Doctors up in arms over council's tariff guidelines

Coming barely two weeks after the Department of Health criticised the private hospital sector's prices, it appears the healthcare industry is about to launch into yet another politically sensitive fight with the government about fair and reasonable rates for their services.

The council - a statutory body which regulates health professions - used a tariff guide published by the Board of Healthcare Funders in 2006 as its starting point for the new rates, adjusting it upwards by consumer price inflation.

The South African Private Practitioners Forum, which represents specialists, yesterday threatened to take the council to court unless it withdrew the guide.

It said the tariffs bore no relation to the costs of running a practice and would portray doctors who charged more in a negative light.

The forum's chairman Chris Archer said the 2006 Reference Price List was an inappropriate starting point.

"There are some massive increases in costs in recent years. For example, my annual malpractice insurance has soared from the R3,000 I paid 15 years ago to a quarter of a million rand," he said.

The new tariff guidelines did not include codes for hundreds of new procedures that had been devised since 2006.

"This puts doctors in a difficult position, as medical schemes won't pay for procedure codes not in the guidelines," Dr Archer said.

Council spokeswoman Bertha Scheepers said the guide was not binding. "They all say it's a ceiling, but it's not. We are sitting with nothing with which to adjudicate (complaints of) overcharging, and had to get something out there," she said.

Doctors could charge more than the guideline tariffs, but had to obtain informed consent from patients first, she said.

Scheepers conceded that the council had not assessed the costs of providing services.

"We are not saying it can't be improved upon. It's a temporary measure until the completion of a scientific process to determine an ethical guideline," she said.

Scheepers declined to answer further questions ahead of a press conference planned for today.

The acting chairman of the South African Medical Association, Mark Sonderup, said he was disappointed by the council's failure to move the pricing debate beyond the impasse reached in 2007, after the courts had scrapped the health department's attempts to devise a tariff guide.

"They had an opportunity to take a step in a positive direction.

"And they have taken us back 10 years," he said.

The South African Dental Association said it was dismayed by the guide, and accused the council of token consultation.

"While the council did meet with the association and the South African Medical Association earlier this year, it is now evident that these meetings were merely an attempt to 'tick the box' of consultation and were not in any way conducted in good faith.

"Since then, there has been no follow-up in terms of further input in the final determination of tariffs," Maretha Smit, CEO of the association, said on Sunday.

Source: Business Day