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HEALTHMAN PRIVATE PRACTICE REVIEW: SEPTEMBER 2019 Content Food for Thought News on Government Special News Financial News News on Medical Schemes General News Special Notices Food for Thought OPINION: NHI Dream: When polemic triumphs over policy By Aslam Dasoo a convenor of the Progressive Health Forum and a member of the Stalwarts and Veterans of the ANC in City Press, 1 September 2019. “There are two White Papers on healthcare that are germane. The first one, introduced by the Nelson Mandela administration, produced a sensible plan to fulfil the obligation of section 27 of the Constitution. The second is the White Paper, spawned 10 years later in the toxic cauldron of the Polokwane conference, evoking a new plan that is a triumph of polemic over policy. One was the product of struggle, of empirical research and the organic participation of the people in its formulation. “The White Paper emanating from the Polokwane resolution is everything that the former is not. It is the result of a political sleight of hand, with a flimsy pamphlet of questionable provenance, lacking credible research, thorough analysis and proper consultation, rammed through by Jacob Zuma’s triumphalist Polokwane brigade. “To rescue, rehabilitate and reinforce the public health service is the truly noble enterprise and a great act of solidarity with our people. Instead, they are offered the thin gruel of the NHI. The government spin is replete with euphemisms about the NHI while private sector parties engage in alarmist hand-wringing, sincere only in their despair at the financial damage to their brands. "Both these narratives are phoney and worthless. “Public health services will struggle to gain accreditation under the NHI unless standards are appreciably lowered. To expect them to compete with an agile and well-capitalised private sector that is inured to the social investiture necessary for healthcare is a mug’s game. "The President and the Minister of Health are eminently sensible politicians and leaders. If they took a risk-adjusted view of healthcare, they would understand the necessity of directing immediate and massive investment into the public health service, turning it into the healthcare provider and employer of choice and a truly world-class national asset. Simultaneously, they should abjure populist exhortations and implement careful regulatory reform of the private health market, akin to what was abandoned a decade ago, to integrate it into a system of universal access to all necessary care, free at the point of care for the whole population. “Rescuing the public health service qualifies as being in the national security interest, the NHI does not." Allow autonomous body to make NHI decisions Andrew Briggs In City Press (8 September 2019) Vuyo Mkize wrote: “The government hopes to see the NHI implemented in full by 2026. However, given that the available healthcare budget is limited, two questions apply: • How will government, as well as the private sector, determine what is covered under their benefits packages; and, • What informs the choice of a new drug, device or intervention?” Commenting on the introduction of the NHI, Professor Andrew Briggs - a world expert on health technology assessment (HTA) at the University of Glasgow, Scotland - said that “process and governance issues will need to be clarified and followed in full” before the government could decide on a universally beneficial and equitable basket of healthcare services. To read more, click the button below News on Government NHI has so many holes, it’s bound to sink, experts warn On Friday, 13 September, the National Department of Health (DoH) released a letter asking for nominations for the steering committee of the national benefits committee. The nominations have to be made by 17 September. “The rush to appoint an interim steering committee comes as the Helen Suzman Foundation requested more time from the NHI health parliamentary portfolio committee to send comments about NHI,” reported Times Select (16 September 2019). The deadline for submissions is October 11. The Helen Suzman Foundation believes “the NHI Bill is far too important and complex to be adequately engaged within this short comment period”. According to experts it was difficult for people to make “informed” comments because the suggested law does not say what type of healthcare services the fund will buy and what it will cost. However, senior government official and head of the NHI office, Dr Nicholas Crisp, said an act of law could not be too detailed because its aim was to create an “enabling environment” for further regulations. “It will cost as much as we can afford. Pay what you can, to get what you can get,” said Crisp. BUSA to engage with state on NHI Business Unity SA (BUSA) is to set up a formal mechanism for engaging with the health department on its plans for universal health coverage, reported Business Day (5 September 2019). After a meeting between BUSA and Health Minister Zweli Mkhize it was agreed to establish a five-member team from each side to engage on the proposed new system. Stavros Nicolaou, Aspen Pharmacare’s executive for strategic trade, said BUSA planned to ask Parliament for a six-week extension on the public comment period for the NHI Bill. NHI Bill in line with constitution Acting chief state law adviser, Ayesha Johaar, told Parliament that the NHI Bill was certified as being constitutionally sound on July 29. On the issue of the provinces, she said the National Health Act determined the roles, responsibilities and functions of the spheres of government with regard to health, and not the constitution itself. This is interpreted to mean provinces may enact provincial laws to deal with health services authorised and contemplated by the national framework and to give effect to national policy. Any amendment to these provisions does not in and of itself offend the constitution. The DA’s shadow health minister, Siviwe Gwarube, a member of the committee, said she did not accept Johaar’s position on the bill. Doctors at their wits end According to research, published in the SA Medical Journal 84% registrars in the clinical medicine school at Wits University are suffering burnout. The researcher, Cathelijn Zeijlemaker, said she was particularly worried by the “extremely high” feelings of depersonalisation she uncovered among 170 registrars who completed an online questionnaire. Zeijlemaker said burnout negatively influences the attitude of registrars to their careers, leading to changes of speciality, changes of career or emigration. Investigated Company awarded large tender The Limpopo health department has awarded a lucrative three-year tender to a joint venture including Buthelezi EMS, a private emergency medical services company which is under investigation by the Special Investigating Unit, the Hawks and National Treasury, reported Spotlight (27 August 2019). Buthelezi EMS (BEMS) and its joint venture partner FIM Aviation have been unable to provide an aeromedical service in terms of the new tender - either leaving patients stranded or requiring the department to make use of other private sector providers in Gauteng. State hospitals and clinics fail safety audit According to a statement issued by the Jack Bloom, DA spokesperson for health in Gauteng, not a single state health facility in Gauteng has been assessed as complying with the Occupational Health and Safety Act (OHSA).The information was revealed by province's Health MEC, Bandile Masuku, in a reply to questions in legislature. The most non-compliant facilities were: Bheki Mlangeni Hospital; Far East Rand Hospital; Tembisa Hospital; Kopanong; Mamelodi; George Mukhari; Ekurhuleni district clinics; Johannesburg district clinics. Meanwhile WITS vice-chancellor, Adam Habib, has challenged Gauteng Premier David Makhura’s call for the DoH to finance the province’s debt-ridden teaching hospitals, saying centralising their funding without fixing their deep- seated administrative and governance challenges won’t give patients a better deal. Gauteng is home to four of SA’s 10 central hospitals, which are linked to medical schools, and provide highly specialised care to patients with complicated conditions. They include Charlotte Maxeke, Steve Biko, Baragwanath and George Mukhari, which serve patients living in Gauteng as well as those referred from other provinces and from neighbouring states. In September Gauteng DoH warned employees it will recover some of the billions in damages claims it is facing from those responsible for the medical negligence. In a recent staff circular, department head, Prof Mkhululi Lukhele, said the department “cannot continue” to allow a situation where legal claims stand at half of its annual budget of R50.8-bn. Recent figures show it is facing claims of R29-bn. Meanwhile none of the government plans designed to improve staff shortages and training at state hospitals have been implemented as doctor shortages persist, reported Times Select (30 August 2019). According to the dean at the Nelson Mandela Medical School, prof Lungile Pepeta, the 2011 Human Resources for Health SA to “increase the output of doctors three times” has never been implemented. What a waste! Gauteng health MEC, Dr Bandile Masuku, revealed that the department has irregularly extended 12 contracts worth more than R1-bn a year. The contracts have been extended monthly for the past three years without going out to tender. Of the contracts, R675-m is for security for tertiary and regional hospitals and clinics. The other contracts, worth nearly R400-m, are for the supply of renal dialysis equipment, collection of medical waste and supply of tubs and small lids to hospitals. CMS hit by probes, lack of funding, staff shortages The CMS is working along with the SIU on the investigation to rid the industry of “fraud and corruption”, Registrar Dr Sipho Kabane, told Parliament (Fin24, 30 August 2019). The CMS has appointed an investigation panel, led by Advocate Tembeka Ngcukaitobi, to look into allegations of racial profiling by medical schemes. Public hearings will be concluded in September and a final report by the panel is expected by November 2019. The Council is also challenged by a lack of resources. Although the CMS has requested an increase of 9.6% on levies, the health and finance ministers have agreed to an increase of 7.03%. Kabane commented that the biggest source of the CMS budget is being strangled. He said the SIU investigation would cost R4.6-m and the investigation, led by Ngcukaitobi, will cost R10-m. Special News READ MORE Doctors: Read the NHI Bill and have your say… Family practitioners must find the time to read through the NHI Bill, take note of the sections that will affect them directly in their daily practices, and make the effort to submit any concerns, queries or points of confusion they may have while the bill is out for public comment. It is not what the government can do, but what doctors can do that is more important when it comes to meeting the health care needs of the country’s people, internationally experienced and respected medical post-graduate lecturer and family practice stalwart, Dr Graham Hukins, indicated recently when moderating a SA Academy of Family Physicians Conference workshop: You now have the opportunity to say what you can do! READ MORE Financial News NHI won’t shift our focus, says Discovery CEO, Adrian Gore. Read more under: News on Medical Aids NHI expenditure will be R450- bn - Fitch Fitch Solutions, a unit of the Fitch Group, projects the government’s healthcare expenditure will reach nearly R450-bn by 2028, following its decision to implement the NHI system, reported Business Report (2 September 2019). According to Fitch’s research government health expenditure could post a 9.9% 10-year compound annual growth rate (CAGR) reaching R449.9-bn by 2028. It expects private health expenditure to gradually decline, posting a 1.6% five-year CAGR, amounting to R224-bn by 2028. Dividend on hold at Aspen Aspen Pharmacare has decided not to declare a dividend for the first time in almost a decade, reported Business Day (12 September). Aspen reported a 15% decline in headline earnings per share to 1,254c, down from a restated 1,475c in 2018 Meanwhile it has been announced that Aspen will no longer produce ARV’s under its own name. Instead, it will produce drugs under license for an Indian pharmaceutical company. Adcock Ingram CEO upbeat about NHI Bill Andy Hall, the CEO of Adcock Ingram (SA’s second-largest generic drug manufacturer) said the reforms proposed under the NHI Bill could boost drug sales, reported Business Day on 29 August. He said Adcock Ingram already operates in a market constrained by restrictions on medicine sales, ranging from government caps on annual price increases to the formularies (lists of approved products) used by large medical schemes, and did not anticipate struggling to adapt to NHI. Dis-Chem’s revenue almost at R10-bn Dis-Chem’s revenue jumped to almost R10-bn in the five months to July 31, 2019. The group recorded a 13.5% jump in group revenue to R9.9-bn. Retail revenue jumped 12% to R9-bn for the period. Group chief executive, Ivan Saltzman, said with the strike and warehouse decentralisation concluded, the group continued to focus on reducing and rationalising its stock holding to improve free cash flow generation. Saltzman said the group was on track to add another 13 stores before year-end and had opened nine new stores to date. Adcock Ingram CEO upbeat about NHI Bill Andy Hall, the CEO of Adcock Ingram (SA’s second-largest generic drug manufacturer) said the reforms proposed under the NHI Bill could boost drug sales, reported Business Day on 29 August. He said Adcock Ingram already operates in a market constrained by restrictions on medicine sales, ranging from government caps on annual price increases to the formularies (lists of approved products) used by large medical schemes, and did not anticipate struggling to adapt to NHI. General News SA men more likely to commit suicide than women According to the latest WHO report: Preventing Suicide: A Resource for Pesticide Registrars and Regulators, men in SA are more than four times more likely to commit suicide than women. Almost 800 000 people die from suicide every year globally. In 2016, the year on which the data is based, SA recorded 6 476 suicides, which translates into a rate of 12.8 people per 100 000. 5 138 were men: a suicide rate of 21.8 per 100 000. The suicide rate of women was just more than 5 per 100 000. The SA Depression and Anxiety Group (Sadag), which operates the country’s only suicide helpline, has received 145 000 calls to its 22 lines so far in 2019. Although the majority of callers are females, some of the more acute or emergency cases are from male callers, especially since men use more aggressive methods of suicide. News on Medical Aids NHI won’t shift our focus, says Discovery CEO According to Discovery CEO, Adrian Gore, the company did not predict any dramatic change in its strategic planning for the medical scheme administration business. Speaking at the company’s annual results for the year ended in June, Gore said the role of the private sector is critical to the success of NHI and not including it would be counterproductive because SA does not have sufficient resources for it. Discovery’s results show profits from its health business increased 10%, while the group’s profits rose 15% to R6.6-bn. *In an article, published in Business Day (5 September 2019) Gore presented an analysis on the implications of funding NHI that showed the average monthly healthcare spend per person by members of medical schemes is R1 726 versus just R372 spent by the government on behalf of people accessing the public health system. Were the government to pursue the most comprehensive version of universal healthcare and replace the R206-bn made in contributions to private medical schemes through contributions to NHI via higher taxes, the average spend on healthcare per person per month would only rise to R576, said Gore. 'Singing in the rain' “It has been one of the more challenging weeks for SA’s quintessential corporate optimist, Adrian Gore, to keep the legendary pep in his step” wrote Rob Rose & Stepehen Cranston in Financial Mail (12 September). “Gore, who built Discovery into SA’s largest medical aid administrator in just 27 years, has long been the antidote to the waves of negativity that seem to assail SA every few months. ”But with SA on the brink of a rating downgrade, unemployment having deepened to 29%, a wave of xenophobic-based looting and an inexplicably brutal spate of violence against women, has Gore changed his tune?" To read a condensed version of the article published in Financial Mail, click on the button below, marked ATTACHMENT DISCOVERY DISCOVERY Council approves the merger of CompCare and Selfmed The CMS has approved the merger of CompCare Wellness Medical Scheme and Selfmed. The amalgamated scheme will be known as CompCare Wellness Medical Scheme. Circulars: Council for Medical Schemes The following Circulars were published by the CMS in August/September 2019. Visit www.medicalschemes.co.za for more info. 57 of 2019 Quarterly Statutory Returns Submission for 2019 (Q2) 58 of 2019 Imposition of Levies for Medical Schemes 1019/20 59 of 2019 Induction Programme for Trustees 60 of 2019 KZN Advanced Broker Training Reminder 61 of 2019 State Hospitals as a Designated Service Provider for Medical Research Survey 62 of 2019 Auditor approvals 63 of 2019 CompCare Wellness Medical Scheme and Selfmed MedicalScheme merger is confirmed 64 of 2019 Request for HIV, TB and STI DATA for the SA National Aids Council (SANAC) 65 of 2019 Advanced Trustee Training in Partnership with GIBS 66 of 2019 Advanced Broker Training in Cape Town 67 of 2019 National Registry Pilot Program Project Plan Deadlines 68 of 2019 Thebemed final curatorship granted Special Notices Social Media Guidelines The HPCSA has released a booklet on Ethical Guidelines on Social Media Booklet 16 Social Media Guidelines. To read the booklet, click on the button below. Doctors can now send an SMS to speak to a Medscheme Medical Advisor How does it work? Doctor to a Medscheme Medical Advisor (MA): In the event that you would like to make contact with a MA: 1. Send an SMS to 44845 between the hours of 09:00am and 16:00pm and include the following information: Your practice number Your full name and surname Patient membership number and dependent code/name Authorisation or reference number (if available) Requested date and two (2) requested times for a MA to call back (optional) Indicate in short the nature of the clinical query, e.g. Hospital, Chronic Medicine or Oncology- related query (optional). 2. A confirmation SMS will be sent to you that a MA will call back at the requested time. 3. The MA will call you at the scheduled time. It is only to be used to discuss the funding of your patients clinical treatment. Claims queries will not be discussed as the Medical Advisor team is not responsible for managing claims queries. For claims queries contact the Healthcare Professional Contact Centre Call Centre on 0861 112666 or email [email protected] / [email protected] The MA will be available to return calls between 09:00am – 16:00pm from Monday to Friday. If an SMS is sent after normal office hours, the MA will only attend to the message the following work day. To advertise in Private Practice Review contact Maretha Conradie: [email protected]. HealthView and Private Practice Review provide news and opinion articles as a service to our members to enhance their understanding of the health care industry. The information contained in these publications is published without warranties of any kind, either express or implied. HealthView and Private Practice Review are published solely for informational purposes and should not to be construed as advice or recommendations. Individuals should take into account their own unique and specific circumstances in acting on any news or articles published. Often these articles originate from sources outside our organization that are reported in the national press. Consequently, any information, trademarks, service marks, product names or named features are assumed to be the property of their respective owners, and are used solely for informative purposes in our publications. There is furthermore no implied endorsement of any of the products, goods or services mentioned in our publications.

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HEALTHMANPRIVATEPRACTICEREVIEW:SEPTEMBER2019

Content

FoodforThoughtNewsonGovernmentSpecialNewsFinancialNews

NewsonMedicalSchemesGeneralNewsSpecialNotices

FoodforThought

OPINION:

NHIDream:Whenpolemictriumphsoverpolicy

ByAslamDasooaconvenoroftheProgressiveHealthForumandamemberoftheStalwartsand

VeteransoftheANCinCityPress,1September

2019.

“TherearetwoWhitePapersonhealthcarethat

aregermane.Thefirstone,introducedbythe

NelsonMandelaadministration,produceda

sensibleplantofulfiltheobligationofsection27

oftheConstitution.ThesecondistheWhite

Paper,spawned10yearslaterinthetoxic

cauldronofthePolokwaneconference,evoking

anewplanthatisatriumphofpolemicover

policy.Onewastheproductofstruggle,of

empiricalresearchandtheorganicparticipation

ofthepeopleinitsformulation.

“TheWhitePaperemanatingfromthe

Polokwaneresolutioniseverythingthatthe

formerisnot.Itistheresultofapoliticalsleightof

hand,withaflimsypamphletofquestionable

provenance,lackingcredibleresearch,thorough

analysisandproperconsultation,rammed

throughbyJacobZuma’striumphalist

Polokwanebrigade.

“Torescue,rehabilitateandreinforcethepublic

healthserviceisthetrulynobleenterpriseanda

greatactofsolidaritywithourpeople.Instead,

theyareofferedthethingrueloftheNHI.The

governmentspinisrepletewitheuphemisms

abouttheNHIwhileprivatesectorparties

engageinalarmisthand-wringing,sincereonly

intheirdespairatthefinancialdamagetotheir

brands.

"Boththesenarrativesarephoneyandworthless.

“PublichealthserviceswillstruggletogainaccreditationundertheNHIunlessstandardsareappreciablylowered.Toexpectthemtocompetewithanagileandwell-capitalisedprivatesectorthatisinuredtothesocialinvestiturenecessaryforhealthcareisa

mug’sgame.

"ThePresidentandtheMinisterofHealthare

eminentlysensiblepoliticiansandleaders.Ifthey

tookarisk-adjustedviewofhealthcare,they

wouldunderstandthenecessityofdirecting

immediateandmassiveinvestmentintothe

publichealthservice,turningitintothe

healthcareproviderandemployerofchoiceand

atrulyworld-classnationalasset.

Simultaneously,theyshouldabjurepopulist

exhortationsandimplementcarefulregulatory

reformoftheprivatehealthmarket,akintowhat

wasabandonedadecadeago,tointegrateitinto

asystemofuniversalaccesstoallnecessary

care,freeatthepointofcareforthewhole

population.

“Rescuingthepublichealthservicequalifiesasbeinginthenationalsecurityinterest,the

NHIdoesnot."

AllowautonomousbodytomakeNHI

decisions

AndrewBriggs

InCityPress(8September2019)VuyoMkizewrote:“ThegovernmenthopestoseetheNHIimplementedinfullby2026.However,giventhattheavailablehealthcarebudgetislimited,two

questionsapply:

•Howwillgovernment,aswellastheprivatesector,determinewhatiscoveredundertheirbenefits

packages;and,

•Whatinformsthechoiceofanewdrug,deviceorintervention?”

CommentingontheintroductionoftheNHI,ProfessorAndrewBriggs-aworldexpertonhealthtechnologyassessment(HTA)attheUniversityofGlasgow,Scotland-saidthat“processandgovernanceissueswillneedtobeclarifiedandfollowedinfull”beforethegovernmentcoulddecide

onauniversallybeneficialandequitablebasketofhealthcareservices.

Toreadmore,clickthebuttonbelow

NewsonGovernment

NHIhassomanyholes,it’sboundtosink,expertswarnOnFriday,13September,theNationalDepartmentofHealth(DoH)releasedaletteraskingfor

nominationsforthesteeringcommitteeofthenationalbenefitscommittee.Thenominationshaveto

bemadeby17September.

“TherushtoappointaninterimsteeringcommitteecomesastheHelenSuzmanFoundation

requestedmoretimefromtheNHIhealthparliamentaryportfoliocommitteetosendcommentsabout

NHI,”reportedTimesSelect(16September2019).ThedeadlineforsubmissionsisOctober11.

TheHelenSuzmanFoundationbelieves“theNHIBillisfartooimportantandcomplextobe

adequatelyengagedwithinthisshortcommentperiod”.

Accordingtoexpertsitwasdifficultforpeopletomake“informed”commentsbecausethesuggestedlawdoesnotsaywhattypeofhealthcareservicesthefundwillbuyandwhatitwill

cost.

However,seniorgovernmentofficialandheadoftheNHIoffice,DrNicholasCrisp,saidanactoflaw

couldnotbetoodetailedbecauseitsaimwastocreatean“enablingenvironment”forfurther

regulations.

“Itwillcostasmuchaswecanafford.Paywhatyoucan,togetwhatyoucanget,”saidCrisp.

BUSAtoengagewithstateonNHI

BusinessUnitySA(BUSA)istosetupaformal

mechanismforengagingwiththehealth

departmentonitsplansforuniversalhealth

coverage,reportedBusinessDay(5September

2019).AfterameetingbetweenBUSAand

HealthMinisterZweliMkhizeitwasagreedto

establishafive-memberteamfromeachsideto

engageontheproposednewsystem.

StavrosNicolaou,AspenPharmacare’s

executiveforstrategictrade,saidBUSA

plannedtoaskParliamentforasix-week

extensiononthepubliccommentperiod

fortheNHIBill.

NHIBillinlinewithconstitution

Actingchiefstatelawadviser,AyeshaJohaar,

toldParliamentthattheNHIBillwascertifiedas

beingconstitutionallysoundonJuly29.Onthe

issueoftheprovinces,shesaidtheNational

HealthActdeterminedtheroles,responsibilities

andfunctionsofthespheresofgovernmentwith

regardtohealth,andnottheconstitutionitself.

Thisisinterpretedtomeanprovincesmayenact

provinciallawstodealwithhealthservices

authorisedandcontemplatedbythenational

frameworkandtogiveeffecttonationalpolicy.

Anyamendmenttotheseprovisionsdoesnotin

andofitselfoffendtheconstitution.

TheDA’sshadowhealthminister,Siviwe

Gwarube,amemberofthecommittee,

saidshedidnotacceptJohaar’sposition

onthebill.

Doctorsattheirwitsend

Accordingtoresearch,publishedintheSA

MedicalJournal84%registrarsintheclinical

medicineschoolatWitsUniversityaresuffering

burnout.

Theresearcher,CathelijnZeijlemaker,saidshe

wasparticularlyworriedbythe“extremelyhigh”

feelingsofdepersonalisationsheuncovered

among170registrarswhocompletedanonline

questionnaire.Zeijlemakersaidburnout

negativelyinfluencestheattitudeofregistrarsto

theircareers,leadingtochangesofspeciality,

changesofcareeroremigration.

InvestigatedCompanyawardedlargetender

TheLimpopohealthdepartmenthasawardeda

lucrativethree-yeartendertoajointventure

includingButheleziEMS,aprivateemergency

medicalservicescompanywhichisunder

investigationbytheSpecialInvestigatingUnit,

theHawksandNationalTreasury,reported

Spotlight(27August2019).ButheleziEMS

(BEMS)anditsjointventurepartnerFIMAviation

havebeenunabletoprovideanaeromedical

serviceintermsofthenewtender-either

leavingpatientsstrandedorrequiring

thedepartmenttomakeuseofotherprivate

sectorprovidersinGauteng.

Statehospitalsandclinicsfailsafetyaudit

AccordingtoastatementissuedbytheJack

Bloom,DAspokespersonforhealthinGauteng,

notasinglestatehealthfacilityinGautenghas

beenassessedascomplyingwiththe

OccupationalHealthandSafetyAct(OHSA).The

informationwasrevealedbyprovince'sHealth

MEC,BandileMasuku,inareplytoquestionsin

legislature.

Themostnon-compliantfacilitieswere:Bheki

MlangeniHospital;FarEastRandHospital;

TembisaHospital;Kopanong;Mamelodi;George

Mukhari;Ekurhulenidistrictclinics;

Johannesburgdistrictclinics.

MeanwhileWITSvice-chancellor,Adam

Habib,haschallengedGauteng

PremierDavidMakhura’scallfortheDoH

tofinancetheprovince’sdebt-ridden

teachinghospitals,sayingcentralising

theirfundingwithoutfixingtheirdeep-

seatedadministrativeandgovernance

challengeswon’tgivepatientsabetter

deal.

GautengishometofourofSA’s10

centralhospitals,whicharelinkedto

medicalschools,andprovidehighly

specialisedcaretopatientswith

complicatedconditions.Theyinclude

CharlotteMaxeke,SteveBiko,

BaragwanathandGeorgeMukhari,which

servepatientslivinginGautengaswell

asthosereferredfromotherprovinces

andfromneighbouringstates.

InSeptemberGautengDoHwarned

employeesitwillrecoversomeofthe

billionsindamagesclaimsitisfacing

fromthoseresponsibleforthemedical

negligence.Inarecentstaffcircular,

departmenthead,ProfMkhululiLukhele,

saidthedepartment“cannotcontinue”to

allowasituationwherelegalclaimsstand

athalfofitsannualbudgetofR50.8-bn.

Recentfiguresshowitisfacingclaimsof

R29-bn.

Meanwhilenoneofthegovernmentplans

designedtoimprovestaffshortagesand

trainingatstatehospitalshavebeen

implementedasdoctorshortagespersist,

reportedTimesSelect(30August2019).

AccordingtothedeanattheNelson

MandelaMedicalSchool,profLungile

Pepeta,the2011HumanResourcesfor

HealthSAto“increasetheoutputof

doctorsthreetimes”hasneverbeen

implemented.

Whatawaste!

GautenghealthMEC,DrBandileMasuku,

revealedthatthedepartmenthasirregularly

extended12contractsworthmorethanR1-bna

year.Thecontractshavebeenextendedmonthly

forthepastthreeyearswithoutgoingoutto

tender.Ofthecontracts,R675-misforsecurityfor

tertiaryandregionalhospitalsandclinics.

Theothercontracts,worthnearlyR400-m,arefor

thesupplyofrenaldialysisequipment,collection

ofmedicalwasteandsupplyoftubsandsmall

lidstohospitals.

CMShitbyprobes,lackoffunding,staffshortages

TheCMSisworkingalongwiththeSIUontheinvestigationtoridtheindustryof“fraudand

corruption”,RegistrarDrSiphoKabane,toldParliament(Fin24,30August2019).TheCMS

hasappointedaninvestigationpanel,ledbyAdvocateTembekaNgcukaitobi,tolookintoallegations

ofracialprofilingbymedicalschemes.PublichearingswillbeconcludedinSeptemberandafinal

reportbythepanelisexpectedbyNovember2019.

TheCouncilisalsochallengedbyalackofresources.AlthoughtheCMShasrequestedanincrease

of9.6%onlevies,thehealthandfinanceministershaveagreedtoanincreaseof7.03%.Kabane

commentedthatthebiggestsourceoftheCMSbudgetisbeingstrangled.HesaidtheSIU

investigationwouldcostR4.6-mandtheinvestigation,ledbyNgcukaitobi,willcostR10-m.

SpecialNews

READMORE

Doctors:ReadtheNHIBillandhaveyoursay…

FamilypractitionersmustfindthetimetoreadthroughtheNHIBill,takenoteof

thesectionsthatwillaffectthemdirectlyintheirdailypractices,andmake

theefforttosubmitanyconcerns,queriesorpointsofconfusiontheymayhave

whilethebillisoutforpubliccomment.

Itisnotwhatthegovernmentcando,butwhatdoctorscandothatismoreimportantwhenitcomesto

meetingthehealthcareneedsofthecountry’speople,internationally

experiencedandrespectedmedicalpost-graduatelecturerandfamilypracticestalwart,DrGraham

Hukins,indicatedrecentlywhenmoderatingaSAAcademyofFamilyPhysiciansConference

workshop:Younowhavetheopportunitytosaywhatyoucando!

READMORE

FinancialNewsNHIwon’tshiftourfocus,saysDiscoveryCEO,AdrianGore.

Readmoreunder:NewsonMedicalAids

NHIexpenditurewillbeR450-bn-Fitch

FitchSolutions,aunitoftheFitchGroup,projects

thegovernment’shealthcareexpenditurewill

reachnearlyR450-bnby2028,followingits

decisiontoimplementtheNHIsystem,reported

BusinessReport(2September2019).

AccordingtoFitch’sresearchgovernmenthealth

expenditurecouldposta9.9%10-year

compoundannualgrowthrate(CAGR)reaching

R449.9-bnby2028.Itexpectsprivatehealth

expendituretograduallydecline,postinga1.6%

five-yearCAGR,amountingtoR224-bnby2028.

DividendonholdatAspen

AspenPharmacarehasdecidednottodeclarea

dividendforthefirsttimeinalmostadecade,

reportedBusinessDay(12September).

Aspenreporteda15%declineinheadline

earningspershareto1,254c,downfroma

restated1,475cin2018

Meanwhileithasbeenannouncedthat

AspenwillnolongerproduceARV’s

underitsownname.Instead,itwill

producedrugsunderlicenseforan

Indianpharmaceuticalcompany.

AdcockIngramCEOupbeataboutNHIBill

AndyHall,theCEOofAdcockIngram(SA’s

second-largestgenericdrugmanufacturer)said

thereformsproposedundertheNHIBillcould

boostdrugsales,reportedBusinessDayon29

August.

HesaidAdcockIngramalreadyoperatesina

marketconstrainedbyrestrictionsonmedicine

sales,rangingfromgovernmentcapsonannual

priceincreasestotheformularies(listsof

approvedproducts)usedbylargemedical

schemes,anddidnotanticipatestrugglingto

adapttoNHI.

Dis-Chem’srevenuealmostatR10-bn

Dis-Chem’srevenuejumpedtoalmostR10-bnin

thefivemonthstoJuly31,2019.Thegroup

recordeda13.5%jumpingrouprevenueto

R9.9-bn.Retailrevenuejumped12%toR9-bn

fortheperiod.Groupchiefexecutive,Ivan

Saltzman,saidwiththestrikeandwarehouse

decentralisationconcluded,thegroupcontinued

tofocusonreducingandrationalisingitsstock

holdingtoimprovefreecashflowgeneration.

Saltzmansaidthegroupwasontracktoadd

another13storesbeforeyear-endandhad

openedninenewstorestodate.

AdcockIngramCEOupbeataboutNHIBill

AndyHall,theCEOofAdcockIngram(SA’ssecond-largestgenericdrugmanufacturer)saidthe

reformsproposedundertheNHIBillcouldboostdrugsales,reportedBusinessDayon29August.

HesaidAdcockIngramalreadyoperatesinamarketconstrainedbyrestrictionsonmedicinesales,

rangingfromgovernmentcapsonannualpriceincreasestotheformularies(listsofapproved

products)usedbylargemedicalschemes,anddidnotanticipatestrugglingtoadapttoNHI.

GeneralNews

SAmenmorelikelytocommitsuicidethan

women

AccordingtothelatestWHOreport:PreventingSuicide:AResourceforPesticideRegistrarsand

Regulators,meninSAaremorethanfourtimesmorelikelytocommitsuicidethanwomen.Almost

800000peoplediefromsuicideeveryyearglobally.

In2016,theyearonwhichthedataisbased,SArecorded6476suicides,whichtranslatesintoarate

of12.8peopleper100000.5138weremen:asuiciderateof21.8per100000.Thesuiciderateof

womenwasjustmorethan5per100000.

TheSADepressionandAnxietyGroup(Sadag),whichoperatesthecountry’sonlysuicidehelpline,

hasreceived145000callstoits22linessofarin2019.Althoughthemajorityofcallersarefemales,

someofthemoreacuteoremergencycasesarefrommalecallers,especiallysincemenusemore

aggressivemethodsofsuicide.

NewsonMedicalAids

NHIwon’tshiftourfocus,saysDiscoveryCEO

AccordingtoDiscoveryCEO,AdrianGore,thecompanydidnot

predictanydramaticchangeinitsstrategicplanningforthe

medicalschemeadministrationbusiness.Speakingatthe

company’sannualresultsfortheyearendedinJune,Goresaid

theroleoftheprivatesectoriscriticaltothesuccessofNHIand

notincludingitwouldbecounterproductivebecauseSAdoesnot

havesufficientresourcesforit.

Discovery’sresultsshowprofitsfromitshealthbusinessincreased

10%,whilethegroup’sprofitsrose15%toR6.6-bn.

*Inanarticle,publishedinBusinessDay(5September2019)

GorepresentedananalysisontheimplicationsoffundingNHI

thatshowedtheaveragemonthlyhealthcarespendperpersonby

membersofmedicalschemesis

R1726versusjustR372spentbythegovernmentonbehalfof

peopleaccessingthepublichealthsystem.

Werethegovernmenttopursuethemostcomprehensiveversion

ofuniversalhealthcareandreplacetheR206-bnmadein

contributionstoprivatemedicalschemesthroughcontributionsto

NHIviahighertaxes,theaveragespendonhealthcareperperson

permonthwouldonlyrisetoR576,saidGore.

'Singingintherain'

“Ithasbeenoneofthemore

challengingweeksforSA’s

quintessentialcorporate

optimist,AdrianGore,tokeep

thelegendarypepinhisstep”

wroteRobRose&Stepehen

CranstoninFinancialMail(12

September).“Gore,whobuilt

DiscoveryintoSA’slargest

medicalaidadministratorinjust

27years,haslongbeenthe

antidotetothewavesof

negativitythatseemtoassail

SAeveryfewmonths.

”ButwithSAonthebrinkofa

ratingdowngrade,

unemploymenthaving

deepenedto29%,awaveof

xenophobic-basedlootingand

aninexplicablybrutalspateof

violenceagainstwomen,has

Gorechangedhistune?"

ToreadacondensedversionofthearticlepublishedinFinancialMail,clickonthebuttonbelow,markedATTACHMENTDISCOVERY

DISCOVERY

CouncilapprovesthemergerofCompCareandSelfmed

TheCMShasapprovedthemergerofCompCare

WellnessMedicalSchemeandSelfmed.The

amalgamatedschemewillbeknownas

CompCareWellnessMedical

Scheme.

Circulars:CouncilforMedicalSchemes

ThefollowingCircularswerepublishedbytheCMSinAugust/September2019.

Visitwww.medicalschemes.co.zaformoreinfo.

57of2019QuarterlyStatutoryReturnsSubmissionfor2019(Q2)

58of2019ImpositionofLeviesforMedicalSchemes1019/20

59of2019InductionProgrammeforTrustees

60of2019KZNAdvancedBrokerTrainingReminder

61of2019StateHospitalsasaDesignatedServiceProviderforMedicalResearchSurvey

62of2019Auditorapprovals

63of2019CompCareWellnessMedicalSchemeandSelfmedMedicalSchememergerisconfirmed

64of2019RequestforHIV,TBandSTIDATAfortheSANationalAidsCouncil(SANAC)65of2019AdvancedTrusteeTraininginPartnershipwithGIBS

66of2019AdvancedBrokerTraininginCapeTown

67of2019NationalRegistryPilotProgramProjectPlanDeadlines

68of2019Thebemedfinalcuratorshipgranted

SpecialNotices

SocialMediaGuidelines

TheHPCSAhasreleasedabookletonEthicalGuidelinesonSocialMediaBooklet16SocialMediaGuidelines.

Toreadthebooklet,clickonthebuttonbelow.

DoctorscannowsendanSMStospeaktoaMedscheme

MedicalAdvisor

Howdoesitwork?DoctortoaMedschemeMedicalAdvisor(MA):IntheeventthatyouwouldliketomakecontactwithaMA:

1. SendanSMSto44845betweenthehoursof09:00amand16:00pmandincludethefollowing

information:

Yourpracticenumber

Yourfullnameandsurname

Patientmembershipnumberanddependentcode/name

Authorisationorreferencenumber(ifavailable)

Requesteddateandtwo(2)requestedtimesforaMAtocallback(optional)

Indicateinshortthenatureoftheclinicalquery,e.g.Hospital,ChronicMedicineorOncology-

relatedquery(optional).

2. AconfirmationSMSwillbesenttoyouthataMAwillcallbackattherequestedtime.3. TheMAwillcallyouatthescheduledtime.

Itisonlytobeusedtodiscussthefundingofyourpatientsclinicaltreatment.ClaimsquerieswillnotbediscussedastheMedicalAdvisorteamisnotresponsibleformanaging

claimsqueries.ForclaimsqueriescontacttheHealthcareProfessionalContactCentreCall

[email protected]/[email protected]

TheMAwillbeavailabletoreturncallsbetween09:00am–16:00pmfromMondaytoFriday.If

anSMSissentafternormalofficehours,theMAwillonlyattendtothemessagethefollowing

workday.

ToadvertiseinPrivatePracticeReviewcontactMarethaConradie:[email protected].

HealthViewandPrivatePracticeReviewprovidenewsandopinionarticlesasaservicetoourmemberstoenhance

theirunderstandingofthehealthcareindustry.Theinformationcontainedinthesepublicationsispublishedwithout

warrantiesofanykind,eitherexpressorimplied.HealthViewandPrivatePracticeReviewarepublishedsolelyfor

informationalpurposesandshouldnottobeconstruedasadviceorrecommendations.Individualsshouldtakeinto

accounttheirownuniqueandspecificcircumstancesinactingonanynewsorarticlespublished.Oftenthesearticles

originatefromsourcesoutsideourorganizationthatarereportedinthenationalpress.Consequently,anyinformation,

trademarks,servicemarks,productnamesornamedfeaturesareassumedtobethepropertyoftheirrespective

owners,andareusedsolelyforinformativepurposesinourpublications.Thereisfurthermorenoimpliedendorsement

ofanyoftheproducts,goodsorservicesmentionedinourpublications.

https://docs.mymembership.co.za/docmanager/419ae5a4-f8c7-11d4-9fb7-0090279a6a88/00143654.pdf
https://ethiqal.co.za/better-data-vital-to-reduce-sas-medico-legal-risk
https://medbriefafrica.co.za/doctors-read-the-nhi-bill-and-have-your-say/
https://docs.mymembership.co.za/docmanager/419ae5a4-f8c7-11d4-9fb7-0090279a6a88/00143655.pdf
https://docs.mymembership.co.za/docmanager/419ae5a4-f8c7-11d4-9fb7-0090279a6a88/00143656.pdf
mailto:[email protected]
mailto:[email protected]

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