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South African Dental Journal

On-line version ISSN 0375-1562
Print version ISSN 0011-8516

S. Afr. dent. j. vol.75 n.3 Johannesburg Apr. 2020




SADA slams HPCSA for outrageously high annual registration fees and asks whether the council has gone rogue



SADA Head Office



The association vows to do all in its power to prevent its members from being subjected to untenable increases.

The South African Dental Association (SADA) is outraged at the unjustifiable increases communicated by the Health Professions Council of SA (HPCSA) for the annual registration fees payable by practitioners registered under the Health Professions Act, including dentists, dental specialists and others.

SADA is of the view that the HPCSA has gone rogue, and on behalf of its members and the professional at large it urgently calls on the Council to suspend and review its annual fee increase for 2020, and to demonstrate an appreciation of the economic reality in South Africa with an increase based on the consumer price index (CPI), and then manage its budgets within those parameters.

SADA is vehemently opposed to the announced 2020 fees and if the Association does not get a reasonable accommodation of its concerns, it will do everything in its power to ensure its members are not subjected to untenable increases, which will put even more pressure on an already financially strained profession. "This is a fight we are prepared to take on" says Mr KC Makhubele, SADA CEO.

Responding to the announcement in Board Notice 11, published in the Government Gazette Number 43024 of 17 February 2020, Makhubele said: "Health practitioners have made the mistake of not vehemently challenging these increases in the past and it seems that the HPCSA is emboldened and doubled up on the increasing percentage. The HPCSA has indeed gone rogue and has to be stopped!"



He said SADA has urgently raised its serious concerns in a letter dated March 5, 2020, to the HPCSA, where it outlined its objections over the registration fee increases for 2020, which are ranging from 21.65% to 21.24% for dentists and dental specialists, respectively. These fees are payable by practitioners by April 1, 2020.

"This follows from 12.29% and 12.13% for dentists and dental specialists from 2018 to 2019," said Makhubele. "Both increases are substantially above CPI. These fees are extremely high and they do not reflect the realities on the ground.

"The nation's economy remains soft, practitioners' reimbursements are down, overhead costs are up; regulatory compliance is increasing; private practice is a tough business but so is the public sector.

Most businesses - large or small, product or service, retail or otherwise - are feeling a financial pinch, including business operated by our members. The cost of running a practice is becoming prohibitively expensive as practitioners are forced to perform more and more administrative tasks without reimbursement.

"A poor economic climate, low medical aid tariffs which are below inflation, and has been the case for many years, and other regulatory developments have increased the financial strain on health practitioners."

SADA is particularly disturbed by the fact that the HPCSA did not consult with its constituents who are registrants with the Council and directly affected by such increases. The Council has sought to unilaterally impose exorbitant increases while neglecting to inform its members, the Association of what the reasons were for the double-digit percentage increases.

SADA asks: Why have they implemented such fees? Is this to line their pockets and continue to sustain the dysfunctional HPCSA, as per the Ministerial Task Team (MTT) Report chaired by Professor Bongani M Mayosi in October 2015, which found that the HPCSA is a deeply dysfunctional mega-organisation of 12 professional boards which lacks coherence and cohesion.

Dysfunction and ineffective? "Is this what we must pay for? Did they not anticipate that this will be met with dissatisfaction? Is the HPCSA really so far removed from its constituents? SADA only became aware of the increases following the publication in the government gazette," said Makhubele, who added that the report of the MTT found the HPCSA is unable deliver effectively and efficiently on its primary objects and functions in terms of the Health Professions Act 56 of 1974.

"The status quo of the ineffectiveness of the HPCSA has not changed since 2015; these fee increases by the HPCSA are but one of the symptoms of the malaise. SADA has tried to engage the various levels of the HPCSA but they don't seem to be willing or capable of changing for the better. We are always met with arrogance, indecision, inordinate delays and half-hearted responses."

The council has failed in many respect which SADA has recorded in the various meetings and correspondence.

This further strengthens SADA's strong support of the MTT in its recommendation: "It is the view of the MTT that the best interests of the health system are not served by the current structure and organisation of the HPCSA. The MTT recommends that consideration be given to the unbundling of the HPCSA into at least two entities: the historic Medical and Dental Council (which constitutes a third of the current membership of the HPCSA) and a Health and Rehabilitation Council (for the rest of the professional membership of the HPCSA). These new Councils would join the South African Pharmacy Council, the South African Nursing Council and other autonomous councils in the Forum of Statutory Health Professions Councils."

SADA affirms that its members view the 2020 registration fees payable to the Council as unreasonable and disproportionately exorbitant in comparison to other re-gisterable categories within the HPCSA. This is a unique feature of the HPCSA, in that the majority of its finances come from the contribution of doctors and dentists through their annual subscriptions.

As such, SADA calls on all organised professions under the HPCSA to reject these increases and implore the HPCSA to urgently suspend its exorbitant and unjustifiable 2020 fee increases and institute reasonable fee increases that are in touch with reality. Failure to do so will be met with a dogged determination by SADA to prevent the HPCSA from crippling its members any further. We hope that the HPCSA will respond positively to our fair and reasonable request.

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