Lesotho grower is Africa’s first to sell medicinal ...
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PrivatePracticeReview2April2021 Viewinwebbrowser
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ReviewarethoseoftheauthorsofthemediasourcesanddonotnecessarilyreflecttheviewsoropinionsofHealthMan,itsdirectors,employeesandassociates.
InthisNewsletterFoodforThoughtNewsfromGovernmentSpecialNewsFinancialNews
PharmaceuticalNewsGeneralNewsNewsfromMedicalAidsCircularsfromtheCMSSpecialNotes
FOODFORTHOUGHT
THEBADNEWS:
ThisishowSA'shealthdepartments(mis)spend
publicfunds“Therecentlyreleased2019/2020auditoutcomesfornationalandprovincialdepartmentsshowedsomeimprovements,butfortheumpteenthtime,itis
dwarfedbyaverygrimpictureofpersistentwastage,financialmismanagementandlittletowhollyinadequateconsequencesforthoseresponsible,”
wroteAllestineOctoberinanin-deptharticle(Spotlight20April2021)
Forexample:TheGautengDepartmentofHealth’sbudgetforclaimsin2019-20wasR2,6-m,buttotalclaimsofR501-mwerepaidoutfortheyear.Thedepartment‘transferredsavingsfrom
otherlineitemswithinthebudgettoclaimsfromthestateinordertopaytheclaims.Theresultwasthatkeyvacantpositionswerenotfilledatsomehospitals.
StatisticsreleasedbytheMinisterforPublicServiceandAdministration,SenzoMchunu(February2021)revealedthatmorethanathird(3301)ofthe9477seniormanagersinthepublicserviceregisteredonPersaldidnothavetherequiredqualificationsforthejob.Inprovinces,mostofthemwereinhealthdepartments.AccordingtoZukiswaKota,programmemanageratthePublicServiceAccountabilityMonitor(PSAM)therearefourriskareashighlightedintheauditreportoutcomesthatareworthseriousattention.“Procurement,planning,parastatalsand(linkedtoitall)politics.”
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SouthAfrica‘sAuditor-Generalhaswarnedthatwithouturgentintervention,anumberofprovincialhealthservicesfacecollapse,wroteMedicalBrief.(22April2021).
Outstandingmedico-legalclaimsamounttoR105.8-bn,withfivehealthdepartmentsfacingclaimsinexcessofthisyear’sentireoperationalbudget.
Alsoread:NewsfromGovernment:'ConCourtconfirmsalternativecompensationremedyfornegligence'
THEGOODNEWS:
DrDulcyRakumakoe:'Buildinganempireofaffordablehealthcare’
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DrDulcyRakumakoe,CEOof10clinicsinGauteng,decidedtogointomedicinesothatSouthAfricanslikehergrandmotherwouldnothavetowaitforhoursto
seeadoctor.–ElnaSchütz,BusinessMaverick(12April2021)
AtQuadcaremedicalcentresaroundGauteng,suchasinAlexandraandEdenvale,onecanseeadoctorandgetbasicmedicationsforabasefeeofR350.Profitabilityisbased
onhighturnoverandcarefulmonitoringofprocessesandresources.Thegrouphopestoexpandtoabout30centresinthenexttwoyears.
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'Experts'aboutCOVID-19:Fake,FictionorFaction?
OnMarch30,NickHudson,co-founderoftheglobalthinktankPANDA(Pandemics-dataandanalysis)gavethekeynoteaddressattheinauguralBizNewsInvestment
Conference:TheUGLYtruthabouttheCovid-19lockdowns
"Wehavebelievedfromthegetgothatitwaswrong,onanumberoflevels,toclosesocietydownandthatithasalwaysbeentimetoreopensociety.Wealsobelievethatthe
truthonlyprevailsifplansaretakentobringittolight.Ourworldisgrippedbyfearandthatfearisverymuchtheproductofafalsenarrative."Towatchthevideo,clickonthebuttonbelow(left)
Hudson'skeynoteaddresscausedwide-spreadreactionregardingpolicymaking,targetedprotection,testingforthedisease,maskwearingandvaccines,towhich
PANDA(NickHudson)responded.Toreadtheresponse,clickonthebuttonbelow(right)
TheUGLYtruth PANDAresponds
NEWSONGOVERNMENT
COVID-19rollout:
Private-sectorstillwaitngonDepartmentofHealth
TheNationalDepartmentofHealthhasyettofinaliseapricingstructureforCOVID-19vaccinesfortheprivatesector,leavingmedicalschemesandhealthcareproviders
unsurehowtomakefinancialprovisionfortherollout,reportedBusinessLIVE(20April2021)
AlthoughHealthMinisterZweliMkhizesaidmedicalschemememberswillbeexpectedtohelppayfortherollouttonon-members,theMedicalSchemesActrestrictspaymentstoschememembers.
Thefollowinghasnotbeenfinalised
Accreditedprivatesectorvaccinationsiteswillbepaidanadministrationfeetocoverprofessionalfeesandthecostofconsumables,andwillbereimbursedbymedicalschemes,butthesecostsarestillbeingcalculated;TheDoHreceived24bidstoprovidetransport,warehousinganddistributionservicesforCOVID-19vaccines,buthasyettoawardthetender.
Thefollowingisstillnotclear:
Howmuchthepricepaidbymedicalschemeswilldifferfromthepricethegovernmentpaystovaccinesuppliers;Howthefeespayabletohealthcareproviderswillbepegged;andHowprivatehealthcareproviders,suchaspharmacies,aretobecompensatedfordispensingvaccinestostatepatients.
ConstitutionalCourtconfirmsalternativecompensationremedy
fornegligence
FollowingaConstitutionalCourtjudgement,SAcourtswillnowbeabletoconsiderorderingalternativecompensation–insteadofalump-sumpayment–to
thoseinjuredasaresultofmedicalnegligence,
"TheConstitutionalCourtjudgmentinvolvedanapplicationforleavetoappealagainstajudgmentoftheSupremeCourtofAppeal(SCA).
"Thepossibilityofprovidingphysicalitemsorstatemedicalservices,insteadofmoney,willbewelcomedbytheprovincialHealthDepartmentswhofacestaggeringmedical
negligenceclaims,"reportedMedicalBrief(14April2021).
Inthispastfinancialyear,EasternCapeHealthpaidoutR920-monmedicalnegligenceclaimsandKZN'smedicalnegligenceclaimsincreasedbyR3-bninthe
2018/2019financialyeartoR23-bnin2019/2020.
Johnson&Johnsonvaccinationrollouton
trackagainaftersuspension
FromWednesday,April28,SA’sJohnson&JohnsonSisonke“TOGETHER”COVID-19vaccinetrialrolloutforhealthcareworkers,isbackontrackwitharevisedimplementation
protocol.TheprogrammewaspausedonApril13,afterdiscussionsbetweentheSAMedicalResearchCouncil,theHealthMinister,andresearchersaboutwhethertopause
administeringtheshotsuntilthereisgreaterclarityonthepossiblelinkbetweenthevaccineandtheblood-clottingeventsreportedintheUSandEurope.Firstinlinewillbe
afurther200000healthcareprofessionalsandthenpeopleolderthansixty.
VaccinecontractsawardedThegovernmenthasawardedcontractsforimportinganddistributingCOVID-19vaccines,whichisduetobeginon
May17,reportedBusinessDay(23April2021).
BiovacandImperialLogisticshavebeenappointedtoprovideimportationservices,whilethejoboftransporting,warehousinganddistributingthevaccineshasbeensplitbetweenBiovacandDSVHealthcare.Biovacwillcoverallthecoldchainrequirementsforvaccinesthatrequirestorageat2°Cto8°C,at-20°Cand-70°C.DSVHealthcarewillonlyprovideservicesforvaccinesrequiringstorageat-70°C.Athirdcompanyisexpectedtobeappointedshortlytoassistwiththe-20°Cservices.
SPECIALNEWS
Whenconditionskeepchanginginbothyourbusinessandpersonalcircumstances
Theglobalpandemichighlightedhowunpredictablethefuturecanbe.Thatsaid,therearemanyunexpectedeventswecanpreparefor.Overthelasttwelvemonths,thefocusturnedtoriskmanagementandhowitcanhelptosafeguardourfuturelifestyles,stress
andcomfortlevels.Yourbusiness,home,carandotherassetsarevaluableandarethereforesusceptibletodamageandtheft.Short-terminsuranceisthemostaffordable
waytomitigaterisktoyourvaluables.
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FINANCIALNEWS
Dis-Chem&Clicksgearupforvaccineroll-out
Dis-ChemhasrecentlyannouncedthatitisplanningforthenextstageofthevaccinerolloutinpartnershipwithBusinessforSA(B4SA)andtheDepartmentofHealth.Thecompanyisnegotiatingwithlandlordsandretailersaswellasnursingagenciestosupplythevaccinationservicesthatthe191Dis-Chemstoresplantoprovide.
AccordingtoClicksCEOVikeshRamsunder,theretailerhasthenecessaryinfrastructure,includingmorethan600pharmaciesand192clinics,tohelpfacilitatethevaccinationroll-out.ClicksandDis-Chemwillalsobeabletodistributevaccinestoothervaccinationsites.
ChantalMarx,headofinvestmentresearchatFNB,saidusingDis-ChemandClicksaspartofthevaccinerolloutis“averycleverwayofscalingdistributionandmakesperfectsense”.ClicksandDis-Chem“won’tbemakinganymoney”,butsheexpectsin-store
salestospikeasthenewlyvaccinatedwaittherequired15minutesafterthejabtoensurethattherearenoside-effects.
PHARMACEUTICALNEWS
Vaccineclaimantsgiveuprighttosue
IntermsofnewregulationsforthecompensationfundSouthAfricanswhoclaimfromaCOVID-19vaccineinjuryfundwillgiveuptheirrightstoapproachthecourtstosuethegovernmentorhealthworkers,shouldtheysuffersevereinjuryfromtakingtheinjection
ThisfollowsasdrugcompaniesprovidingvaccinestoSA,likeJohnson&Johnson(J&J)andPfizer,insistedonano-faultcompensationschemerunbythegovernmentasaprerequisiteforsupplyingthevaccines.
TheregulationswerepublishedonApril22.However,itisnotclearfromwhichdepartments’budgetthegovernmentwillsourcemoneytopayclaims.
BrainclotsfarmorelikelyfromC-19thanvaccines
ReutersreportedonApril15,thataccordingtoBritishresearchthereisamuchhigherriskofbrainbloodclotsfromCOVID-19infectionthanthereisfromvaccinesagainstthedisease.
Theresearcherssaidinapre-printstudythattheriskofCVSTwaseightto10timeshigherfollowingCOVID-19infectionthanitwasfromexistingvaccinesforthedisease.TheresearchersfromOxfordUniversity,highlightedthatCOVID-19wasassociatedwithmorecommonclottingdisordersthanCVST-suchasstrokes-andthatrecentdebatearoundvaccineshadlostsightofhowbadthediseaseitselfcouldbe.TheteamworkedindependentlyfromtheOxfordvaccineteamwhichdevelopedAstraZeneca’sshot.
Malariavaccinetrialresultsmayindicatea‘game-changer’ThefirstmalariavaccinetomeetaWorldHealthOrganisation(WHO)-specifiedgoalofmorethan75%efficacyhasbeendevelopedbyscientistsattheUniversityofOxford,
reportedReuters(23April2021).TheshotusesMatrix-Madjuvanttechnologyandwasusedintrialsinvolving450childrenages17monthstofiveyearsinBurkinaFasoand
“waswell-tolerated”,theteamattheuniversity’sJennerInstitutesaid.TheSerumInstituteofIndiahasagreedtoproducethemalariavaccineonceapproved.
LesothogrowerisAfrica’sfirsttosellmedicinalcannabis
flowertoEUALesotho-basedcannabiscultivator,MGHealth,hasbeenapprovedbytheEuropeanUnion(EU)asthefirstmanufacturerinAfricatoexportthemedicinalcannabisflowerasanactivepharmaceuticalingredienttotheEU,reoprtedBusinessInsider(16April2021).MGHealthoperatesacannabiscultivationandmanufacturingfacilityinthemountainousregionnearMohaleDam.
MeanwhiledoctorsinOntarioinCanadaarestillhesitanttoprescribemedicalcannabistopatientssufferinglong-termpain–20yearsafteritwasfirstintroducedanddespitehundredsofthousandsofCanadiansusingmedicalcannabis–accordingtoastudypublishedintheCanadianMedicalAssociationJournal.
GENERALNEWS
QualityofHIVcarehigherinclinicsthanhospitals
AccordingtothelatestresearchfromWitsUniversityandBostonUniversityintheUS,HIVpatientsinSA
experience
hugegapsinthequalityofcarealthough96%ofSouthAfricanslivewithin10kmofahealthcarefacilitythatprovidesantiretroviraltreatment(ART).
Qualityofcarewashigherinclinicsversushospitals;inruralhealthfacilities
ratherthanurbanareas;andinlargerfacilities.Qualityofcarewaslowerinareaswithgreaterpoverty.
KZNscoredbestandLimpopoworstonstartingtreatmentontime,retainingpatientsincare,suppressingviralloadandmonitoringpatientsfortreatmentfailure.Researchers
areconvincedthattargetinglow-performingfacilitiesforadditionalsupportcouldreducetheoverallburdenofdiseaseandunderstandingthedifferencesinqualityofcareover
timecouldguideinterventionstoimprovehealthoutcomes.
SouthAfrica'sCoronavirusUpdate:(28April2021)CasesReported:1,578,450
Deaths:54,285Recovered:1,503,611
SA’s‘sugartax’showsresultsAccordingtoaseniorresearcherat
Priceless-SA,thelateststudyhasfounda51%reductioninsugar,a52%decreaseincaloriesanda29%reductioninthevolume
ofbeveragespurchasedperpersonperday.Thisfollowstheimplementation,in
2018,ofSA’s“sugartax”.Thee-studywasrecentlypublishedin
LancetPlanetaryHealth.Thestudyhighlightedthatthe
announcementandimplementationofthetaxcoincidedwithlargereductionsin
purchasesintermsofvolumesandsugarquantitiesfromtaxablebeverages,withnon-significantchangesfornon-taxable
beverages.
NewappdeliversmedicineAnewSAapp,PharmaGo,waslaunchedinMarchtofacilitatefreesame-dayand
next-daydeliveriesforessentialandover-the-countermedication,
reportedFinancialMail(15April2021).PharmaGo,createdbyRaeesCarim,passesthecustomer’sprescriptions,uploadedontheapp,toa“pharmacy
panel”availableonlytothepharmacistfillingtheprescription.Thisensures
informationsecurityanddiscretionandisexclusivetoPharmaGo.Paymentisvia
creditordebitcardandissentdirecttothemedicalaid.
Atlaunch,PharmaGohad73pharmaciesonboard.Itusesexistingdistribution
networksfordeliveries.
NEWSFROMMEDICALAIDS
DoHdeclarescertainDSPpracticesbyschemesirregular
CertainpracticesbymedicalschemesinselectingDesignatedHealthcareProviders(DSPs),aswellasimposingexcessiveco-paymentsonmembers,havebeendeclaredanirregularandundesirablepracticebytheDepartmentofHealth
(Section61oftheMedicalSchemesActNo131of1998).
AnoticetothiseffectwaspublishedintheGovernmentGazette(23April2021)ThisfollowsinformationprovidedbytheCouncilforMedicalSchemes(CMS)regardingthewayinwhichsomemedicalschemes:
Unilaterallyandwithoutrestriction,determinethecriteriatoapplywhenselectingtheirDSPs;SelectDSPswithoutengaginginafairprocurementprocess;Unfairlylimitsthenumberofselectedserviceproviders(includingpharmacies)availabletoprovidehealthcareservicestothemembers;andObligememberstouseonlytheselectedlimitednumberofDSPsorriskpayingexorbitantco-payments.Regulationswillbepublishedinthenext6monthstoprovideguidelines.
MedicalSchemeshaveturnedintoa
'businessscience'
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ProfMarietjiedeVilliers,formerdeputydeanofthemedicalschoolatStellenboschUniversityandformerdeputychairpersonoftheMedicalandDentalProfessions’Board,
saysmedicalaids"haveturnedintoabusinessscience".
AccordingtoDeVilliersthedaysarelonggonewhenmedicalaidsweretomakeiteasiertopayforpatientsandeasiertocollectmoneyfordoctors.
Theyhavebecome"entrepreneurialbusinessesandafocusontheclientormemberisnolongerthepoint,”reportedChrisBatemaninMail&Guardian(16April2021).
“Acombinationofanoutdatedregulatoryenvironmentwellbehindtheglobalcost-efficiencycurve,ineffectivefee-for-servicestructures,highspecialistandhospitalcosts,
plusanever-ageingmedicalschememembershipcreatewhatonefundingexpertcallsa‘deathspiral’.”
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C-19vaccine:
MedicalSchemeswon’tsubsidisenon-members
Threemedicalschemes,DiscoveryHealth,FedhealthandProfmed,havepouredcoldwaterontheideathattheycouldsubsidisevaccinationsforpeoplewhodonothavemedicalcover,reportedTimesLIVE(14April2021).
DiscoveryCEOAdrianGoresaidasaresultofglobalvaccineshortages,procurementshouldbelefttothestate,thoughwithstrongprivatesectorcollaboration.
However,ProfmedCEOCraigComriesaidwhilemanufacturerswerenotyetwillingtosellvaccinesdirectlytoprivatebusinessorganisations,theschemehadhaddiscussionswith“many”manufacturers.
Fedhealthprincipalofficer,JeremyYatt,saidsubsidisingvaccinationswouldbeillegalasamedicalaidisanot-for-profitorganisation,andthefundsthereforebelongtothememberswhocontributeeverymonth.
CircularsfromtheCMS
ThefollowingCircularswerepublishedbytheCMS
inApril2021.
22of2021RevisedexemptionconditionstoCircular56of202023of20212021/22leviesformedicalschemes24of2021PublicationofSection61Gazette25of2021ManagedCareOrganisationsAccreditedbytheCMS
26of2021SAICAAccountingGuide27of2021COVID-19VaccinesMembershipData28of2021InternetServiceProviderMigration
SPECIALNOTES
RegisterforHSSworkshop
HealthSystemsStrengtheningResearchWorkshop13May2021
HSSisacollaborationbetweentheUniversityofStellenboschBusinessSchool(USB),theSchoolofPublicLeadership(SPL),theDepartmentofEconomics(Facultyof
EconomicandManagementSciences),theIndustrialEngineeringDepartment(FacultyofEngineering)andtheDepartmentofGlobalHealth(FacultyofMedicineandHealth
Sciences).Thisworkshopaimsto:
Strengthenandexpandcross-facultyresearchnetworksofresearchersandpostgraduatestudentswhostriveforoptimalhealthcarequalityandequityinoursociety;Facilitatecross-disciplinarythinkingandproblemsolvinginhealthsciencesthroughsharingresearchplansandprogress;andThinkinnovativelyaboutsolutionsthatwillworkforpublicandprivatehealthcareusers.
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