Sama claims workmen’s fund system ‘dysfunctional’
THE SOUTH African Medical Association (Sama) will today instruct the country’s doctors not to treat patients who have been injured on the job, claiming the Workmen’s Compensation Fund claims system is “dysfunctional”.
The association was also planning on calling for a judicial review of the fund, following findings of maladministration, lengthy delays in payments, and even non-payment of doctors and patients.
The fund is intended to pay compensation for death or disability caused by occupational injuries sustained or diseases contracted by employees in the workplace.
However, Sama said the compensation fund had failed to distribute millions of rand in funding and contributions by employers to beneficiaries, resulting in huge backlogs of unpaid claims.
Sama is the country’s largest representative body for both private and state doctors.
“Claims that are literally decades old have not been paid and the backlog shows no signs of abating. Despite repeated assurance by the various officials who have occupied the position of the Compensation Commissioner to address the maladministration and backlog in claims processing, the position has not improved,” said Dr Mzukisi Grootboom, Sama chairman who personally had been investigating alleged maladministration at the Fund.
The DA released findings of a report following an investigation into the state of the fund.
The investigation, which was carried out by Sama, the National Employers Association of SA and Independent Practitioners Association Foundation, found that across the country doctors were increasingly turning injured patients away because of the fund’s failure to settle claims.
As a result of the delays or non-payment of claims, Grootboom said many doctors had taken a financial knock with some practices facing closure as a result.
One of the practices set to close this week is the Workers’ Accident Rehabilitation Centre in Durban.
Grootboom said a similar practice in Benoni was in “great distress” and was now using its financial reserves to continue operations.
“We don’t think the centre will survive another year. There are many private practices that are in a similar situation because of the continued maladministration of the Compensation Fund. Private practitioners are increasingly and justifiably unable to continue to personally bear the healthcare costs of those injured workers who approach them for treatment,” he said.
While the association would not force medical practitioners not to treat injured workers, “it is our standpoint that patients who are brought to private practices should not be treated unless their injuries are life-threatening. We are merely advising medical doctors on the issue”, said Grootboom.
The acting compensation fund commissioner issued a statement in response to the call by Sama, saying the Fund was trying “to improve its systems to improve efficiency”.