logo

July 2014

CERTIFICATE OF NEED

After consultation with affected stakeholders and pressure imposed by various provider groups, the Director-General of Health has announced that the proclamation enacting the sections of the National Health Act related to certificates of need would be withdrawn. The Director-General advised, however, that the process relating to the preparation of relevant Regulations would continue. It was therefore likely that these sections would again be implemented once the Regulations were in place.

SINGLE EXIT PRICE (SEP)

The Minister of Health has advised that not all stakeholders were satisfied with the extent to which medicine prices have been adjusted annually. However, he had to ensure that price adjustments took account of the availability, affordability and quality of medicines. The Minister would therefore like to review the use of the current formula as a reference guide for making a recommendation on the determination of the extent to which medicine prices could be adjusted on an annual basis. Interested parties were invited to provide comments on alternative methodologies for adjusting medicine prices for 2015 in the following areas:

  • The feasibility of establishing a single exit price (SEP) inflator for fully imported generic products, locally produced generic products and originator medicines; and
  • The formula used as a reference guide in making a recommendation in respect of the extent to which medicine prices might be adjusted on an annual basis.

DEMARCATION REGULATIONS

National Treasury has advised that the comment date for the draft Demarcation Regulations has been extended to 31 July 2014. It has also published a list of frequently asked questions and answers pertaining to the draft Regulations. It was stated that the envisaged finalisation date for the draft Demarcation. Regulations was October 2014.

ROAD ACCIDENT BENEFIT SCHEME BILL

The Department of Transport and the Board of the Road Accident Fund have extended the comment period in respect of the Road Accident Benefit Scheme Bill, the draft Regulations and draft Rules for a further 90 days from 8 July 2014.

HPCSA GUILTY VERDICTS

CATEGORIES OF COMPLAINTS TYPES OF COMPLAINTS PENALTIES
Accounts (Medical Scheme Fraud)
  • Rendering inaccurate accounts
  • R10 000 fine
  • R50 000 fine of which R40 000 suspended for 3 years and suspension from practice for 3 years of which the operation was suspended for 3 years
  • Suspended for 6 months of which the operation was suspended for 3 years
  • R10 000 fine of which the operation was suspended for 3 years
  • Admission of Guilt Fine of R10 000
Advertising
  • Unprofessional advertising on the internet
  • Admission of Guilt Fine of R10 000
Charging for services not provided
  • Charging for prescription spectacles not provided and failed to provide the correct prescription spectacles
  • Charged for medicines not dispensed
  • Caution and reprimand and payment of R1 500 to complainant and had to attend 2 ethics lectures
  • R10 000 fine
  • R50 000 fine of which R40 000 suspended for 3 years and suspension from practice for 3 years of which the operation was suspended for 3 years
  • R30 000 fine of which R15 000 suspended for 3 years
  • R10 000 fine of which the operation was suspended for 3 years Suspended for periods ranging from 6 months to 3 years of which the operation was suspended for periods ranging from 3 to 5 years
Commission
  • Paying commission to entity selling services rendered by the practice online
  • Paid commission for referrals
  • Admission of Guilt Fine of R10 000
  • R20 000 fine of which R10 000 suspended for 3 years

 

Correspondence from HPCSA
  • Failure to respond to HPCSA’s correspondence requiring an explanation pursuant to a complaint
  • Admission of Guilt Fines ranging from R10 000 to R15 000
Failure to provide adequate care
  • Failure to assess a patient timeously after being informed of her deterioration after a laparoscopic gastric bypass operation
  • Failure to recognize complications
  • Assessment and care of patient inadequate
  • Failure to provide adequate and appropriate care, treat patient timeously and broke patient’s tooth during treatment
  • Provided inadequate treatment to fractured elbow
  • Failure to pursue reasonable clinical treatment
  • Liposuction: Inadequate postoperative care and premature discharge
  • Prepared report without proper investigations
  • Operated on the wrong finger
  • Failure to monitor patient properly and provided insufficient care
  • Caution
  • Caution and reprimand
  • Fines ranging from R5 000 to R7 500
  • Suspension from practice for periods ranging between 6 months to 5 years of which the operation was suspended for periods ranging between 2 to 5 years
  • Admission of Guilt Fines ranging from R10 000 to R50 000
Fee-sharing
  • Practitioner shared fees with a non-professional
  • Admission of Guilt Fine of R10 000
Fraud
  • Pleaded guilty on charges of fraud
  • 5 years suspension of which the operation was suspended for 5 years
Informed Consent
  • Performed laparotomy with-out patient’s consent
  • Admission of Guilt Fine of R20 000
Laboratory
  • Failure to conduct laboratory without qualified staff and without providing qualified supervision
  • Admission of Guilt Fine of R15 000
Medical Certificates
  • Issued fraudulent medical certificate
  • Altered dates on sick note when approached by employer
  • R10 000 fine
  • Admission of Guilt Fine of R7 500
Medicine
  • Prescribed medicine for which patient was allergic
  • Admission of Guilt Fine of R20 000
Mobile Practice
  • Conducted mobile practice which was not registered at the Board
  • Admission of Guilt Fine of R50 000
Over-charging
  • Practitioner over-charged for services rendered
  • Admission of Guilt Fine of R15 000
Patient records
  • Failure to take adequate notes and/or document findings subsequent to a consultation
  • Failure to keep proper patient records
  • Reprimand
  • R10 000 fine
Practising whilst suspended
  • Practitioner practised whilst being suspended from the register
  • Caution
Referrals
  • Failure to refer patient
  • Referred patient to a person/wellness centre not registered at the HPCSA
  • Reprimand
  • Admission of Guilt Fine of R50 000
Stationery
  • Professional stationery included misleading statements about qualifications and training
  • 1 year suspension of which the operation was suspended for 5 years
Unregistered person
  • Employed unregistered person who consulted patients
  • R10 000 fine

CALL FOR SUBMISSIONS

The Private Healthcare Inquiry Panel has issued a “Call for Submissions” to all those who wish to participate in the Market Inquiry. The Call for Submissions comes after the Panel, having considered public comment, finalised and published the Administrative Timetable, Statement of Issues and Guidelines for Participation.

The invitation to all stakeholders to make full submissions to the Panel is another key milestone in the Inquiry, which is now entering its crucial investigative phase. The Panel urges participants to make full and detailed submissions at the outset, and looks forward to the same level of interest and cooperation that has been demonstrated to date.

The Panel is particularly interested in submissions on the key issues identified in the Statement of Issues, read with the Terms of Reference for the Inquiry.

The matters identified in the Statement of Issues include, but are not limited to:

  • Factors driving costs, prices and expenditure in private healthcare;
  • Market power and distortions of competition at various levels of the sector;
  • Barriers to entry and expansion by firms at various levels of the sector;
  • Factors limiting access by consumers to private healthcare, including affordability;
  • Imperfect information as it affects consumers as well as firms in the sector;
  • The impact of the regulatory framework (including various statutes, regulations and rules) on competition in private healthcare;
  • The specific impact of interventions previously made by the competition authorities in regard to the healthcare sector;
  • The interaction between the public and private healthcare sectors.

“We are encouraged by the level of interest and participation in the Inquiry thus far and would like to urge all those affected by the Inquiry to familiarise themselves with these documents, and to take this opportunity to engage fully and openly with the Inquiry” said Clint Oellermann, Inquiry Director.

Full details, including the documents and forms, can be accessed on the Competition Commission and Health Market Inquiry websites. Written Submissions can be e-mailed to submissions@healthinquiry.net

The closing date for full submissions is 31 October 2014.