HEALTHMANPRIVATEPRACTICEREVIEW:MAY2019

InthisNewsletter:

NewsonGovernmentSpecialNewsFinancialNewsPharmaceuticalNews

GeneralNewsNewsonMedicalSchemesSpecialNotices

NewsonGovernment

SuspendedCEO&CFOatNHLSfired

GoodnewsforHIVfundinginSA

TheNationalHealthLaboratoryService(NHLS)

hasfiredsuspendedchiefexecutiveofficer

JoyceMogaleandchieffinancialofficer

SikhumbuzoZulu,following“procurement

irregularities”worth

R200-m.

MogaleandZuluweresuspendedinFebruary

2017.AccordingtoastatementfromtheNHLS

boardchairperson,EricBuch,theCEOandCFO

werechargedwithirregularitiesandfailureto

fulfiltheirdutiesinrelationtothree

procurements.Thechargesrelatedtoexceeding

delegationsofauthority,irregularpayments

madetoserviceprovidersandirregular

appointmentofserviceproviders.

TheUnitedStatesadministration’sbacktracking

onaplantocutUSfundingforSouthAfrica’sHIV

programmeby30%(R2.9-bn)is“amajorvictory

forpeoplelivingwithHIV”,saidnon-

governmentalorganisations(NGOs).

CitingthepoorperformanceofSA’sHIV

programme,theUSPresident’sEmergencyPlan

forAIDSRelief(PEPFAR)earlierthreatenedto

slashfundstothecountry.

Theabout-turn,decidedonduringthesecond

roundofPEPFAR’splanningmeetingsin

WashingtonDC,willnowseeSAreceivingupto

$730-minthe2019/20financialyear.

Clinicshitbyvaccineshortages

DuetoastockscarcityoftheDT(diphtheriaandtetanus)vaccine,manySouthAfricanparentsnow

havetohavetheirchildrenimmunisedprivately.AccordingtoKopanoKlaas,casemanagerforthe

StopStockoutsProject,reportsofshortagesandstockoutscontinuenationwide.Astudyofglobal

vaccineusefoundthatoneinthreeWorldHealthOrganisationmemberstatesexperiencedatleast

onestockoutofonevaccineforatleastamontheveryyear.

ImmunisationsagainstDTareavailableatallprimaryhealthcareclinicsandcentres.TheDTvaccine

providesprotectionagainstthreediseases:diphtheria(whichcancausefatalswellinginthethroat

area),pertussis(whoopingcough)andtetanus(aconditionofseveremusclespasmscausedby

contaminationofdirtywounds).

SpecialNews

READMORE

AccountabilityneededtocountermedicalnegligencePre-existingcontingentliabilityresultingfrommedico-legalclaimsinthepublichealth

servicethatcannotbeavoided,andwhichisnowimpactingontheGovernment’sfiscalliability,isa

directmanifestationofmulti-facetedgovernancefailuresinthesystem.

“Afuturecontingentofmedicalliabilitywillcontinueatthesamescaleunless

somethingchanges,”ProfAlexvandenHeever,ChairofSocialSecuritySystems,Administrationand

ManagementStudiesattheUniversityoftheWitwatersrand,warnedinarecentSAMedico-Legal

Association(SAMLA)PresidentialPresentation.

VandenHeever’spresentationwasoneofseveralonpressingmedico-legalissuesvideo-recorded

bySAMLAforsubmissiontoPresidentCyrilRamaphosa’soffice.

Keyamongthesegovernancefailures,hepointedout,wastheabsenceofstrategicaccountability

frameworks.Thesecompriseofindependentsupervision,performancerequirements,transparency

andconsequencesatbothameta-andmicro-governancelevel.

READMORE

FinancialNews

Netcaresqueezedbyprescriptivemedicalaids

OnMay13,hospitalgroupNetcareexperiencedthebiggestone-daydropinitssharepriceinalmost

twomonthsafteritsaidprofitswillbesqueezedbyincreasinglyprescriptivemedicalaids,reported

BusinessReport(14May).Theschemesrestrictmemberstospecifichospitals,allowingthemto

“shiftmarketshareinreturnforpricediscounts”,Netcaresaid.

AccordingtoSentioCapitalportfoliomanager,ImtiazSuliman,medicalaidschemeswere“goingtoputmoreandmorepressureonthehospitalgroupstobemoreselectiveinadmitting

patients”.

Netcarewarnedinvestorsthatmarginsinitshospitalsandemergency-servicesdivisionswould

shrinkbetween50and80basispointsinthesecondhalfofthefinancialyear.

Describingthesqueezeastheresultofmedicalschemesofferingcheaperoptionstomembers,

NetcareCEORichardFriedlandsaiditisa“newfactoflife”.

LatestGlobalCreditRatingforTransmed

ThelatestGlobalCreditRatings(GCR)affirmedthenationalscaleclaimspayingabilityrating

assignedtoTransmedMedicalFundofBB+(ZA),withtheratingoutlookaccordedasNegative.

PharmaceuticalNews

IsSA’stopcontraceptiveputtingwomenatrisk?

"Isitbettertohaveanunwantedpregnancy,complicationsinpregnancyoranincreasedriskof

contractingHIVandtuberculosis?”wroteKatharineChildinTimesSelect

(29April2019).

“ThisisthequestionSApolicymakersandbirthcontrolexpertsaroundtheworldareaskingas

evidencemountsagainstthemostpopularcontraceptiveinsub-SaharanAfrica."

DepoProvera,athreemonthlycontraceptiveinjectionwiththesynthetichormoneDepo-

Medroxyprogesterone(DMPA),haslongbeensuspectedofincreasingtheriskofHIV.Onemajor

studysuggeststheriskcouldincreaseby40%,butotherstudiessuggestthereisnorisk.UCT

researchershavenowshowntheactiveingredientsintheDepoinjectionstopstheimmunesystem

fromfightingTB,thecountry’sbiggestkiller.

However,scientistshavecautionedthatthiswasastudyofcellsinalaboratoryandnotinpeople.

TheDepoProveraDPMAinjectionispopularbecauseitistakeneverythreemonths,canbeused

secretlyandrequiresfewervisitstoaclinictoaccesscontraceptionthanotheroptions.Asaresult,

16.5-mwomeninsub-SaharanAfricauseit.

READMOREINATTACHMENT:DEPOPROVERA

‘Breakthrough’slimmingpill

A“breakthrough”slimmingpill-thatexpandsin

thestomach-wastwiceassuccessfulasa

placebo,accordingtoresearchpresentedat

theEuropeanCongressonObesity.

Ofthosetakingthedrug,alreadygiven

regulatoryapprovalintheUS,59%achievedat

least5%lossofbodyweight,withaverage

weightlossof10kginsixmonths.

Thetreatment,calledPlenity,issaidtohaveno

seriousside-effectsandcouldbecome“the

treatmentofchoice”formillions.

Thetreatmentinvolvestakingthreepillsbefore

mainmeals,withtwoglassesofwater.

Thecapsulescontaintinyparticlesofsuper-

absorbenthydrogel,nobiggerthanagrainof

salt,whichthenexpandinthestomachforminga

gel,sothatthepersonfeelsfull.

Amazonacquiresonlinepharmacy

Onlineshoppinggiant,Amazon,hasrecently

acquiredanonlinepharmacyintheUScalled

Pillpack.

“Inthewakeofthismove,localpharmacyexperts

havebeenconsideringthepossibilitythate-

pharmaciescouldbeamassivestepforwardfor

peoplewhostruggletoaccessmedicationin

SouthAfrica,”reportedSaturdayStar(11May).

ErikRoos,chiefexecutiveofPharmaDynamics,

saidsellingmedicineonlinecouldhavelife-

savingbenefitsforpatientslivinginruralareas.

Bysupplyingmedicinesonline,e-pharmaciesare

abletowarehouselargequantitiesofstock,

whichreducesthecostofmedicines.

ChiefexecutiveofthePharmaceuticalSocietyof

SouthAfrica(PSSA),IvanKotze,sayse-

pharmacieswouldnotbeinthebestinterestof

patientsasitisessentialthatpatientsdiscuss

medicinewithapharmacistbeforetakingit.

Nopressure,butperhapscheckifyouarehypertensive

AheadofWorldHypertensionDayonMay17,medicalexperts

haveurgedpeopletotakeablood

pressuretest-thefirststepinthefightagainstthecondition,

whichoneintwoSAadultshave.

TwoyearsagoithasbeendecidedthatMaybedeclared

“MeasurementMonth”bytheInternationalSocietyof

Hypertension(ISH),theSouthernAfricanHypertensionSociety

andtheNationalHealthDepartment,amongothers.

Thescreeningcampaignhasalreadytestedmorethan2.7-m

peoplesinceitsinception.InSA,anestimated53menand78

womenolderthan30diefromtheimpactofhypertensionevery

day.

Malpracticeinsurance

NatmedMedicalDefence(Pty)

Ltd,a24yearsold,leading

SouthAfricanMedical

MalpracticeInsuranceBroker,

haspublishedacomprehensive

overviewofmedicalmalpractice

insuranceinSouthAfrica

titled:UnderstandingMedical

MalpracticeInsurancein

SouthAfrica.Thisisthefirst

timesuchathoroughworkhas

beenpublishedinSA.

GeneralNews

UNreportwarnsofdisastrousconsequencesofantibioticresistanceAccordingtoanewreport,releasedbytheUnitedNationsInteragencyCoordinatingGroupon

AntimicrobialResistance(IACG),medicalprogressisthreatenedbyworldwideantimicrobial

resistance.

Itconcludedthatdrug-resistantdiseasescouldcause10-mdeathseachyearby2050.Thereport

followsaSouthAfricanstudythathasexposedveryseriousshortcomingswiththewaydoctorsand

nursesareprescribingantibiotics.

Currently,atleast700000peopledieeachyearworldwideduetodrug-resistantdiseases,including

230000peoplefrommultidrugresistanttuberculosis.Thereportcanbefoundat:

https://www.who.int/antimicrobial-resistance/interagency-coordinationgroup/

PilotBloodTesttoflagChronicFatigueSyndrome

Peoplesufferingfromadebilitatingandoftendiscounteddisease,knownasChronicFatigue

Syndrome,maysoonhavescientificproofoftheirailment.

ResearchersattheStanfordUniversitySchoolofMedicinehavecreatedabloodtestthatcanflagthe

disease,whichcurrentlylacksastandard,reliablediagnostictest.

AccordingtoanarticleinMedicalBrief(8May),DrRonDavis,professorofbiochemistryandof

genetics;DrRahimEsfandyarpour,aformerStanfordresearchassociate;andtheircolleagueshave

devisedablood-basedtestthataccuratelyflagsallChronicFatigueSyndromepatientsandnoneof

thehealthyindividuals.Thediagnosticplatformcouldevenhelpidentifypossibledrugstotreat

ChronicFatigueSyndrome.

NewsonMedicalAids

'Bigshift'tocheapermedicalcare

AccordingtoMedicalaidbrokerAlexanderForbesthenumberofcorporateclientswhoreviewed

theirplansforthisyearhaddoubled.Forthefirsttime,morepeoplehaddowngradedthanupgraded,

reportedSundayTimes(5May2019).

Profmedprincipalofficer,CraigComrie,said2019wasthefirsttimetheschemeintroducedlow-cost

optionsandabout3500ofits70000membershadswitched.

Butmedicalaidswarnspendinglessmeanshigherpremiumsultimately,becauselessispaidinto

thepoolforalltoshare.

DiscoveryHealthCEO,JonathanBroomberg,saidamoreimportanttrendthandowngradingwas

“thatmembersjoiningDiscoveryHealthMedicalSchemearetendingtojoinatlowerplanlevelsthan

theyhaveinthepast”.

Bonitasprincipalofficer,GerhardvanEmmenis,saidnewmemberspreferredcheaperplans.While

94%ofmembershadnotchangedtheirplansthisyear,10,949haddowngradedand7,345had

upgraded.

GEMSCOO,StanMoloabi,saidtheEmeraldValueoptionhadbeenintroducedtoaddressthe

financialrisktotheschemeofpeoplebuyingcheapercover.

NewprincipalofficerforBonitas

BonitasMedicalFund,hasannouncedtheappointmentofanewPrincipalOfficer,MrLeeR

Callakoppen.HehasbeeninvolvedwithMedschemeandtheAfroCentricGroupinvariousfunctions

includingHumanCapital,FacilitiesManagementandTransformationforthepastdecade.

Circulars:CouncilforMedicalSchemes

ThefollowingCircularswerepublishedbytheCMSinMay2019.Visitwww.medicalschemes.co.zaformoreinfo.

35of2019Commentsinvitedonrevisedadministratoraccreditationstandards

36of2019:AmendmenttoRegulation31and32oftheMedicalSchemesAct

37of2019ProposedamalgamationbetweenCompCareWellnessMedicalSchemeandSelfmedMedicalSchemeeffective1July2019

38of2019ProposedamalgamationbetweenMomentumHealthandBPMedicalAidSociety-1July2019

SpecialNotices

ExpertWitnessWorkshop:19June,GlenhoveConferenceCentre

TheExpertWitnessonedayworkshopwillcoverallaspectspertainingtoconductingethicaland

professionalmedico-legalworkinahighlypracticalandhandsonway.

BenefitsofAttending:•Acquireknowledgeandskillsonmedicalexpertcompetencesandprocedures;

•Understandyourdutiesandobligationstothecourts;

•Beawareoftheskillsandpitfallsasanexpertwitness;and

•Masterwhatisrequiredtoperformasanexperttoahighstandardandhandsonway.

Whoshouldattend?Doctors,Midwives,Dentists,Psychologists,MedicalSpecialists,SeniormedicalstaffandMedico

legalLawyers.

Formoreinfoandaregistrationform,readATTACHMENT:WORKSHOP

ConsultingroomsavailableatGraystonShoppingCentre,Sandton

ConsultingroomsforaPediatrician,Gynaecologist,Endocrinologist&NeurologistavailableatGraystonShoppingCentre,GraystonDrive,Sandton.

Formoreinformation,contactDrYairEdinburg:Tel010-822-3151/2/3

EquipmentforSaleHaagStreitslitlampandHaagStreitapplanationtonometeronmanualhydraulicstand:Price:R65

000

Ageingslitlampunit(chair,slitlamptable,phoropterarm,lightandprojector

shelf-noinstruments):Price:R4000

ContactDrColinCohen:0828947380

Imedrecruit-GynaecologyPracticeforSaleAwell-establishedgynaecologypracticeintheSouthernSuburbsofCapeTownhasanopportunity

foraninterested,qualifiedObstetricianandGynaecologistSpecialisttopurchaseanexistingbusy

practicewithinfrastructure,staffandequipmentwithaclientbaseofapproximately6000patients.

iMedrecruitisanicherecruitmentcompanyofferingsuperiorstaffingsolutionsforthemedical,

healthcareandindustryrelatedfraternities.

FormoreinformationcontactCarolynBaldwin:carolyn@imedrecruit.co.za

(0210010304)

ToadvertiseinPrivatePracticeReviewcontactMarethaConradie:maretha@healthman.co.za.

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