The Democratic Alliance has threatened legal action if the uniform patient fees system (UPFS) is not urgently reviewed, because many patients cannot afford it.
Briefing the media at Parliament on Wednesday, DA MP and health spokesperson Dianne Kohler-Barnard said unaffordable fees imposed on patients at state hospitals by the Department of Health are causing a horrifying decline in the number of patients able to obtain treatment.
Using Cape Town’s Groote Schuur hospital as an example, she said there has been a 67% decrease in the number of patients at one unit. This is a microcosm of what is happening at state hospitals throughout South Africa.
”Despite numerous appeals by doctors and desperate patients, the health department has so far done nothing.
”This is a gross violation of patients’ constitutional rights, and the DA calls on the minister of health to urgently review the UPFS. Should she fail to do this, we will consider legal action,” Kohler-Barnard said.
The UPFS was first introduced in 1993. Hospitals were instructed that patients should be charged a full consultation fee for every single hospital visit — even if they had to be treated several times a week over the course of several years.
Units treating chronic patients negotiated more reasonable packages that allowed their patients to be charged for only some visits, but in January last year the department, without warning or consultation, banned these packages.
No explanation or justification for this has been forthcoming, she said.
Last week, the DA produced evidence of a massive R1,2-billion in unpaid hospital fees.
”It is the DA’s view that the minister introduced these fee changes to compensate for the losses to state revenue as a result of this non-payment.”
‘Catastrophic’ effect
The effect on patients has been catastrophic. In some cases, fees charged are higher than the patients’ monthly income, and often the fees are higher than those charged in the private sector.
For example, for a private consultation, a private patient will pay R156,40 for 15 minutes.
Under the UPFS, patients are charged between R70 and R365 a treatment, depending on income.
A patient in the highest-income category will be charged 233% more in a public hospital than in a private one.
Kohler-Barnard said a medical professional the DA spoke to believes that for the highest-income category, ultraviolet treatment in a public hospital is now the most expensive in the world. As a result, many patients are no longer able to receive treatment.
”At the dermatology unit at Groote Schuur, for example, figures we have obtained show that there has been a 67% drop in patient attendance over the past 18 months.”
A range of other chronic patients are equally affected by these changes, including those who suffer from kidney failure, cancer, motor-accident injuries, strokes and other injuries requiring physiotherapy, as well as those diagnosed with psychological disorders and cystic fibrosis.
The problems have been compounded by the department’s refusal to communicate with doctors or patients about the changes.
”Doctors we have spoken to say they have tried more times than they can count to get through to health department officials to get an explanation or official document describing the new rules. But they have got nowhere.
”This situation is completely unacceptable,” Kohler-Barnard said. — Sapa