There is uncertainty whether medical-aid companies will pay out claims for medication prescribed by doctors who have not obtained licences to dispense medicine by the May 2 deadline. This follows threats by groups representing doctors to continue providing patients with drugs after May 2, when new dispensing regulations stipulated by the Medicines and Related Substances Control Amendment Act come into effect.
The legislation has sparked widespread protest among doctors, who are fighting to keep their dispensing licences. They argue that the new regulations go against free-market principals. Gary Taylor, director of Medscheme, which administers up to 7 -million claims a month, said the company would still pay for medication prescribed by a doctor who has a practice number.
However, the company would review its decision depending on reaction from the Health Professionals Council of SA , which registers doctors, and the Board of Healthcare Funders, which issues the practice numbers, on May 2. Council spokesman Phephela Makgoke said problems could arise if doctors broke the law.
If the doctors pay their annual fees and comply with our regulations we cannot strike them off, he said.
But they would be forced to investigate if the health department's director-general lodged a complaint about a doctor who had not applied for a licence. The Board of Healthcare Funders said yesterday it would not remove the practice numbers of doctors who did not apply, but was devising a new system that would show whether a dispensing doctor had a licence or not.
Dispensing doctors have argued that they are serving the needs of the community, particularly in rural areas where access to hospitals or clinics is limited. Under the new act, doctors would have to obtain a dispensing license from the director- general of health, which would only be granted if there is no pharmacy in a 5km radius.
The South African Medical and Dental Practitioners and South African Medical Association have taken a hard-line stance, voting on April 4 to continue dispensing medicines beyond May 2, following unsuccessful talks with the department. A committee of health officials and representatives from both bodies have until May 2 to come to an agreement .
Association spokesman Joe Maelane said that if the committee did not reach a conclusion by then, government would have to look at a practical time frame to implement the legislation .
While the number of dispensing doctors is estimated at 11000, the health department has awarded only 13 licenses. One reason is believed to be the boycott by dispensing doctors.
The department has urged doctors not only to meet the deadline, but also to apply soon enough to have their applications processed in time. ( Source Chantelle Benjamin: Business Day & SAPA, 20 April 2004)