Doc­tors sought for ser­vice to NHI

Business Day - - FRONT PAGE - Ta­mar Kahn Science and Health Writer kahnt@busi­nesslive.co.za

The health depart­ment is seek­ing new ways to en­tice pri­vate-sec­tor gen­eral prac­ti­tion­ers to pro­vide their ser­vices un­der the Na­tional Health In­sur­ance (NHI) scheme af­ter a lack­lus­tre re­sponse to its at­tempts to get them to work in state fa­cil­i­ties.

The health depart­ment is seek­ing new ways to en­tice pri­vate­sec­tor gen­eral prac­ti­tion­ers (GPs) to pro­vide their ser­vices un­der the Na­tional Health In­sur­ance (NHI) af­ter a lack­lus­tre re­sponse to its at­tempts to get them to work in state fa­cil­i­ties.

Only 250 pri­vate-sec­tor GPs were con­tract­ing with the state at the end of March, ac­cord­ing to the Foun­da­tion for Pro­fes­sional De­vel­op­ment MD Gus­taaf Wolvaardt. This is a far cry from the state’s orig­i­nal tar­get of 900 GPs, which it had hoped to reach by March 2015.

Part of the prob­lem ap­pears to be the rate of­fered by the gov­ern­ment, which ranges from R470 per hour in ur­ban ar­eas to R573 per hour in a ru­ral set­ting. A GP in pri­vate prac­tice can ex­pect to earn be­tween R1,200 and R1,600 an hour, says Casper Ven­ter, the MD of HealthMan health-care con­sul­tancy.

An­other is­sue is the fact that the GP con­tract­ing model re­stricts doc­tors to work­ing in state fa­cil­i­ties, an is­sue the SA Med­i­cal As­so­ci­a­tion flagged as a po­ten­tial prob­lem at the out­set. It said pri­vate-sec­tor GPs are will­ing to work with NHI but want to see pa­tients in their own con­sult­ing rooms, rather than work­ing in gov­ern­ment clin­ics.

Now the depart­ment is plan­ning a dif­fer­ent ap­proach. From April 2019, it will of­fer GPs the op­por­tu­nity to see state pa­tients in their own con­sult­ing rooms, un­der a “cap­i­ta­tion” model in which they will re­ceive a set fee to take care of a spe­cific num­ber of pa­tients per month, says the depart­ment’s deputy direc­torgen­eral for NHI, An­ban Pil­lay.

The funds pre­vi­ously ear­marked for the 250 GPs who were con­tract­ing with the state have been trans­ferred to the pro­vin­cial eq­ui­table share so pro­vin­cial health de­part­ments can con­tinue to make use of their ser­vices, he said.

The depart­ment is in talks with groups rep­re­sent­ing GPs in the Western Cape, Gaut­eng and KwaZulu-Natal about how to im­ple­ment the model, he said.

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