The first medicine-dispensing licences, allowing health-care practitioners to provide medicine to clients, were handed out by the Health Ministry in Pretoria on Tuesday.
Health practitioners have until May 2 to apply and qualify for such certificates.
This follows a law promulgated last year to prevent doctors from dispensing medicine without the licences.
”There have been cases where these professionals were pressurised to prescribe and dispense particular drugs as opposed to others,” said Minister of Health Manto Tshabalala-Msimang.
She described bulk buying, discounts, mark-up charges on expensive medicines and other ”perverse incentives” as contributing factors.
Tshabalala-Msimang hoped the new legislation would stop unethical business practices by some doctors.
But dispensing doctors plan to take the Department of Health to the High Court in April over the ”impracticability” of the medicine-dispensing licence regulations.
There are an estimated 11 000 dispensing doctors in South Africa. The National Convention on Dispensing, which has about 8 000 members, is bringing the legal action.
The dispensing licence is one of several aspects of regulations under the National Health Bill, due to become law on May 2, that has caused conflict between the department and doctors.
Tshabalala-Msimang said the law was designed to regulate the price of medicine and improve the service that accompanies such dispensing.
”All incentives and discounts on sale of medicines are to be outlawed from May 2 2004,” she said.
Dr Humphrey Zokufa, head of pharmaceutical policy and planning, said while many doctors accepted the need for improved regulation and dispensing practices, strong resistance had come from others not wishing to conform with the new requirements.
South African Medical Association (Sama) chief Kgosi Letlape is one of those unhappy with the legislation and has urged doctors to defy the law and continue dispensing medicines after May 2, even if they do not have a licence to do so.
”Doctors must put their patients first,” Letlape said. ”We are not saying that doctors should stop applying for dispensing licences, but we foresee problems with the applications process.”
Letlape said Sama wanted to negotiate ”several issues” with the department, including the distribution of medicine, but could not do so until the court case was concluded.
Meanwhile, Tshabalala-Msimang said more than 620 applications had been received from health practitioners to attend the course accredited by the Pharmacy Council.
”In processing the applications, we consider the existence of other licensed health facilities in the area, the estimated number of health-care users, the health status of the population and the pattern of disease in that specific area,” she said.
Dr Vitima Mtegha was one of the first to receive her certificate from the minister on Tuesday.
”My patients leave for work early and come back late. By being able to provide them with the medicine at the same time as their appointment I am saving them time,” she said.
Mtegha, who completed the required course in about four months, described it as easy.
”But it allows me to dispense all medicines including anti-retrovirals and considering that about 10% of my patients have HIV/Aids, I think it’s a good move,” she said. — Sapa