By KEDIBONE MOLAETSI
12 July 2025- The Portfolio Committee on Health on Friday announced that it would consult Parliament’s legal advisors to draft recommendations for legislative amendments to improve transparency and accountability in medical schemes. This decision follows a meeting with the Minister of Health, Dr Aaron Motsoaledi.
The Chairperson of the Committee, Dr Sibongiseni Dhlomo said they have received a briefing on a report detailing systematic discrimination against black healthcare providers by medical schemes in South Africa. Dhlomo said the report, which was presented by the independent Section 59 panel, has raised concerns regarding the treatment of Black practitioners in the healthcare system.
“During the briefing, committee members posed questions about the implications of the report’s findings. Some members expressed concern over the disproportionate allegations of fraud, waste and abuse directed towards Black practitioners compared to their non-black counterparts.
“Others asked what the Council of Medical Schemes is doing to address the backlog of complaints. The complaints include troubling delays in responding to systemic issues reported since 2019. Some members of the committee emphasised the need for accountability and sought further information on the punitive measures against medical schemes found guilty of discriminatory practices,” he said.
Dhlomo further said they enquired about the department’s intentions to acknowledge the harm inflicted upon Black practitioners. He added that the committee made several recommendations to address the findings of the report.
“Among them was to establish an early warning system within medical schemes to alert healthcare providers to potential issues related to Section 59 of the Medical Schemes Act. The committee believes this approach will protect honest practitioners from unwarranted scrutiny and will ensure timely corrective actions to mitigate financial losses.
“The committee also called for greater transparency about the algorithms and software used by medical schemes to monitor claims. The committee also stressed the need for these systems to be fair and unbiased. Members agreed that robust legal frameworks are essential to empower the Department of Health and the Council for Medical Schemes to take decisive action against discrimination,” said Dhlomo.
He said some members also highlighted the importance of creating a legislative environment conducive to genuine accountability and change. Dhlomo said the committee resolved to consult with legal advisors about possible legislative amendments to improve transparency and accountability.
“It also stressed the need for a comprehensive strategy to address the backlog of complaints with the Council for Medical Schemes. The committee also highlighted the value of collaboration with the Health Professions Council of South Africa (HPCSA) is crucial to fostering accountability among practitioners and enhancing the overall integrity of the healthcare profession.
“The committee also highlighted that engaging stakeholders, including medical schemes and practitioners, in constructive dialogue will be vital to address the report’s findings and implement necessary reforms,” he said.
The Guardian 