MPs tell HPCSA to continue working on doctors’ tariffs

Londiwe Buthelezi

The portfolio committee on health has given the Health Professions Council of SA (HPCSA) the go ahead to work out tariff guidelines for private doctors, saying that even though this was not its mandate, someone had to step in.

“Continue making tariffs. I know there is a question as to whether you are the legal body to do so, but the bottom line is that we need a tariff,” Monwabisi Goqwana, the chairman of the committee, said yesterday.

Goqwana said an independent body had to be appointed to do the research on which tariffs could be based. Parliament was prepared to organise its own researchers.

The body representing medical schemes, the Board of Healthcare Funders of Southern Africa (BHF), suggested the Department of Health was a neutral party that was suitable to conduct this research, but the SA Medical Association (Sama) argued the department could not be neutral.

“When this was at the level of the Council for Medical Schemes [CMS], you could see the progress,” Mzukisi Grootboom, a board director at Sama, told the committee.

So the committee would look at the possibility of involving both the department and the CMS in the independent research. The research would look at the cost of running doctors’ practices, and this cost would help determine a fair tariff for the patient, the service providers and the funders.

Doctors and specialists associations told MPs that they had rejected the HPCSA’s guideline tariffs because these prices did not reflect the cost of running their practices.

Sama acting chairman Mark Sonderup said doctors’ input costs had increased by 62 percent since 2003, yet the guideline tariff for some procedures was 5 percent less than the 2003 benchmark.

The SA Private Practitioners Forum said the medical aid rand conversion factor was three times more in real terms in 1968 than what it was now for medical procedures, and two times more for consultations.

But Rajesh Patel, the head of benefit and risk at the BHF, argued that these cost studies were “bad research” and that even if there was any merit to them, they could not be used to determine a policy.

He said health-care providers had manipulated the tariff codes in such a way that they could charge three different bills for one procedure.

Anban Pillay, the head of pricing at the Health Department, said when the department requested practice costs from the health practitioners, the number of doctors that responded did not reflect the number of those practising in South Africa.

Yesterday, HPCSA chief executive and registrar Buyiswa Mjamba-Matshoba, said the organisation had not withdrawn the tariffs but had only put them on hold pending the council’s meeting on September 3.

Mjamba-Matshoba said the guideline tariffs were based on the 2006 national health reference price list determined by the CMS together with the department, but an inflator of 46.6 percent had been added to them to bring them up to date.