Government replaces circumcision device

THE government is replacing the controversial Malaysian-made Tara KLamp used in medical male circumcisions with a new, Israeli-made PrePex device.

The new device will be introduced to all nine provinces in South Africa in the next few months.

Its proponents say it is cheaper, easy to use and safer. Unlike the Tara KLamp, the new device has been approved by the World Health Organisation.

WHO pre-qualifies MMC device

MEDIA RELEASE: The announcement last week that the World Health Organization (WHO) prequalified the PrePex device for non-surgical voluntary medical male circumcision (VMMC) offers another important option for expansion of VMMC programs in countries hard hit by the HIV epidemic. VMMC, as part of comprehensive HIV prevention programs, is starting to make an impact on the HIV epidemic in many communities and countries.

The impact of PrePex, and other non-surgical devices that could also be prequalified, will depend on several factors including the cost of the devices, the quality and scope of data available to guide decisions about product introduction, and sustained investment in product introduction including pilot projects and social marketing.

Motsoaledi outlines integrated health school plan

Health Minister Aaron Motsoaledi has launched an integrated health school policy in partnership with the Departments of Basic Education and Social Development to deal head-on with health problems confronting school-going youth.

Motsoaledi said it was a constitutional imperative to provide health care to all children, even those out of the school system. “We want all vulnerable children to develop their full potential.”

He was speaking at the opening of the South African Conference on Orphans, Children and Youth made vulnerable by HIV and Aids, which included the launch of Child Protection Week and Pledge, held at Inkosi Albert Luthuli International Convention Centre in Durban.

Circumcision beneficial for women too

The benefits of medical male circumcision have been proven to also extend to women. It has been shown that female partners of men who are circumcised have a less risk of contracting the Human Papilloma Virus (HPV), a sexually transmitted virus that causes cervical cancer.

KZN health rejects concerns over circumcision device

The KwaZulu-Natal health department on Wednesday rejected the Treatment Action Campaign's concerns over a device used to perform male circumcisions.

Since 2010 a total of 175,927 men were circumcised. Of these 35,989 were circumcised using the Tara Klamp (TK) and there had been no problems, provincial health MEC Sibongiseni Dhlomo told reporters in Pietermaritzburg.

He was responding to the TAC's asking the Public Protector to investigate the TK's procurement and ongoing use. The plastic device is clamped over the foreskin of a man's penis for seven to 10 days until the foreskin falls off.

According to the TAC the device sometimes had to be surgically removed.

Free State: Health sector to be revitalised with 10-Point Plan

Health MEC Fezi Ngubentombi and her department kicked off the 2011-2012 financial year on a high note, promising to revitalise the health sector and inject new funds in the health sector that previously saw hospitals and clinics running out of essential drugs.

As a starting point, she promised to launch or relaunch forums that she saw as vital partners in the provision of health in the province, and more importantly, the Traditional Healers Forum and the district health councils of Lejweleputswa, Motheo and Thabo Mofutsanyana, as well as breathe new life into hospital boards and clinic committees of the same districts, among others.

Medical costs 'criminal'

Health Minister Aaron Motsoaledi yesterday predicted the death of private medical schemes in the next decade owing to soaring costs for treatment.

Addressing the SA National Editors' Forum in Cape Town, Motsoaledi said private schemes were rapidly shifting out of the reach of the country's middle class and described the cost of private healthcare as "criminal in the extreme".

"Our research has shown that private hospitals will charge up to R15000 to perform a circumcision, while township GPs can perform the same procedure for a few hundred rand," he said.

Revamped Germiston hospital opened

One would be forgiven for mistakenly thinking they were walking into an upmarket government office park when entering the new Germiston Hospital.

The R498 million new state-of-the art Germiston Hospital, which was opened by Gauteng Premier Nomvula Mokonyane on Monday, was also renamed after struggle heroine Bertha Gxowa, who worked tirelessly for progress in South Africa.

'Health synergy needs a shot in the arm'

Health Minister Aaron Motsoaledi has presented an olive branch to managers of private hospitals at the Hospital Association of South Africa conference in Cape Town.

A few months ago the private hospital industry was dealt a severe blow by the bad publicity Motsoaledi handed out when he spoke of the exorbitant cost of private circumcision procedures compared to their cost in the public sector.

But, yesterday, Motsoaledi almost forgot to mention the high cost of private healthcare, merely alluding to it in passing.

He discussed blood products, drugs and expensive, unnecessary equipment, which he said drove up costs in the public sector.

Minister takes on 'predatory' system

The South African healthcare system was becoming a microcosm of society’s gap between the haves and the have-nots.

This was said by Health Minister Aaron Motsoaledi, who was addressing the Board of Healthcare Funders (BHF) conference held at Sun City on Monday.

Motsoaledi said due to the exorbitant fees being charged by the private healthcare sector, the country has two health care systems: one for the poor and the other for the rich.

“Private hospitals are charging exorbitant fees that are out of control. The charges must never be allowed within the health care sector of our country", he said.

According to Motsoaledi,the situation has worsened compared to what it was under the apartheid regime, and these high fees have to do with investment, not with healthcare provision.

"Most of the hospital groups are based in Johannesburg and are listed on the JSE", he said. "Let there be an independent commission to regulate this. It now dependents on your pocket, and poor people are suffering".
Motsoaledi warned the private healthcare sector that healthcare is not purely a business, but a social service.

“We have arrived at the era of predatory measures in the healthcare system because of the fees that are being charged”, he said.

He also lambasted private doctors for charging fees on circumcision as high as R15,000.

“These charges must never be allowed within the healthcare system of our country", Motsoaledi said.

Motsoaledi hopes that an announcement on pricing commission would bring down the exorbitant fees.

“People die on the roads because they have no money or medical aid. This must never be allowed"

Dr Clarence Mini of the BHF said in order to have equality within the healthcare sector, the prices charged by private health sectors need to be regulated.

“We support the Minister's intention to establish an independent pricing commission and would like to pledge our support”, Mini said.

Support is not coming from all fronts ,though, as Motsoaledi said there was “stiff resistance“ from certain service providers, so much so that they have threatened to take legal action against his department in order to avoid the establishment of the proposed commission.
The Council for Medical Schemes said scheme expenditure on healthcare benefits increased by 17.9% to R76.3 billion in 2009, from R64.7 billion in 2008.

According to them, hospitals accounted for les than half (R28.3 billion) of the total amount paid to all the healthcare providers.

Expenditure on private hospitals, on the other hand, increased by 18.1% to R28.0 billion compared with 28.1% expenditure on provincial hospitals, to R288.9 million.
Expenditure on medicines dispensed by pharmacists and providers other than hospitals increased to R13 billion in 2009, which is an increase of 17.4%.

Payments to specialists increased to by 19.1% to R16.7 billion, general practitioners (GP’s) increased by 8.4% to R5.7 billion, while payments to dentists increased by 15.8% to 2.2 billion.

Dental specialists saw expenditure decrease by 9.7 %, while supplementary and allied health professionals increased by 21.4% to R6.0 billion in 2009.

The Minister partly blamed a 2004 Competition Commission ruling which gave healthcare providers the loophole to charge excessive fees.

Motsoaledi said he was in the process of establishing an Office of compliance which would include an inspectorate, an ombudsman and an accreditation division. 

Recently Medi-Clinic denied that they were overcharging on their services.

“It is incorrect to assert that prices are arbitrarily and unfairly expensive and no limits on fees apply. The minister elected to use a single circumcision bill in the private hospital industry." said the group's Tertia Kruger in a statement.

The Minister also mentioned that the National Health Insurance (NHI) scheme still has to go through cabinet and will be released for public comment before the end of the year.

Motsoaledi said the policy will cost the country R80,50 billion to implement it due to escalating health prices. The NHI is a funding model that provides all citizens with adequate health care coverage at an affordable cost through a prepayment funding mechanism. The NHI will be implemented in 2012.

The issue of compensation of practitioners has always been hotly debated by medical schemes and service providers. Recent developments like the scrapping of the Reference Price List (RPL), a tariff plan which sets the ceiling amount providers can charge for practitioners has exacerbated the disarray.

The RPL was set aside by the South Gauteng high Court in July last year after it found that the processes relating obtaining information, determining and publishing the RPL in 2007 were flawed.  Currently there is no official tariff plan that determines how much doctors should charge patients for a consultation. 

Health practitioners are charging between R220 and R1100 for a consultation depending on their specialty. In 2009 medical schemes paid specialist R16,7 billion, general practitioners R5,7 billion and dentists were paid R2,2 billion. The overall claims paid increased by almost 18% when compared to 2008. The jump was attributed by the Council of Medical to the absence of the tariff plan.