Doctors turn patients away

Cape Town - 150519 - Solly Lison is one of the doctors who won't treat state patients that are reliant on the Compensation Fund because of continued non-payment by the fund. Reporter: Sipokazi Fokazi Picture: David Ritchie

Cape Town - 150519 - Solly Lison is one of the doctors who won't treat state patients that are reliant on the Compensation Fund because of continued non-payment by the fund. Reporter: Sipokazi Fokazi Picture: David Ritchie

Published May 20, 2015

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Cape Town - After practising as a doctor for 40 years and treating numerous trauma patients who were injured on duty, a Sea Point doctor says he no longer offers his services to patients who are dependent on the Workmen’s Compensation Fund to settle their medical accounts.

Dr Solly Lison is one of many South African doctors who are refusing to treat injured employees due to the non-payment of the fund to medics, which some doctors have described as “disastrous”.

This week the DA announced the findings of research it commissioned into the current state of the compensation fund and its effect on access to health care for injured South Africans in need of medical care.

The investigation, which was carried out by SA Medical Association, the National Employers Association of SA and Independent Practitioners Association Foundation among others, found that across the country doctors were increasingly turning injured patients away because of the fund’s failure to settle their claims.

The survey said some practitioners had been waiting to receive their reimbursements from the fund for close to a decade. The non-payments had accumulated into such big amounts for some that they had resorted to not treating these employees to save themselves from the headache of claiming their money.

Lison, who is also the chairman of Qualicare – a body that represented more than 600 GPs in the province – said while in the past he used to treat these injured patients, as settlements were done within a reasonable period, for the past nine years he had not been treating them as a result of non-payment by the fund.

“For me it’s not really worth the effort and my time to treat these patients. If they come to my rooms I would obviously do the necessary to stabilise them as required by law, but nothing more than that… I would transfer them straight away to the public sector,” he said.

Lison said although the Department of Labour had taken the trouble of establishing the fund as an insurance for employees, in reality the promise of compensating injured employees remained a “theoretic promise”. “There’s plastic surgeons and orthopaedic surgeons who devoted a lot of time to treat these patients and used their expertise to save their limbs, but up to today they had not been paid. In medicine our time and expertise is money… it’s so demoralising not to be compensated when you have put so much effort in treating individuals,” he said.

Although he had stabilised patients in recent years, Lison said he didn’t bother submitting claims because these would not be settled anyway.

But although it was easy for doctors to simply turn patients away, said Dr Anthony Behrman, the chief executive of Qualicare, it was the same patients who were disadvantaged at the end. Because so many were refused treatment in the private sector, Behrman said these patients ended up choking the public health-care system, ultimately delaying their recovery as the state facilities also lacked the capacity to treat them.

“Even the intermediary companies who used to pay GPs up front and take the risk of not being paid by the fund are now giving up as they, too, are not paid. It’s a disastrous situation,” he said.

He said for the past few years a company known as CompSol, which handled between 40 and 60 percent of all medical claims against the fund, was now owed more than R500 000. They had since stopped to avoid the “administrative headache” of not receiving their money.

The turning away of patients by private practitioners also meant that should employees be disabled the doctors were no longer able to help them with medical reports to receive benefits due to them such as disability grants or insurance.

Xola Mnene, spokesman for Compensation Commissioner Shadrack Mkhonto said the fund was “not aware of the results of the DA survey which brought the allegations and conclusions”. “South Africa is a constitutional democratic state wherein everyone has the right to accuse anyone. However, it will be important that the accused person is offered an opportunity to dissect the details of any accusation and be allowed to make an informed response. It will be important that the DA shares (its findings) with the Compensation Commissioner so he can act on the findings.”

Cape Argus

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