As dispensing doctors in South Africa we are outraged by the National Department of Health's continued attempts to discourage general practitioners from dispensing medicines to their patients; attempts which were initiated more than fifteen years ago. The department was taken to the Constitutional Court in 2005 and aspects of the regulations were struck off thereby allowing doctors to continue dispensing.
The department appears hell-bent on discouraging doctors from dispensing. The dispensing fee for general practitioners was set so low in 2004 (16.00% of item value up to R100.00 and 16% thereafter), that General practitioners dispensed at a loss. Since then the department has deliberately not complied with the law which requires the dispensing fee to be reviewed annually.
The department has now added salt to the wound. Despite various high level meetings with the department with the aim of formalising methodology to inform an annual review of the dispensing fee, the department recently issued a notice requiring doctors to submit detailed data on dispensary expenses. This action flies in the face of an agreement reached with the Department of Health, in that the National Convention on Dispensing represents dispensing general practitioners and that an agreement on methodology will be negotiated with the NCD.
We view this tactic as a perpetuation of this negative attitude towards dispensing doctors; as one aimed at dividing general practitioners as well as covering up an administrative paralysis and inability to constructively engage on the issue of the annual review of the dispensing fee. This practice is condemned and shall be opposed by all dispensing doctors vehemently.
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Dispensing general practitioners play a significant role in providing cost-effective medication, dispense at a much lower dispensing fee than most pharmacies and, as proven by cost reviews, provide the most cost effective scripts for their patients.
We are ready to go to court again. We shall take the department to court for noncompliance with their own legislation which we know was crafted for ulterior motives as confirmed by the constitutional court. The same authors who crafted this law continue to occupy leadership positions within the department.
(We condemn this behaviour) too much. The department should not impoverish the private sector in order to enrich the public sector. This is an attempt to drive general practitioners into poverty with the hope of driving them into the public sector and we say NO to this exercise in futility.
Several years ago, the National Convention on Dispensing (NCD), the South African Medical Association (SAMA) as well as Focus on Health (Pty) Ltd did cost studies. Elements of these studies, with specific reference to the costs associated with dispensing, have been used selectively by the Department for reviews of the dispensing fee even though they were ostensibly rejected by the protagonists. The results were rejected because they did not like the results. Now the notice, issued in the name of the minister, purports to ask doctors to provide the same information again. We reject this with contempt.
We shall take the department to the highest court in the land to protect the profession, as well as the interests of the patients and specifically their right to cost effective medication.
They have ignored us, they must at least answer us through the courts. If you can't lift the ceiling, do not lower the floor.
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