Pretoria - The Ministry of Health says its plans to develop a benefits registry through information requested from the Council for Medical Schemes (CMS) is not to collect personal or private information, as the Democratic Alliance (DA) claims.
The ministry on Monday said the aim is to ensure that the public sector is able to identify medical scheme members so that their scheme can be billed for services rendered in the public sector.
The ministry said it has noted with concern the statement by the DA suggesting that Health Minister Aaron Motsoaledi has made an unlawful request to the CMS for access to personal information.
The DA further claimed that the information requested is collected for research purposes.
The National Department of Health had planned to develop a benefits registry, which has been included in the annual performance plan of the department since 2014/15.
“Our annual performance plans have been approved by Parliament for the past three years. Developing the national registry has been part of the approved plans and no Member of Parliament ever raised a query,” said the ministry.
It said a number of medical schemes have contracts with the public sector for their members to access services. However, their members fail to identify themselves and/or provide accurate information regarding their scheme so that their scheme can be billed.
Consequently, the Ministry said, a number of medical scheme members are accessing services in the public sector for free, whereas they are being billed for these services in the private sector.
Separate from this, the ministry said it also seeks information regarding the profile of each medical scheme option, burden of disease of each option and distribution of scheme members.
“The objective here is to obtain summary information, not individual personal or private information. Personal medical information of individual members will not be made available.
“This information is critical for planning so that we appreciate which options members are choosing, what is the disease burden in the option, age profile and geographic distribution. It is not solely for research purposes as the DA claims.”
The ministry said the information is crucial for a regulator such as the CMS to plan and develop policy in this regard.
It said the information will assist in planning for the delivery of healthcare services under Universal Health Coverage.
“We are aware that some schemes do not want this information to be available neither to the department or the public. They have a lot to hide. They go around mobilising proxies to fight this battle for them.
“We are the last to act unethically in respect to patient confidentiality because we are the custodians of that. We do not think we are acting unconstitutionally in putting up a planning tool,” the ministry said.
According to Section 42 of the Medical Scheme Act, the Registrar may require additional particulars. Section 42 (3) states that the Registrar may require such information as to enable the council to make recommendations to the Minister on the matter referred to in section 7(c).
Section 7 (c) of the act states that the functions of the council include making recommendations to the Minister on the criteria of the measurement of quality and outcomes of the relevant health services provided for by medical schemes and other such services as the council may from time to time determine.
Section 7 (h) states that the council can perform any other functions conferred on the council by the Minister. - SAnews.gov.za
