MEDICAL professionals and emergency medical services joined forces in the North Gauteng High Court in Pretoria yesterday to challenge the validity of the national health reference price list of last year, claiming that the list does not reflect the actual costs involved in the provision of healthcare services. The list gives benchmark tariffs that determine the average tariff for all medical procedures and services. Three applications were consolidated into a single hearing in the high court. The first application was launched by the Hospital Association of SA and the second by the South African Private Practitioners' Forum and 22 other professional bodies, including the Association of Surgeons and the South African Heart Association. The third application was lodged by emergency medical services ER24 and Netcare 911. The professionals and associations want the court to review and set aside the 2009 price list in relation to the practitioners and disciplines involved. They also want the court to declare the schedules accompanying the list unlawful and to compel the director-general of health to apply his mind to all submissions made by the professional bodies. In addition, the applicants want the court to supervise the revision of the 2009 list. The medical professionals are challenging the publication of the price list in December 2008 for 2009. They feel the 2009 list provided an across-the-board 10,7% increase for all healthcare disciplines in the private sector, with no material variations across disciplines and no change to the structure of the 2008 list. They said although the list claimed to be a non-binding guideline for the determination of levels at which medical schemes reimburse, and how healthcare providers charge, the list actually determined the levels at which medical schemes were reimbursed for services. Arguing for the South African Private Practitioners Forum and 22 other bodies, Paul Kennedy SC said the applicants brought the application not only in their own interests but also for the benefit of their members and the public. He said that the tariffs were no longer related to actual costs incurred by the practitioners. Jeremy Gauntlett SC, for the Hospital Association of SA, said the price list was regulatory and therefore had the capacity to affect rights. But Health Minister Dr Aaron Motsoaledi persisted with his argument that the price list constituted an administrative action. He said the regulations did not have direct legal consequences for the professionals and had no impact on their rights.

Ernest Mabuza: Business Day, 23 February 2010