Smaller entrants struggle to compete in Private Healthcare Sector

On the second day of this round of hearings, the Panel heard from the Clinix Health Group, the South African Nursing Council and Office of Health Standards Compliance. Testimony from each of these groups was extensive and lengthy as a result summaries of these proceedings will be published individually.

History and Structure of Clinix

Clinix Health Group was founded in 1992 by Dr Peter Matseke and presently operates 8 hospitals with 1450 beds in Gauteng, Limpopo and North West. Dr Matseke’s undertaking to bring private healthcare to previously disadvantaged communities was regarded as a major risk within the medical industry at the time. Currently Clinix is investing aggressively in world class facilities and the employment of nurses, cleaning staff and community based caregivers from communities in which its hospitals are based. Prior to establishing Clinix, Dr Matseke ran a successful medical practise working as a medical officer in the surgical department at Chris Hani Baragwanath Hospital.

Business Model

The group provides infrastructure, clinical services and bills for services rendered. The role of the doctors is to manage clinical processes, admit patients and they bill separately for their services.  In addition, Clinix  uses specialist services such as radiologists who act on the instructions of the referring doctors. The services account includes accommodating charges, theatre billing, equipment charging and pharmaceutical items.

Clinix hospitals serve communities where most of the people are low income earners and the majority of which are not medically insured.

Regulation and Staffing

The Clinix representative who led the submission spo

-
VǭP
P restricts the use of doctors and nurses from abroad. Further, Clinix observed that there is a huge shortage of sufficiently skilled nurses and told the Panel that Clinix focuses on training and encouraging continuous learning. Clinix outlined the guidelines which it operates to ensure patients safety and quality care, making specific mention of its Physician Advisory Board (PAB). The PAB is an autonomous committee which  explicitly focuse\
ical ma
the quality of care within Clinix hospitals.

Relationship with Funders

Clinix recognised that Designated Provider Networks provides administrators the ability to channel significant volumes of patients to specific providers. It would make sense they added if these DSP’s included Clinix facilities because of the locations of Clinix hospitals, however this is not the case. They used the Discovery KeyCare plan to make the point, drawing to the Panel’s attention the fact that medical schemes do no reimburse service fees for members who do not use a network hospital or network specialist. This they said puts hospitals and specialists in the areas they serve at risk of non-payment.

Clinix lamented the imbalance in negotiating power with bigger schemes stating that this hindered its ability to compete. Clinix asserted that funders, in the endeavour of curbing escalating costs, have embark͝~Jٹx$ ^,BfMϘnNWr/ؼ
?H=4E`?Y̕R
2uAemͱBYYڍVt98`Ъm3`m]0j0y66j~{27l3OA7s=s444 =akJw)duuJIMh)$(.ҢeiXKk}I
YM@’o8$!d!!gL)g@SF-l@wOf)}5Tx6v[BS71qJX
“
Սl=הR_P0”?{=F
՘K8pbw4itKKŽ0Ӭi?RBe?
KӢk~t;qEHF#Θ
6WNpW<--xBc!whWhd!%Sy8 !O{@咨?y"b_*]ޠxa{_*TTrx$_(i _Of6