Outcry over medical kickbacks scandal

May 04 2000

By Lynne Altenroxel

Widespread condemnation accompanied by demands for a commission of inquiry and stricter legislation was the overwhelming response on Thursday to the expose on medical kickbacks.

The reaction came on the day that the Health Professionals Council of South Africa admitted it had received about 2 500 complaints of misconduct each year against members of the medical profession.

The Star was inundated with calls from people claiming to be industry insiders who confirmed that kickbacks were rife in medical circles and citing specific examples.

Their calls followed an investigative report, which revealed that two of South Africa's largest pathology companies, Lancet and Ampath, were spending millions of rands paying doctors to use their laboratories when ordering tests.

The Department of Health responded by asking the Health Professionals Council to investigate the issue "as a matter of urgency".

In a statement, the department said it had been concerned about the possible existence of perverse incentives and that it viewed the allegations in a very serious light.

The Board of Healthcare Funders (BHF), an umbrella body for medical aid companies, said it was concerned that The Star's report had exposed merely the tip of the iceberg.

"The BHF believes it is high time that South Africa follows the lead of several countries, such as the United States and Australia, in passing legislation that will specifically outlaw behaviour by medical practitioners such as that which has been alleged," board chairperson Brian Brink said in a statement.

Backing the calls for strict legislation was the National Pathology Group (NPG), which said it was distressed by the report.

"There must be a national law, there's no doubt about that," said NPG chairperson Dr Tjaart Erasmus.

"The only way this can be controlled is through statutory law."

Erasmus said the NPG "became aware of this as an increasing problem a number of years ago" and set up a code of conduct for pathologists. Since then there had been no "official" complaints in terms of the code.

The South African Medical Association also added to the chorus, saying it had "for some time been concerned over the lack of control over incentives and commissions to doctors for services that are not really essential and in patients' best interests".

"The South African Medical Association strongly condemns the payment of favours, commissions or kickbacks as incentives to doctors to refer or recommend patients, to prescribe certain treatments, or to perform certain procedures," said Dr Zolile Mlisana, chairperson of the association's board of directors.

Health Professionals Council acting registrar Leonhard Rode said the days when money-making by doctors was passed over in silence were gone.

"It has become a business," he said. "I don't think it (perverse incentives) is limited only to pathology."

Meanwhile, the Democratic Party has called for an inquiry into the matter by the Competition Commission.

"A root cause of this problem is the high concentration of ownership, with two very dominant companies, namely Lancet and Ampath, which control about 85 percent of the market," DP health spokesperson Jack Bloom said.

"It is quite clear that there is a very cosy closed shop of private pathologists who are holding the consumer to ransom and that appropriate controls are needed to prevent abuse."

Members of the public wishing to provide information on similar cases can use the email address lalt@star.co.za.

Acknowledgement to