THE REPORT’S RECOMMENDATIONS

IT WANTS the current fragmented licensing framework to be replaced with a national licensing framework for all health facilities.

• Developing standards of care, evidence-based treatment protocols and processes for conducting health technology assessments. The inquiry could not find good evidence of publicly available cost-effective standards of care and treatment protocols being used in the healthcare sector.

• Developing a standard system to monitor the quality of healthcare services.

• Creating a regulatory solution where a supply side regulator will set tariffs (after extensive consultation with stakeholders in a public forum), or a multilateral price-setting mechanism.

• Making tariffs for Prescribed Medical Benefits binding and that tariffs for non-PMB conditions will have the status of reference tariffs.

• Entry into bilateral negotiations between funders and providers, not just corporate providers like hospitals and pathologists. The HMI says bilateral negotiations are essential if wider adoption of risk transfer through performance-based contracts is to be attained.

• Involving a broad group of stakeholders in a price-setting forum that includes providers, representatives, funders, the government and civil society.

• Introducing a standardised coding systems across the sector.

• Greater transparency in the selection of “designated” service providers to be on scheme networks, an open tender process in selection and DSP contracts should not be longer than two years.

• A review of the Health Professions Council of SA’s Ethical Rules that it believes adversely affect competition.