HST seeks to employ an IT Supervision and Support Specialist to provide supervision and technical support on IT related activities of the HST.
The Competition Commission says the proposed pricing regulations on drugs would remove the benefit of competition in the distribution chain and so may actually keep prices high rather than low for consumers.
Medical aids are unlikely to lower rates when medicine prices are fixed. The dust that has been kicked up by the controversial Medicines Control Act will settle in three or four months, when medicine prices are likely to stabilise and drop.
Health Systems Trust
The lack of transport to ensure timeous transfer of patients between levels of health care facilities and for delivery of medicines, vaccines, and other essential equipment is a commonly heard cry from health workers, particularly from those working in rural areas, but is often overlooked and rarely researched. It is essential to have the correct vehicle mix and a sound transport management system to ensure efficient and effective health service delivery. Public sector transport policies and management systems in South Africa are complex. Policy decisions for the management of the national fleet are set by the national Department of Transport, remote from the level of service delivery. The provincial departments of Transport lease vehicles for service delivery to user departments, such as the Department of Health. A Fleet Management Service Provider is contracted to the national Department of Transport to coordinate fuel and oil purchases and maintenance of the national fleet. Management of the national fleet has been identified by the national Department of Transport (NDoT) as not being part of the core business of the department. The policy direction of the NDoT is to outsource the management of the national fleet, (as has been done in the Northern Cape Province), and improve the subsidised car scheme for public servants. How these policy decisions will affect health service delivery is not known, particularly within a decentralised health system. This chapter explores some of the complexities of the present transport management systems for health service delivery within the public sector through three provincial case studies, namely Limpopo, Mpumalanga and Gauteng. Some recommendations for improved management and for further research are made.
Regulations set by the Healthcare Professions Council of SA (HPCSA) at the end of last year have optical companies up in arms. Franchise company Torga Optical says that regulations put forward by the council will sound the death knell for similar operations in the next six months, and it is the consumer who will suffer.
The Freedom of Expression Institute has come out in full support of advertisements made by Marie Stopes South Africa in regards to its abortion services. This results from a complaint lodged by the African Christian Action Group (ACAG) with the country's advertising watch-dog the Advertising Standards Authority of South Africa (ASASA) that by using the words safe and pain free, Marie Stopes was deliberately misleading the public and therefore contravening the Code of Advertising Practice.
The pricing committee appointed by Health Minister Manto Tshabalala-Msimang to advise her on overhauling the way medicines are priced in SA said yesterday it had almost completed its work and planned to make its recommendations by mid-December. The committee's work is intended to do away with a host of perverse incentives in the current industry structure which drive up the price of medicines, such as the practice among pharmacists of charging dispensing fees that are based on a percentage of the price of the medicines they sell. The system encourages pharmacists to stock the most expensive medicines, and it is expected to be replaced by a fixed dispensing fee. The committee is also advising the minister on how to set the price of medicines when they leave the factory gate, doing away with bulk discounts and other price-related incentives manufacturers offer wholesalers and distributors. Fees will be set for wholesalers and distributors along similar lines to the dispensing fees for pharmacists. If the minister approves the committee's proposed regulations for a transparent pricing system, they will be published in the Government Gazette and the public will have three months to submit comments. Public hearings will also be heard on the draft regulations, said committee chairman Prof Diane McIntyre, who is also a health economist at the University of Cape Town. The proposals are likely to elicit strong reaction from industry, as the regulations have far reaching implications for all the players in the distribution chain . Under the terms of the twice- amended Medicines and Related Substances Act, the new pricing system is due to come into effect in May next year. McIntyre said the committee had not probed ways to import cheaper medicines, but had confined itself to the local market. (Source: Business Day, Nov 28 2003) Related Link //\// MSF publication Untangling the web of price reductions: a pricing guide for the purchase of ARVs for developing countries - fifth edition http://www.accessmed-msf.org/documents/5theditionuntangling.pdf
0nly registered practitioners will be allowed to own medical practices, in terms of a new policy. Corporate owners who were not medical professionals themselves, could not be registered with the Health Professions Council (HPCSA) of SA and therefore could not be held accountable, Boyce Mkhize, the HPCSA registrar, told reporters in Pretoria. It also happened that practitioners were forced into practices inconsistent with ethical rules, he said. Corporate involvement would still be allowed though. This entailed that non-practitioners could provide services like financing, investment, administration or rental to a professional practice on an arms-length basis and be remunerated on a market-related, pre-determined fee. The rent which a private hospital, for example, charged a doctor for the rent of rooms, could no longer be based on the number of patients seen. Mkhize said franchise arrangements had the inherent ability to violate or contradict a number of ethical rules, for instance the franchisee having to pay a share of professional fees to the franchisor. It could result in the franchisor seeking to dictate the manner in which a practice was conducted. Ethical transgressions At present, franchising was quite prevalent in the optometry industry, while some pathology groups had corporate ownership, he said. The HPCSA had given six months' amnesty, effective from 8 October 2003, for practices to extricate themselves from corporate ownership or franchise arrangements, Mkhize said. Those presently involved in what the new policy considered to be undesirable business practices, had to submit proof that they had rectified their situation. Ad hoc inspections would be done after the six-month period. According to Mkhize, not a large number of practices are involved in such undesirable business arrangements, but he said the impact was significant, since they could generate perverse incentives. The new policy prohibits radiologists and pathologists from being part of group practice with other health professionals. With this measure the HPCSA wanted to prevent over servicing, like doing unnecessary tests or X-rays, the registrar said. ( Source :SAPA, 8 October 2003).
The Government Gazette of 6 December 2002, No. 24116, announced that the SA Pharmacy Council has resolved to investigate the principle of franchising of retail pharmacies in South Africa and of the use of trading titles or trademarks or logos or brand names by retail pharmacies. To achieve this objective, the Council has appointed its Registration and Permits Committee to conduct an investigation. The issues that the Committee is to consider will include the following: . Whether the franchising of retail pharmacies constitutes a contravention of the provisions of the Pharmacy Act, 53 of 1974) and, if so, in what respect. Consideration will also be given to the legality or not of the use of trading titles, trademarks, brand names or logos by pharmacies where the lawful owner of the trading title, trademark, brand name or logo is not a registered pharmacist. . Whether the concept of franchising of retail pharmacies and the use of trading titles, trademarks, brand names or logos constitutes a contravention of the Rules relating to acts or omissions in respect of which the Council may take disciplinary steps or not. . The setting of guidelines and/or criteria in order to determine the conditions upon which the franchising of retail pharmacies should be allowed, should it be concluded that franchising is in fact permissible in terms of the Act. . The setting of guidelines and/or criteria in order to determine the conditions upon which the use of trading titles, trademarks, brand names or logos should be allowed, should it be concluded that the use of such trading titles, trademarks, brand names or logos is in fact permissible in terms of the Act. All stakeholders are invited to make written submissions regarding the above investigation. The written submissions should be directed to the Registrar of the SAPC and should reach him by not later than 15 January 2003.(Source: PSSA Newsletter #1/2003 - 6 January 2003)
NGO questions if government can turn words into deeds Despite a promising start, negotiations over a national AIDS policy could drag on into the new year. A meeting between negotiators at the National Economic Development and Labour Council (Nedlac) is expected to take place before the end of the week, and AIDS activists have requested that an agreement be reached by tomorrow. But yesterday, business sector negotiator Vic van Vuuren said it was unlikely that all parties who needed to be consulted about the far-reaching agreement could be canvassed this year. The delay is a dramatic change from the position a week ago, when negotiators at Nedlac appeared ready to announce a major breakthrough on Sunday as part of World AIDS Day commemorations.But, last Thursday night, the process came to a halt as government and business negotiators said they still needed to get a mandate. More meetings were held and, by Saturday, a joint statement announcing that an agreement had been reached was prepared. But, due to disagreement about the wording, it was never released. On Sunday, the Department of Labour said the announcement of an agreement had been premature. Now, AIDS activists from the Treatment Action Campaign say, the negotiations have turned into a demoralising controversy. Each day wasted is a day in which lives are lost, the TAC said yesterday. The framework agreement under discussion covers a broad spectrum of AIDS issues and includes provisions for treatment with antiretroviral triple therapy and extending access to the anti-AIDS drug Nevirapine to pregnant women across the country. It seems that the government is unable to turn policy into practice, the TAC said.(Source: Lynne Altenroxel,The Star, 5 December 2002)