A Gauteng health circular that called for the province’s state hospitals to charge foreign patients for services was hastily withdrawn following the national department’s claims that it was a junior official’s mistake. But now that same circular has resurfaced as part of the provincial department’s legal arguments in denying an asylum seeker kidney treatment she needs to stay alive.

In March, the Sunday Times reported how the circular, a directive from the Gauteng health department, said foreign nationals would be forced to pay to use state hospitals, including for emergency treatment...