Doctors cannot continue to subsidise medical aid societies- minister

Q & A:

DR. LABODE: Thank you Madam Speaker. My question is directed to the Deputy Minister of Health and Child Care. Hon. Minister, you recently increased the consultation fees for doctors. You know the ripple effects of this. The Medical Aid Societies are going to increase their subscription fees, which will come back to the Civil Service and we already know that Hon. Chinamasa is failing to pay PSMAS as we stand. What was your justification? Where is the money coming from? Thank you.

THE DEPUTY MINISTER OF HEALTH AND CHILD CARE (DR. CHIMEDZA): Thank you Madam Speaker. Let me thank the hon. member for asking a very pertinent and burning question at the moment. Maybe a bit of background will help the hon. Member that since the dollarisation, remember when all civil servants were getting $100, there was a thumb-suck figure that went into remuneration of private practitioners. When we started, some were paid $50, some were paid $20 and others were paid $60 but the figure that prevailed was $20, not on agreement but was forced by medical aid societies. As a Government, we felt people were struggling and we allowed that to continue.

From 2009 to date, there has not been an increase for fees in private practitioners, especially general practitioners. There has been however a consistent increase from the medical aid societies of collections. They have been raising their subscriptions along the way but it is not the duty of the Ministry to designate fees. The Ministry of Health and Child Care only comes in when there is a stalemate. We do not believe that it is the duty of the Ministry to decide how much is paid to who because each professional body has a right to decide their fees.

What has been happening is, if there is a disagreement, like there has been between medical aid societies and the private practitioners, the doctors, will say our fee is $35 and the medical aid societies say our capacity to pay is $20. The doctors will add that difference as copayment. Therefore, the Minister and myself have said we do not want any member who is on medical aid scheme to be charged co-payment. When they reached a stalemate and for the benefit of the House in November last year, we tried to put them together and they still did not agree on a fee. Some of the fees that are now $35 were $60. That was the fee that the general practitioners want, the basis being they are paid 75% of the fee of the specialist. Currently, the physicians are getting $120, so the general practitioners should be somewhere around $80 or $90 but we said the situation does not allow that.

As a Ministry, we took what medical aid societies were proposing, which was an increment by a dollar when they have raised their fees with a percentage, I do not know. The doctors have also given us a fee that they wanted. So, we rationalised these figures and came up with the figures that we have put on the table so that we do not lose our key professionals. Currently, most of the doctors that are working in Government are getting very little from the Government because we do not have the capacity to pay them adequately and their practice is what is keeping them in this country. If we kill that, we have no professionals in this country. Therefore, we have a lot to balance; it is not just raising fees. It is maintaining the professionals that we have. Thank you.

DR. LABODE: Hon. Minister, I put to you that for a civil servant, the subscription from the Ministry of Finance and Economic Development is $27 and it includes your consultation, X-ray, laboratory and drugs. The doctor has already demanded $35. What is going to happen? Co-payment will still happen because the medical aid societies do not have money to pay. It will happen whether you like it or not.

DR. CHIMEDZA: The concept of medical aid is an insurance concept. Those that are well will subsidise those that are sick. What you pay is not directly linked to what you are going to pay to the doctor. While you are being a very strong advocate for medical aid societies, they have been raising their fees for the past four years without corresponding increments to the people that actually provide this service. We have seen what has happened with the Premier Services Medical Aid Society that you have mentioned. Instead of giving the service providers that benefit the patient, they have been giving themselves $500 000. We are not going to allow the hospitals, the doctors and nurses to subsidise medical aid societies. They collect money from the patient and they should remit to where the service is being provided. That is what we are saying. I thank you.

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