Opposition parties have strongly criticised Health Minister Manto Tshabalala-Msimang over her medicine-dispensing fees policy, with the Democratic Alliance (DA) calling for the suspension of the new fees system.
”It may take another protracted and expensive legal battle over dispensing fees to convince the minister of health that she cannot simply act on her own whims,” DA spokesperson Gareth Morgan said on Wednesday.
The minister should, as a matter of urgency, suspend the implementation of the new fees she announced recently, and which are due for implementation in January, and meet with the relevant role-players in the pharmacy industry.
”To avoid a legal battle, the minister at the very least needs to hold discussions directly with pharmacists about these new fees — something that, quite astoundingly, has not happened yet, although the livelihoods of [about] 2 800 pharmacists, and their dependants, are directly affected by these fees,” he said.
In September last year, she was ordered by the Constitutional Court to go back to the drawing board after the dispensing fees she had announced were found to be inappropriate.
Now, according to an actuarial study into the implications of the new fees, only about 22% of pharmacies are likely to survive because the fees allow for an average mark-up of R21,45 an item, whereas pharmacies need to be able to charge about R28 to cover their overheads.
The implications are particularly dire for rural areas, where the closure of a pharmacy will make medicines inaccessible to many, and the consequences of the loss of thousands of jobs attached to pharmacies also needs proper consideration.
”The process so far has been one-way communication. The pharmacists have not been able to hold a single meeting with the pricing committee, which is astonishing considering that the committee’s mandate was effectively to determine the future of their profession,” Morgan said.
Ruth Rabinowitz of the Inkatha Freedom Party said the problems with medicine pricing are entrenched in the White Paper [on health], which makes the minister and her director general the ”Big Sister and Big Brother of health care”.
”They decide everything about anything to do with health care and take on the roll of financial techno-wizards, although they have no expertise in finance.”
They should rather set minimum standards for all health facilities, lay down reasonable minimum packages for medical schemes, set maximum prices only, allowing for bulk discounts in a transparent pricing structure, expose pharmacies to open competition and ensure that nobody disobeys the law.
The virtually arbitrary manipulation of prices up or down for medicines, among other things, has given her the ”sticky rope to ensnare health providers in a web of bureaucratic controls that makes health-care provision in our country irrational and uneven”, Rabinowitz said. — Sapa