In an about-face, the South Africa Medical Association (Sama) has written to the Department of Health and dissociated itself from further court action by doctors aimed at forcing the government to drop new medicine dispensing regulations.
This comes after Sama has spent months urging doctors not to comply with the new dispensing regulations. Many of the doctors, who are now technically not able to dispense medicines, feel left in the lurch by the medical association.
Earlier this month the Pretoria High Court dismissed an application by doctors organised under the National Convention on Dispensing (NCD) and supported by Sama that the dispensing regulations be declared unconstitutional.
The implication of the judgement is that no doctor may dispense medi-cation to a patient without being in possession of a dispensing licence. The judgement immediately criminalised the work of thousands of doctors who have not applied for the necessary documentation.
Some doctors have accused Sama of treachery, saying it conducted roadshows urging doctors not to comply, but has now left them in the lurch. But Sama says it has already advised its members to comply.
Sama president Kgosi Letlape maintained that the organisation wrote to the government to point out that the ruling would have negative implications for patients.
“We were saying we wanted to meet government to discuss the implications and how we could ameliorate the situation of patients on the ground,” Letlape said.
The Mail & Guardian has a copy of the letter to acting health director general Dr K Chetty, which reads in part: “We wish to state unequivocally that we accept the court decision on the above matter and as we have done in the past, we will continue encouraging doctors to fully comply with the law.
“In this regard therefore the board of the Medical Association has resolved to withdraw from the National Council on Dispensing [NCD] and we will no longer be a part of any further litigation process in respect of this matter.
“We further believe that now is the right time for us to work together to expedite the licensing process. There are a number of challenges still to be tackled in the short term so that patient care and access in our communities are not compromised.”
One doctor told the M&G that at the beginning of May Sama told doctors not to enrol for the course, saying it was unnecessary because most doctors were competent, having dispensed medicines for a long time.
“They told us if we were prosecuted they would protect us. Towards the end of May after Minister of Health Manto Tshabalala-Msimang had disclosed that some within the Sama and NCD executive had applied while encouraging others not to, they issued a statement encouraging people to apply. Sama accused the minister of being personal when she named those executives who had applied … Most of us feel let down because we banked on the court appeal.”
Another doctor said many of his colleagues continued to dispense without the licence and refrained from doing so only where medical aids demanded proof of the licence before paying. He said many were now applying frantically because they were worried about the survival of their practices.
Tshabalala-Msimang said in a statement on Wednesday that it was unfortunate that it had taken so long for Sama to adopt a rational approach to the transformation process in the health sector.
“Thousands of doctors were influenced by Sama not to comply with the requirements of the Act … The main objective of the dispensing regulations is to ensure that South Africans receive safe and quality medicines from health professionals with appropriate dispensing competencies. The department is committed to support doctors and other health professionals to comply with the laws and issue licences where they are due.”
Letlape said Sama had 17 000 members; he was not aware how many had applied or completed the dispensing course.
Tshabalala-Msimang’s spokesperson, Sibani Mngadi, said so far more than 1 500 licences to dispense had been issued. The situation is improving because the department is receiving 40 proofs of completion of the course a day.