Medical health practitioners have accused medical aids of racial discrimination on eNCA’s Tonight with Jane Dutton.
Companies accused include Discovery, Medscheme Medical Aid, and the Government Employees Medical Scheme (GEMS).
Chief Executive at the Council for Medical Schemes (CMS) Dr Sipho Kabane told eNCA the list of allegations includes “racial profiling, blacklisting of doctors, keeping a list of health professionals, spy cameras, coercion, [and] bullying”.
Chairperson of the National Health Care Professionals Association (NHCPA), Dr Donald Gumede, told eNCA he had “evidence” to back up these claims and added that the organisation believed black, Indian, and coloured medical practitioners had been unfairly discriminated against.
A clinical social worker, Nomaefese Gatsheni, told eNCA that Discovery attempted to make her disclose confidential patient information.
“I get audited every two years, and normally the medical aid, which is Discovery on my side, they will demand the confidentiality of my patients, the minute I refuse to give them the confidentiality of the patient, then I’m told ‘ok, if you don’t agree with that we’re gonna pay the patient and they will pay you’. Guess what happens, now a patient will receive the money and don’t pay me. I’ve been struggling with that for over two years,” she said.
“Medical schemes and administrators do have a responsibility of making sure that the funds which have been contributed by members are not illegally claimed, so there are certain measures that they are allowed by the act to make sure they verify the claims and make sure they are legitimate,” said Kabane.
He said, however: “We don’t support the view that people can demand to see confidential clinical information of patients because that’s unethical .. and it’s bullying.”
“The only time we are allowed to disclose this information is when a patient is threatening to harm herself and others or when a court subpoenas you,” Gatsheni added.
Discovery has dismissed all the allegations, saying in a statement that there is “absolutely no truth” to them.
According to the statement: “The National Health Care Professionals Association (NHCPA) brought an application in the high court against several medical aid schemes and their administrators, requesting that our forensic processes be declared unlawful and unconstitutional.”
However, the statement says the case was dismissed and that the NHCPA was denied leave of appeal, further alleging that several members of NHCPA “have been identified as perpetrators of medical aid fraud”.
Discovery says they are against “any discrimination against healthcare professionals” and that they have been accused of racism as a result of them acting on their responsibility to “deal strictly with fraud and corruption”.
Medscheme and GEMS, meanwhile, told eNCA they would comment after a meeting with Health Minister Aaron Motsoaledi, which will take place on Thursday.
(Compiled by Daniel Friedman)