage that makes facilities visibly key population-friendly,” Mohale added.
Turning constitutional promises into practice
South Africa’s Constitution and human rights framework promise equality for all. But how does this translate in hospitals and clinics?
Mohale pointed to several policies:
- The National Health Act (No. 61 of 2003), which enshrines dignity and non-discrimination in healthcare.
- The Batho Pele (“People First”) Principles, which demand consultation, service standards, redress, and accountability in public service delivery.
- The National Strategic Plan for HIV, TB, and STIs (2023–2028), which explicitly identifies LGBTQI+ people as a key population requiring tailored services and protection.
“These commitments are not abstract,” Mohale said. “They are the foundation on which our health services must operate, ensuring that no one is denied care because of who they are or whom they love.”
Rebuilding trust in the system
Research shows that many queer South Africans delay or avoid healthcare altogether for fear of stigma. Mohale acknowledged this and said the Department is actively working to rebuild trust.
“Integrated and Ideal PHC [primary healthcare] clinics are being strengthened to provide inclusive services. Staff are being continuously trained and oriented to treat all patients with dignity. We also use social media, dialogues, and public advocacy to raise awareness about the services available to the LGBTQI+ community,” he explained.
Peer navigators, who are themselves LGBTQI+, are being included in healthcare teams to help patients feel more supported. Facilities are also introducing Key Population Friendly signage to signal inclusivity from the outset.
Immediate support for those denied care
If a queer person is denied care or mistreated, Mohale advised a clear course of action:
“Document the incident, note the staff member involved, and ask to speak to the facility manager. If unresolved, file a complaint with the Office of Health Standards Compliance (OHSC) or the South African Human Rights Commission (SAHRC),” he said.
Community organisations like OUT and the LGBT+ Health Division can also provide guidance and advocacy. “Writing to the Key Population Manager at the National Department of Health allows us to follow up with provinces and secure a commitment to address the issue,” Mohale added.
A long road ahead
While these measures are promising, LGBTQI+ South Africans know that policy does not always match reality. Still, Mohale’s responses highlight that official structures and accountability systems do exist, and the Department acknowledges its responsibility to transform healthcare into a safe and affirming space for all.
As Mohale concluded: “Our Constitution, policies, and principles are clear, LGBTQI+ people have the right to respectful, inclusive healthcare. The Department is committed to ensuring that every patient receives care without fear of stigma or discrimination.”
