Doctors urged not so sign global fee accords

THE SA Medical Association (Sama) has thrown its weight behind calls for health practitioners not to sign agreements with medical schemes that bundle the money available for health services into a global fee.

The Health Professions Council of SA (HPCSA) urged practitioners in a statement not to sign global fees agreements that may violate the HPCSA’s ethical rules.

They also urged health professionals to defer entering into global fee or similar financial and clinical arrangements or contracts until all aspects relating to the law, ethics, clinical autonomy and funding mechanisms have been properly canvassed with all parties.

There has been controversy around alternative reimbursement models in the commercial health-care industry. The global fee contract models provide a single payment to a health-care team to cover all the tests, procedures, medication etc, varying from the current fee-for-service model, which sees medical schemes reimbursing each health-care provider individually.

Sama chairperson Dr Mzukisi Grootboom said: “We support this 100%. There are certain things we need to clarify in terms of the conditions where they don’t disadvantage patients and they are not in breach of the HPCSA’s rules and where they take away the professional autonomy of doctors.

“Doctors need to make decisions in the best interests of their patients,” Grootboom said.

He welcomed the intervention by the HPCSA. “Let’s just wait and work out what the issues are.

“We first need to understand that those contracts do not disadvantage members of medical schemes. We don’t want people ending up with diseases or ill, for the sake of saving money.”

He said the appeal to wait on signing contracts would have no impact on the public.

Council for Medical Schemes (CMS) acting registrar Dr Sipho Kabane said he had taken note of the HPCSA’s statement and as one of the key stakeholders the CMS is in the process of engaging with the HPCSA and others based on the concerns raised. Comments will be made once the engagement process with various stakeholders had been finalised, he said.

Practitioners are advised to get advice and guidance by contacting the council on professionalpractice@hpcsa.co.za