A formidable challenge to regulation 8 of the PMB legislation is being mounted by Genesis Medical Scheme and SAMWUMED in a court action against the Minster of Health. We are reliably informed that the Department of Health has decided not to oppose this action.
This challenge was initially attempted in 2012 and was dismissed, but you will recall that Judge Cynthia Pretorius did not deal with the merits of the application, merely with the Locus Standi of BHF in bringing the application.
If successful, this will see all PMBs being remunerated at scheme rate only. It is anticipated that regulations will require that service providers accept the scheme rate without allowance for charging any co-payment. It is further feared that certain schemes may elect to reduce rates at which they reimburse PMBs conditions to state hospital rates.
This would have a huge impact on private surgical practice. The Surgicom Board has decided to support the SAPPF in a legal action to challenge any attempt to repeal regulation 8. It has been estimated that the legal costs of this will be approximately R1 million and that general surgeons will probably be expected to cover 10% of this.
The current dilemma is that Surgicom's membership only represents 30% of the general surgeons engaged in private practice. It is unreasonable to expect Surgicom to fund a court action on behalf of all surgeons in private practice, when only one third contribute to the costs. We need the financial support of every general surgeon.
We would like to appeal to all Surgicom members to encourage their surgical colleagues to join Surgicom at ths time. We have written to all surgeons asking them to consider this and have provided a complimentary edition of the March 2015 Surgicom newsletter which reflects the wide range of current Surgicom activities and benefits, including preliminary details of a joint venture with Discovery Health which should see Surgicom members receiving a higher level of remuneration, independent of any existing direct payment arrangements. This will not be available to non-members.
Please assist us in gettting all general surgeons to fully support this.