The Zimbabwe Dental Association (Zida) has cried foul over the continued flouting of legal provisions by local medical aid societies, who are limiting patient choices and prescribing dental service providers of their choice, effectively sidelining the rest of the registered dentists.
By Phyllis Mbanje
“Provision of proper standard care is being compromised because these societies are redirecting patients to ‘preferred’ providers and funder-owned facilities, which creates unfair competition and restricts patient choice,” Zida president Lovemore Mahachi said.
Medical aid societies are said to be carrying out the unfair practice despite Statutory Instrument 330 of 2000 making it illegal for the societies to limit the choice of patients by referring them to specific service providers they may own or have vested interests in.
Section 16 of the instrument, which deals with extent of restriction of members’ choice of health services, categorically says: “If an open medical aid society invests any of its assets in the business of or grants loans to a healthcare provider, private or State-aided hospital or specialist medical unit or facility, it shall not require or recommend that any of its members be treated there.”
Most medical aid societies provide a list of practitioners and specialists to patients, limiting their ability to see practitioners of their choice.
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“It is unlawful for them to re-direct patients to specific providers, particularly those which they own themselves at the exclusion of other providers,” Mahachi explained.
“Patients need to know that it is not permissible by the provisions of this law for the medical aid societies to choose their clients’ service providers.”
Currently medical aid societies like CIMAS demand authorisation letters from patients who would have sought dental services.
“If a patient comes through, we merely prescribe what needs to be done, but they have to go back to their society to get authorisation to then get treatment,” the Zida president said.
Zida subscribes to the International Dental Federation (IDF) regulations and guidelines which emphasise that treatment decisions are a matter between the patient and the dentist and must be maintained.
“Third party reimbursement programmes (medical aid societies) should be open to all legally qualified dentists who choose to participate,” part of the IDF regulations read.
IDF also states that patients have a right to choose a dentist of their choice.
The Health ministry, as a regulatory body, is said to have recognised the problem.