New PSEMAS rule chokes rural health

• Healthcare providers can only register one practice

22 July 2020 | Health



Healthcare providers with satellite practices had until yesterday to decide which one of them would be contracted to the Public Service Employee Medical Aid Scheme (PSEMAS).

The revised PSEMAS contract stipulates that only one practice per service provider may be contracted to the state medical aid, which could lead to satellite practices in especially rural areas facing closure.

The Namibia Private Practitioners Forum (NPPF), through its lawyer Eben de Klerk, has described this as a deliberate refusal of healthcare services to PSEMAS members.

According to the NPPF, several requests were made to the Office of the Prime Minister as well as PSEMAS for consultation prior to the change, but these were “ignored”.

De Klerk said permanent practices are not sustainable in most small towns in the country. The only way healthcare providers can expand their services to these towns is through satellite practices, he said.

No response

In requests sent to Elizabeth Kharuchas, the deputy director in the medical aid division of the finance ministry, the NPPF asked that the practical implications of clause 3.10 of the new contract be removed.

Kharuchas referred Namibian Sun's sister publication, Republikein, to the ministry's media liaison department, which failed to respond days later.

Queries directed to her included about the motivation for the clause and whether the amended contract, which was previously postponed for two months until 31 May for the ministry to finalise the amendment process, has reached its final form.

Small towns hardest hit

President of the Namibian Dental Association, Dr Maren Thomas, reiterated that PSEMAS members living in small towns and rural areas would be hardest hit.

“This goes against measures put in place by the Namibian Association of Medical Aid Funds (NAMAF) to curb fraudulent claims by giving each practitioner and facility a practice number. It enables authorities to follow claim processes from every practitioner and facility in the country,” Thomas said. Government will consequently force service providers to act fraudulently when reaching out to patients in smaller, rural communities and claiming for work done in other areas, he said.

Thomas added that patients in smaller towns will now also be forced to pay more for transport and accommodation to visit practitioners at their primary practice.

State hospitals lacking

Travel expenses and the lack of chronic medication at state hospitals were highlighted by a doctor who has a practice in Otjiwarongo and another in Khorixas.

According to the doctor, he opened a satellite practice in Khorixas to meet patients, who previously had to travel to Otjiwarongo for medical care, halfway.

His Khorixas practice is open every Monday and Thursday, and is also used by a registered nurse and, once a month, by a dietician.

Between 50 and 80 mostly PSEMAS patients visit the practice every day, of which half have acute and chronic conditions, and others come to pick up chronic medication.

The nearest doctor's practice and pharmacy is 135 kilometres or a N$180 taxi ride away in Outjo.

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