Can we afford to loose 64% of our doctors?

One of the first articles FAnews Online carried this year dealt with government’s determination to tackle soaring costs at private hospitals. We looked at the impact of the Council for Medical Schemes and Department of Health’s vendetta on the share price

Medical schemes have also come under severe regulatory pressure of late. Changes to the Medical Schemes Act 2003 introduced three new concepts: open access, community ratings and minimum health benefits. Of these Department of Health interventions the provision of Prescribed Minimum Benefits (PMB) has had the greatest impact. Medical schemes have to treat a list of illnesses as PMB without using their members’ savings. As a consequence the benefits offered by medical schemes will change significantly in future years. The most likely outcome is that entry level medical schemes will become PMB only schemes – with the medical savings account gradually taking a back seat.

This is where things get crazy!

Since taking over as Health Minister it seems Manto Tshabalala-Msimang is intent on destroying the private healthcare sector. Her initial stance on HIV/Aids caused massive delays in the rollout of treatment campaigns for those struggling with the disease. We recall an embarrassing SA healthcare exhibition at a Canadian Aids symposium some years ago. And to this day Tshabalala-Msimang still plays the ‘diet’ over ‘modern medicine’ card whenever she gets the chance.

She has tackled the pharmaceutical industry and medical schemes – has started threatening private hospitals – and her actions haven’t gone unnoticed by South Africa’s doctors and specialists. Her National Health Amendment Bill could chase as many as 64% of the country’s doctors from our shores... This frightening fact emerged from a survey of 1 159 doctors and specialists conducted by E2 Solutions. The bottom line is this: if the proposed Health Act amendments are passed these doctors will ply their trade elsewhere...

And private hospitals will struggle too. Medi-Clinic’s views are summarised in part of their response to the proposed amendments: “Should private hospitals be forced to agree to tariffs that are not economically feasible for them, or have such tariffs imposed on them by the tribunal, further investments in private hospital companies would be jeopardised. This would lead to the demise of private hospitals and detrimentally affect the health care sector as a whole.”

What’s getting up the industry’s nose?

“The intention of this bill is to secure the sustainability of the private health sector in our country and not to destroy it as has been suggested in some quarters,” said Tshabalala-Msimang. But it seems state intervention in the prices set by the private health sector will meet strong resistance from the private hospital groups. And we can’t see how the minister’s vision for an improved private healthcare sector will come about when only one third of the doctors and specialist remain in the country to implement it.

It seems the Health Minister (once again) refuses to listen to the voices of reason. On Thursday 5 June she rejected any notion that the amendments would cause problems. “Over the past years, the private health sector has been unable to increase access and also appears to be unable to contain cost escalations,” she said. Has the Minister forgotten that the private healthcare sector is not responsible for providing healthcare access to all? As we understand things this form of medical cover is intended for individuals who can pay for access over and above the basic medical care offered by the state.

During the 5 June National Assembly debate Democratic Alliance spokesperson Mike Waters noted that 37 of the 94 provisions in the Health Act of 2003 has still to be implemented. This indicated there were plenty of public health issues for the minister to focus on. Waters had some strong words for the minister, saying that she was: “obsessed with introducing more and more legislation whose only aim is to destroy those parts of the system that do work, while laws that could help our health service to work better gather dust.”

Editor’s thoughts:
Independent research company, Monitor Group, ranks South Africa’s private healthcare sector among the five best in the world. Why do you think our Health Minister is so intent on passing regulations to reduce this sector to nothing more than a glorified state-controlled medical tool? Add your thoughts below, or send them to gareth@fanews.co.za