The Health Funders Association (HFA), one of SA’s key medical scheme industry bodies, has written to the sector regulator objecting to its plans to publicly release the interim findings of its investigation into racial profiling before the affected parties have had a chance to comment.
The Council for Medical Schemes (CMS) launched an investigation in June 2019 in terms of section 59 of the Medical Schemes Act, after complaints by black medical practitioners that they were being unfairly targeted.
The investigators’ interim report was due to be released on Sunday, but was blocked at the 11th hour by legal action taken by the Government Employees Medical Scheme and another industry association, the Board of Healthcare Funders (HFA). The HFA, which counts SA’s biggest medical scheme administrator, Discovery Health, among its members, was not party to the legal action.
The HFA issued a statement on Monday morning saying it had written to the CMS on Friday, and “on numerous occasions in the past six months”, indicating that it did not believe the plans to release the interim report to the public complied with a decision by the section 59 steering committee established to oversee the investigation. This committee includes representatives of the three-member investigating panel, the CMS, the medical scheme industry and other stakeholders.
“It was agreed at the steering committee level that the interim report would be released to each of the affected persons and organisations for comment, in accordance with the committee’s own terms of reference and consistent with the audi alteram partem principle. These comments would then be considered by the panel and any appropriate amendments made by the panel prior to public release of the report,” said the HFA.
“The HFA values the very important work that has been carried out by the panel thus far, but is also mindful that agreed processes and procedures should be respected to prevent undue or unfair harm or prejudice to any affected person,” it said.
Gems and BHF said in their court application, launched on Saturday, that they had not been given an opportunity to study the report or comment on it, and that it was not supposed to be released to the public before it had been finalised.
“It was always the understanding of the applicants that affected parties would have the right to comment on the interim report before any report would be made public,” they said.
If the interim findings were made public before the schemes had provided their comments, the report could “permanently tarnish” their reputations.
The investigation was conducted by a three-member panel chaired by Tembeka Ngcukaitobi. In his responding affidavit, he said the applicants knew as far back as November 27 that the CMS planned to hold a media conference to release the interim report and had not raised any objections. They had no grounds to seek an urgent application to stop publication of the interim report, he said.
The matter was heard by judge Colleen Collisson, who reserved judgment until Tuesday morning.
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