Private medical sector wants help to fight Covid-19

30 June 2020 - 06:30 By ERNEST MABUZA
The Progressive Health Forum has made a proposal that private sector practitioners be funded during this lockdown.
The Progressive Health Forum has made a proposal that private sector practitioners be funded during this lockdown.
Image: 123RF/slasny

The private medical sector is willing to participate in the required national response to fight the spread of Covid-19.

However, the about 15,000 private sector specialists and GPs willing to join in this effort have been affected by the dwindling patient numbers in their practices due to their clients' fear of contracting the virus and limitations on hospital admissions and surgical procedures.

“This significant decline in income puts the continuing viability of practices in serious doubt. The stark reality that otherwise viable practices will close is of great concern, as it would imperil the Covid-19 response,” said Dr Aslam Dasoo of the Progressive Health Forum (PHF), an advocacy group.

In a media briefing on Monday, the major representative organisations of the medical profession, together with the forum, have made a proposal to ensure that private sector practitioners survive during this period when their patients are not seeking medical care in their numbers.

Prof Alex van den Heever of the Wits School of Governance and member of PHF, said the PHF proposed that there should be guaranteed payments by medical schemes to private practitioners on a non-repayment basis, based on 2019 earnings.

He said this will involve a guaranteed payment to medical practices of up to 70% of historical claims, using 2019 as a base year, and 30% based on activities that exceed the 70%.

"Payments will be guaranteed upfront. If a practice is billing at 50% they will be topped up to 70%. All the 70% of the advanced payment is not a grant. It is not paid as a bailout; it is in anticipation of future claims," he said.

Van den Heever said the actual buy-in would have to be between medical schemes and practitioners.

He said the Council for Medical Schemes (CMS) - a statutory body to provide regulatory supervision of private health financing through medical schemes - has been informed of this proposal.

He said the council may have a comment and indicated it would give a response on Wednesday. "Ultimately nobody can pronounce until they see a final agreement."

Van den Heever said nothing changes in terms of how the practice interacts with the medical scheme. "A medical scheme assesses and pays. What will happen is that in certain months, claims might be at 30% of 2019, they will be topped up to 70% of what they have claimed in 2019."

A number of medical associations outlined how the Covid-19 have affected their practices.

Dr Chris Archer, CEO of the South African Private Practitioners Forum (SAPPF), said although the private sector was both ready and willing to participate in the required response, the financial pressure was real.

He said unlike their public-sector counterparts, who are salaried, private medical practices faced significantly reduced income and require funds to honour staff and overhead commitments.”

Dr Nkateko Munisi, chairman of the South African Medical and Dental Practitioners Association (SAMDP), which represents 2,000 doctors, mostly from township practices, said less than half of clients were being seen at members' practices during the pandemic.

Munisi said many patients were avoiding visiting the practices for fear of being infected and for financial reasons as a result of the lockdown.

Dr Mark Human, chairman of the South African Medical Association (Sama) in the Gauteng region, said private practices have seen a 60% average decline in patient numbers during the hard lockdown.

He said some specialists - like ophthalmologists, dentists and ear, nose and throat specialists - had effectively shut down due to the high risk of infection in these specialties.

Dasoo said the proposed framework reduced uncertainty for medical practitioners and medical schemes over periods of greatest risk.