Dr Donald Gumede testifying at the SAHRC preliminary hearing. Image: Times Live

The South African Human Rights Commission (SAHRC) has held a preliminary hearing into ongoing claims by Black, Indian and Coloured doctors that they are being racially profiled and bullied by medical schemes. Yesterday’s hearing in Braamfontein in Johannesburg followed complaints lodged by the National Health Care Professionals Association (NHCPA) with the SAHRC and was aimed at determining if the Commission should launch a full enquiry into medical schemes. The hearing was held as the Council for Medical Schemes (CMS) prepares to kick off its high-level investigation led by advocate Tembeka Ngcukaitobi into allegations of racial discrimination by schemes.  

Submissions from the NHCPA, Discovery Health (DH), Medscheme and GEMS were heard by SAHRC Gauteng manager Buang Jones. According to NHCPA chair Dr Donald Gumede, the complaints relate to medical schemes holding Black, Indian and Coloured doctors ransom by paying patients directly or withholding payment from practitioners pending the outcome of investigations into alleged fraud, with schemes also demanding confidential doctor-patient information to prove suspected fraud. Gumede said he believed that these alleged practices were racially motivated as he didn’t receive any similar complaints from white doctors. He also asked why schemes were not reporting evidence of fraud and corruption to the HPCSA and the Special Investigating Unit instead of directly going to the doctors and forcing them to pay back the money they believed was lost to fraud before resuming payments for services rendered to members. Gumede said these payments claimed from doctors run into millions of rands.

“We believe it is more of a money-making scheme than actually combatting corruption,” Gumede said.

Medical schemes denied the allegations with Discovery Health CEO, Dr Jonathan Broomberg saying that they have no racial, demographic or gender breakdown of the doctors on DH’s healthcare network. Calling the claims “wild and unproven”, he said there was no evidence of racial discrimination and that the allegations were based on opinion. Jones, however criticised Discovery’s claim that it did not know the racial demographics of its network doctors, saying that for the medical scheme industry to be transformed, schemes will have to determine how many people were benefitting from their doctor networks.

GEMS principal officer Dr Gunie Goolab and Medscheme CEO, Anthony Pederson also denied that race was indicated on their systems, saying that their information was based on the PCNS numbers supplied by the BHF.

Meanwhile SAMA has reminded interested parties that they have until the 19th of this month to make submissions to the CMS relating to its Section 59 investigation into allegations of racial profiling, blacklisting for payments, blocked payments, demands of confidential clinical information, “bullying and harassment, coercion, entrapment and use of hidden cameras.

Submissions should be sent to cmsinvestigation@medicalschemes.com