Picture: 123RF/SAMSONOVS
Picture: 123RF/SAMSONOVS

The Health Professions Council of SA (HPCSA) is reviewing the rules governing the contracts between medical professionals, in the wake of criticism that its current stance stifles competition.

The HPCSA regulates health professionals and their conduct. Its ethical rules govern how health-care practitioners, ranging from specialists to physiotherapists, may run their practices, and any relationships they may have with other health establishments. These rules prohibit subcontracting and fee-sharing, impose restrictions on the financial interests that professionals can hold in health-care businesses and prevent private hospitals from employing doctors.

The HPCSA has previously been criticised by the Competition Commission’s Health Market Inquiry (HMI), which said it was insensitive to the benefits that increased competition could have in making health care more affordable. The inquiry is investigating the barriers to competition in the private health-care sector, and said in its interim report in 2018 that the legal restrictions created by the HPCSA’s interpretation of its ethical rules dampened potentially cost-saving innovation, particularly the rules prohibiting fee-sharing and subcontracting.

 “We have come up with a proposal that we’ve discussed with the Competition Commission,” HPCSA registrar Raymond Billa told delegates to the Board of Healthcare Funders (BHF) annual conference on Wednesday. The BHF is an industry association for medical schemes and administrators, and its annual conference is a key gathering of players in the private health-care industry.

 “The HMI says the ethical rules are stifling competition. We’ve looked at them and there is a way forward to change them and comply with the Competition [Act],” he told delegates to the conference.

The proposed changes to the rules would be discussed with stakeholders before being finalised, he said.

In response to questions from the floor, Billa said he hoped the process of revising the ethical rules would be completed by the end of the year.