File picture: Pexels
THE TUG-of-war that erupted between health-care practitioners and several medical aid schemes led to an inquiry into allegations of racially profiling doctors and alleged vigilantism against doctors.

It comes after the chairperson of the National Health Care Professionals Association (NHCPA), Dr Donald Gumede, accused several medical aid schemes of racially profiling black, Indian and coloured doctors.

Gumede alleges that the schemes are unfairly targeting them by demanding they disclose private and confidential information about their patients, failure to which payments due to them are withheld.

Among some of the demands made by medical schemes is that doctors should submit their clinical notes and patient files, doctors alleged.

It is not the first time that allegations of racism in the health-care sector have been raised.

On Thursday the Council for Medical Schemes (CMS) with various organisations including doctor associations, the Board of Healthcare Funders convened a meeting in which the matter was discussed.

In the meeting a decision was taken to institute an inquiry into the allegations. The inquiry will start in a week and will take a period of four months after which a provisional report will be issued.

Dr Gumede said the probe was long overdue.

“We say no to vigilantism by anybody. It doesn’t matter who you are, or whether your pockets are deep, or whether you are black, red, white.

“We say yes to the rule of law, everybody should be equal before the law. It should not depend on your socio-economic status or the colour of your skin and we condemn severely coercion and extortion of health-care professionals by the schemes,” he said.

Gumede said where there was wrongdoing and fraud, lawful channels should be followed to address the issue and the matter reported to relevant authorities.

President of the Health Professions Council of SA (HPCSA), Dr Kgosi Letlape, was scathing in his response.

He slammed the “culture of vigilantism” and what he described as “de-professionalisation” of practitioners.

“One of our major concerns is that the working environment public and private is not conducive to ethical behaviour from health-care practitioner, Letlape said.

“We have seen major changes to the Medical Schemes Act that are lawful but a lot of them will not pass the mastery of ethics.

The preferred provider system is an unethical system because it is not equitable, it has preferential treatment, it violates the rights of the patient for choice of a practitioner so there are fundamental basic ethics that it violates and we have always asked the funders why they don’t set the terms and conditions and any practitioner that is prepared to meet those terms and conditions should be allowed to see patients under those terms and conditions.”

He slammed the practice of withholding payments from doctors.

“The second issue that promotes unethical behaviour is that you provide services as a professional and you are not sure that you are going to be paid. And you are now in a situation where when a funder pays you they have no obligation to pay you, they are doing you a favour,” he said.

The Health Funders Association’s (HFA) Lerato Mosia said: “It’s a pity and very unfortunate that we have got to a point like this today, where it almost seems like it has really got out of hand. However we are positive as HFA that a process that we have embarked on starting this year is going to bring good outcomes to this situation.”

Mosia says they are fully behind the CMS in finding a solution.

“It is a crisis that we are facing on fraud, waste and abuse as a country, one that has got dire consequences for everybody and eventually obviously for the country as a whole, one thing we do need to do is to acknowledge that there should come a time that we sit and discuss this to the fullest degree,” she said.

Meanwhile, the SA Medical Association (Sama) welcomed the probe and said the investigation must be conducted without favour or bias.

“Sama will not comment on any racial issues because we cannot prove it currently. But if it is proven we will comment on that,” said Sama chairperson Dr Angelique Coetzee.

Board of Healthcare Funders (BHF) and Healthcare Forensic Management Unit’s Dr Hleli Nhlapo denied allegations of racial profiling.

“I must say it upfront, in the constituency of BHF I don’t know of anyone who uses race to discriminate against claims. What we use in the industry is the PCNS number,” he said.

Sunday Independent