The Board of Healthcare Funders (BHF) has called on the government to consider regulating where private sector doctors and specialists work, so as to distribute their services more evenly across the country.
According to a report by BusinessDay, the BHF released research on Friday (31 August) showing that almost half (22,802) of the health-care professionals working in private practice in 2017 were in Gauteng, which is home to about a quarter of South Africa’s population.
The BHF’s head of research, Charlton Munrove, said other approaches to licensing should also be considered – including incentivising doctors to work in certain areas.
This follows similar recommendations made by the Competition Commission’s health market inquiry, which recommended that the health department develop a new framework for licensing all health-care facilities.
While its emphasis is on private hospitals, the inquiry said licensing could be extended beyond acute facilities over time, BusinessDay said.
The recommendation is unlikely to be popular among South African doctors, with a previous Constitutional case ruling against regulations requiring them to obtain a certificate of need – or ministerial approval – prior to practising.
It also follows numerous warnings from legal and medical experts who indicated that the incoming National Health Insurance Bill could drive doctors to emigrate from the country in search of better working opportunities.
Speaking in June, director of healthcare at Werksmans Attorneys, Neil Kirby said that given the current scarcity of doctors, it would not be a good strategy to freeze out those who did not stick to NHI rates.
Norton Rose Fulbright director Michelle David added that doctors would not want to be told what to charge, especially as the largest purchaser of services (government), will also be able to set tariffs.
In addition to a number of legal cases that are now beginning to materialise, some analysts have also cautioned that the amendments could lead to a brain drain in the country.
Speaking to the Sunday Times, Graham Anderson, principal officer of Profmed medical scheme, said that if doctors were forced to drastically change how much they will charge they would emigrate, and that emigration was the main cause of members leaving Profmed – which caters to people in the professions.