The government is planning to implement a set of legal standards that all GP practices must live up to, which could kill private practice and force you to get state-standard healthcare. Although government claims this is for the sake of the patients, these regulations will make it extremely difficult, if not impossible, to run a GP practice.
The Office of Health Standards Compliance (OHSC) will enforce these standards, but they are also making the regulations and they will control the appeals process. In other words, the OHSC will be the judge, jury and executioners of medical doctors in private practice. They will have the right to fine, discipline a doctor, or even shut down a GP practice.
It seems that these regulations are a deliberate attempt to cripple private practitioners and force them to rather embrace the National Health Insurance program (which is government’s long term plan to phase out medical aids and insure everyone on a state healthcare system). Basically, the standards of running a GP practice have been set so high that it will be impossible to run a private GP practice, forcing doctors to run government-sponsored NHI clinics instead.
In a nutshell, here are the biggest potential problems with the regulations (not all problems, just the biggest!):
- It will make the government part of the doctor-patient relationship. The OHSC will have the right to access anyone's medical information upon inspection of a GP practice. This is supposedly in order to make sure the doctor is doing his job, (and more importantly, is writing his notes in the exact format required by this new legislation!), but it means that doctor-patient confidentiality will be transformed to doctor-patient-government confidentiality. Considering the history of abuse of power in our country, both by the old and the new dispensation, this seems like a dangerous thing to let government get away with.
- Turn the entire patient-doctor consultation into a bureaucratic mess. God forbid your doctor does not record your religion and sexual orientation at every visit, and he better damn sign it in black ink with a time and date, and then he must scan it into his electronic records.
- Basically regulate what treatment your GP should give you. The regulations strongly imply that GPs must obey, to the letter, the treatment guidelines as defined by the department of health. Basically, whether you have hypertension, diabetes, or pneumonia, the government wants the treatment to be the same regardless of where you go. So if a GP decides that you as an individual actually need a uniquely tailored treatment according to your needs, he is guilty of a crime. Also, it basically means that your GP will not be allowed to treat you differently than a patient getting care from a state facility - the regulations make it compulsory to treat all patients the same, regardless of whether they go private or state, so GPs will have to give the state standard of treatment.
- Make it extremely easy to sue doctors for relatively minor issues. This might sound great on paper, but if a small number of patients are suing doctors for millions, then doctors will have to pay more insurance, which ends up being charged to the patients, which will make healthcare more expensive for everyone.
- Make it extremely difficult to set up a new practice. The regulations require a GP to own a massive amount of equipment, a lot of which he will never actually use in the day-to-day running of a practice; so a GP will need massive financing to even start a practice, which means he will have to focus on servicing only the rich who can afford the high fees needed to pay the GP the money he needs to buy all that useless equipment.
- Make the doctor take medico-legal responsibility for everything: if a child misses a vaccination appointment, it's the doctor's fault. If a patient doesn't go for an x-ray, it's the doctor's fault. If the patient doesn't go to a specialist, it's the doctor's fault. If the patient doesn't come for his repeat script, it's the doctor’s fault. If the patient fails to return for an annual check-up, it's the doctor's fault. Basically, patients are considered to all be 5 year old children and the doctor takes full responsibility for them and if anything goes wrong, the doctor is at fault. Again, this sounds wonderfully patient friendly, but this is just a bunch of lawsuits waiting to happen. So your GP is going to have to spend time running after patients and getting them to where they need to be instead of focusing on, you know, the actual practice of medicine.
- Make the doctor have to spend an enormous amount of time doing admin work. The regulations force the doctor to have standard operating procedures for absolutely everything - from giving an injection, to appointment systems, to taking a blood pressure, referral to specialist etc. And these regulations have to be regularly updated, and available for inspection at any time to inspectors.
- All doctors must annually be certified in CPR; so if your GP has a medical condition or is just an older person who is not fit to do chest pushes during CPR, he must basically close shop. You will no longer be allowed to be a doctor if you are not fit/healthy enough to do CPR. Nevermind that 99.9% of patients going through GP practices everyday don't need CPR.
These are just some of the many issues these regulations are going to cause. If you are interested in reading the actual document, please find the link to it from my google drive at the bottom of this post.
If you have never heard of the OHCS, they have a FAQ page that summarises their mission:
http://www.ohsc.org.za/index.php/who-we-are/ohsc-faq
The copy of the draft regulations on my google drive:
https://drive.google.com/file/d/0Bz_moIVGwjoeazRZY1ZjRW1YTnNDVWZMVGk5UkYtRW05TTlR/view?usp=sharing
The Office of Health Standards Compliance (OHSC) will enforce these standards, but they are also making the regulations and they will control the appeals process. In other words, the OHSC will be the judge, jury and executioners of medical doctors in private practice. They will have the right to fine, discipline a doctor, or even shut down a GP practice.
It seems that these regulations are a deliberate attempt to cripple private practitioners and force them to rather embrace the National Health Insurance program (which is government’s long term plan to phase out medical aids and insure everyone on a state healthcare system). Basically, the standards of running a GP practice have been set so high that it will be impossible to run a private GP practice, forcing doctors to run government-sponsored NHI clinics instead.
In a nutshell, here are the biggest potential problems with the regulations (not all problems, just the biggest!):
- It will make the government part of the doctor-patient relationship. The OHSC will have the right to access anyone's medical information upon inspection of a GP practice. This is supposedly in order to make sure the doctor is doing his job, (and more importantly, is writing his notes in the exact format required by this new legislation!), but it means that doctor-patient confidentiality will be transformed to doctor-patient-government confidentiality. Considering the history of abuse of power in our country, both by the old and the new dispensation, this seems like a dangerous thing to let government get away with.
- Turn the entire patient-doctor consultation into a bureaucratic mess. God forbid your doctor does not record your religion and sexual orientation at every visit, and he better damn sign it in black ink with a time and date, and then he must scan it into his electronic records.
- Basically regulate what treatment your GP should give you. The regulations strongly imply that GPs must obey, to the letter, the treatment guidelines as defined by the department of health. Basically, whether you have hypertension, diabetes, or pneumonia, the government wants the treatment to be the same regardless of where you go. So if a GP decides that you as an individual actually need a uniquely tailored treatment according to your needs, he is guilty of a crime. Also, it basically means that your GP will not be allowed to treat you differently than a patient getting care from a state facility - the regulations make it compulsory to treat all patients the same, regardless of whether they go private or state, so GPs will have to give the state standard of treatment.
- Make it extremely easy to sue doctors for relatively minor issues. This might sound great on paper, but if a small number of patients are suing doctors for millions, then doctors will have to pay more insurance, which ends up being charged to the patients, which will make healthcare more expensive for everyone.
- Make it extremely difficult to set up a new practice. The regulations require a GP to own a massive amount of equipment, a lot of which he will never actually use in the day-to-day running of a practice; so a GP will need massive financing to even start a practice, which means he will have to focus on servicing only the rich who can afford the high fees needed to pay the GP the money he needs to buy all that useless equipment.
- Make the doctor take medico-legal responsibility for everything: if a child misses a vaccination appointment, it's the doctor's fault. If a patient doesn't go for an x-ray, it's the doctor's fault. If the patient doesn't go to a specialist, it's the doctor's fault. If the patient doesn't come for his repeat script, it's the doctor’s fault. If the patient fails to return for an annual check-up, it's the doctor's fault. Basically, patients are considered to all be 5 year old children and the doctor takes full responsibility for them and if anything goes wrong, the doctor is at fault. Again, this sounds wonderfully patient friendly, but this is just a bunch of lawsuits waiting to happen. So your GP is going to have to spend time running after patients and getting them to where they need to be instead of focusing on, you know, the actual practice of medicine.
- Make the doctor have to spend an enormous amount of time doing admin work. The regulations force the doctor to have standard operating procedures for absolutely everything - from giving an injection, to appointment systems, to taking a blood pressure, referral to specialist etc. And these regulations have to be regularly updated, and available for inspection at any time to inspectors.
- All doctors must annually be certified in CPR; so if your GP has a medical condition or is just an older person who is not fit to do chest pushes during CPR, he must basically close shop. You will no longer be allowed to be a doctor if you are not fit/healthy enough to do CPR. Nevermind that 99.9% of patients going through GP practices everyday don't need CPR.
These are just some of the many issues these regulations are going to cause. If you are interested in reading the actual document, please find the link to it from my google drive at the bottom of this post.
If you have never heard of the OHCS, they have a FAQ page that summarises their mission:
http://www.ohsc.org.za/index.php/who-we-are/ohsc-faq
The copy of the draft regulations on my google drive:
https://drive.google.com/file/d/0Bz_moIVGwjoeazRZY1ZjRW1YTnNDVWZMVGk5UkYtRW05TTlR/view?usp=sharing
