Registration fee hike gets healthcare workers hot under the collar

Desperate doctors are hoping a petition will convince the Health Professions Council of South Africa (HPCSA) not to implement yet another registration fee increase, a year after a similar fee hike from a body they say is failing to fulfil its mandate.

The HPCSA has again increased registration fees, but unlike the 15% increase imposed on only the medical and dental board, the new fees for this year apply to all boards including dieticians, psychologists, emergency care practitioners, occupational therapists, and optometrists.

The registration fees which were gazetted last month range between R531 for a medical intern to up to R7,446 for a medical or dental specialist.

A psychologist would have to fork out R1,616 while a visiting psychology student has to pay a registration fee of R813.

ALSO READ: Doctors unhappy with 15% registration fee hike amid pandemic

In an online petition which has garnered more than 23,000 signatories, medical practitioners found the hike, which totalled up to nearly 30% in the past two years, unfair, especially since the HPCSA was apparently not available for health professionals when in need, the doctors said.

Unfair and unjustifiable

Doctors found this to be unjust particularly during the economic impacts of the Covid-19 pandemic which saw them at the forefront of fighting the outbreak.

“It is unjustifiable to raise the registration fees by this amount once again, as doctors across the country struggle for weeks and months to obtain documentation from the HPCSA. Calls and emails go unanswered for weeks,” said Louie Kuhn who started the petition.

“HPCSA services are becoming increasingly automated and more employees are working from home. Surely this amounts to a decrease in running costs and should amount to a drop in registration fees.”

These sentiments were shared among all frustrated medical practitioners, said Dr Erick Tankama, a registered medical officer in the public sector.

“As such, we have not really had any salary increment of note. Adding to the difficult times of Covid, it is actually extremely insensitive of the HPCSA to increase our registration fees yearly regardless of the economical circumstances the whole country is under. On top of this, their service to register practitioners is not up to standard.”

“The question is, are they charging us these exorbitant sums of money to take care of their bureaucracy only, or to render a service to us as registered practitioners?” asked Tankama.

A psychologist from Pretoria, Dr Helena Niedinger, said she was de-registered by the HPCSA for an outstanding R200 fee, which she was not made aware of.

“The HPCSA doesn’t even send us invoices anymore and I had no idea that I was de-registered. Then I was told my practice is operating unlawfully because I am no longer licensed. I got an advocate involved and after trying to institute legal action against them, the council decided I just pay my R200 to be registered again. I know people who have been de-registered for owing just R100,” she told The Citizen.

What exactly are doctors paying for?

The fees charged by the HSPCA are meant to cover administrative costs and to take on any medical litigation doctors might have to face, explained former chairperson of the South African Medical Association Dr Angelique Coetzee.

“These fees are used for day-to-day admin and workings of the HPCSA – so it’s administrative costs. But the major expenditure was the board and the professional conduct – a big chunk of the money went to medical litigation against medical professional conduct,” said Coetzee.

But it seems medical professionals have now lost trust in the HPCSA, despite having had meetings with the council in October last year to discuss the exorbitant fees.

ALSO READ: HPCSA to determine the ‘magnitude’ of claims against paediatric surgeon Dr Peter Beale

Like pharmacists and nurses, who have their own independent councils, Coetzee says the same should be applied to the medical and dentistry boards.

What doctors expect from the HPCSA is transparency and instant feedback.

“As a doctor, I expect the HPCSA to not have a backlog of medical negligence cases or cases where doctors and patients made a litigation. I want the litigation to be completed on time. I want transparency and openness on what my money is used for. I want to know that if I phone the HPCSA regarding a query about my issues, which I have paid for, then there is instant feedback,” she said.

The HPCSA said it is aware of the concerns raised by medical practitioners regarding the annual fees and is currently engaging relevant stakeholders, to ensure common understanding of the processes followed and the main contributors in determining the annual fee increase.

“We remain committed to a continued stakeholder engagements with all relevant and affected parties on this matter. Council is further committed to the Medical and Dental Professions Board and its practitioners and will continue to focus on strategies which will improve service delivery, improve efficiencies, reduce costs in the best interest of council’s continued existence and delivering on its mandate to protect the public and guide the professions,” said HPCSA president Professor Simon Nemutandani.

rorisangk@citizen.co.za