Private practitioners say govt is stonewalling on payments and culpability

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Tensions between the SA Private Practitioner’s Forum and the government are coming to a head over a dispute about payment and legal immunity when it comes to treating COVID-19, reports Daily Maverick.

It says the conflict could foreshadow the battles that lie ahead involving the implementation of the National Health Insurance.

An organisation representing South African doctors working in the private sector has expressed unhappiness over perceived stonewalling from the government with regards to the COVID-19 treatment effort. Daily Maverick reports that in a letter to members, the South African Private Practitioners Forum (SAPPF) says its repeated attempts to negotiate with the national Health Department in “offering our support in combating this pandemic” have not met with a satisfactory response.

The report says at the heart of the issue is the treatment of “state-responsibility patients” for COVID-19 in private medical facilities – and what the doctors will be paid.

Health Department spokesperson Popo Maja told is quoted as saying he could not give comment on the issue as he had not seen the relevant figures. But, the report says, according to the SAPPF, the Health Department has offered a per diem rate of R2,493 per patient to specialists managing COVID-19 patients in private hospitals. This fee is standard regardless of whether the patients are in ICU or High Care, and must be split between a team of doctors if a patient requires more than one specialist within a 24-hour period.

And, the SAPPF says: “We have requested from the minister some type of blanket indemnity from prosecution for medical negligence, should claims for medical negligence arise as a consequence of working outside one’s scope of practice in treating a COVID-19 patient. No such indemnity has been offered.”

The report says this issue has arisen worldwide as doctors from all specialisations have been drafted to treat COVID-19. In several US states, doctors are now shielded from lawsuits over COVID-19 medical treatment. The UK’s Medical Protection Society has called on the British government to introduce emergency laws to protect doctors from criminal and regulatory investigation during the COVID-19 crisis.

Daily Maverick reports that the SAPPF paints the government as being uncooperative in the face of good-faith attempts by private-sector doctors to volunteer their services at the risk of their own health. “This lack of engagement suggests that the intention is to exclude the private sector, as far as possible, from an integrated national response, except when absolutely necessary,” the body states.

“In cases of necessity where the public sector is overwhelmed and help is required from the private sector, it appears that the relationship will be a one-sided take it or leave it affair, with no negotiation and no consideration given to the realities of costs experienced by private practitioners or facilities.”

Daily Maverick reports that government health officials have a very different take on the dispute. Senior health figures, speaking off-record, strongly implied that the payment conflict arose from the clash of worlds between the private and public sector, with the private sector accused of not being transparent about their costs and providing estimates based on a “for-profit” universe.

It was also denied that the government has been unwilling to come to the table: extensive and intricate negotiations have already taken place, it is claimed.


Full Daily Maverick report



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