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PRESS STATEMENT BY THE SAPPF
HPCSA SCRAPS ETHICAL TARIFFS
In a press release on the 26 November 2008, the Health Professions Council of South Africa (HPCSA) decided to
scrap its ethical tariff used by doctors as a ceiling for patient accounts. The HPCSA states that the
establishment of the new National Health Reference Price List (NHRPL) by the Department of Health eliminated
the need for the HPCSA to publish an "ethical tariff" for doctors. The HPCSA also states that the National
Department of Health followed an "extensive consultative process" with stakeholders and healthcare practioners
to establish the NHRPL.
The HPCSA states that they will deem practitioners to be overcharging if patients did not consent to a fee
charged higher than the NHRPL or the rate payable by the medical scheme whichever is higher.
The South African Private Practitioners Forum (SAPPF), representing the interest of specialists of all specialist
groups who work in private practice, questions the accuracy of the information quoted in the media statement
and condemns the principles noted in the document in the strongest terms.
The National Department of Health was only prepared to meet with specialists on the 19 January 2008,
15 April 2008, 02 October 2008 and the 20 November 2008 after several requests were sent to the Department.
Specialist groups have been requesting meetings on an ongoing basis with the NDoH, without even responses
from the Department. Letters were sent to the newly appointed Minister of Health, Ms Barbara Hogan, to
assist with facilitating the last meeting with the NDoH, with success, for which we thank her. Claims
thus by the HPCSA that there was "extensive" consultation is thus totally incorrect. We question the role
and part the HPCSA played in this so-called "extensive consultative process" with healthcare practitioners.
The failure of the NDoH to engage with stakeholders from an early stage in the process means that the NHRPL,
in contradiction to the HPCSA statement is still not established and cost based tariffs have not been finalised
or published. The regulations governing the NHRPL state that the NHRPL had to be published before the end of
September 2008, another failure by the NDoH. The current NHRPL and tariffs do not reflect the cost of
rendering a medical service and the sustainability of most specialist practices imandates charging outside of
the present reference fee.
The current NHRPL fees are totally inadequate to even cover the cost of private practitioners, one of the reasons
we are experiencing a massive brain drain of doctors. If this tariff had to be enforced, as the media statement
suggests, private practitioners will be placed under severe financial threat. We view this decision by the HPCSA
as totally irresponsible and instead of guiding the profession, would rather seem intent on destroying it.
The media statement by the HPCSA shows a lack of understanding and the necessary depth of knowledge regarding
the NHRPL process and the challenges faced by medical practitioners currently in South Africa.
We fear that patients will not be protected by this decision of the HPCSA, as practitioners are forced, for their
own financial survival, to both charge co-payments and fees outside of the current flawed NHRPL process, or consider emigration.
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