Pretoria - The Progressive Health Forum (PHF), a body of South African doctors, wants law enforcement agencies to probe the controversial R600 million multivitamins contract irregularly awarded by the Government Employees Medical Scheme (GEMS) through the quotation system in breach of the law.
It said the contract appeared to have been an arrangement to defraud GEMS because the scheme breached its own rules and ignored warnings from the Health Professionals Council of SA (HPCSA) and the SA Pharmacy Council.
Dr Aslam Dasoo, the forum’s convenor, said the police and the Special Investigating Unit (SIU) should look into the contract because there was no rationale for awarding it in terms of the Medical Schemes Act.
“The matter must be reported to the SAPS and, if warranted, the Special Investigating Unit (SIU) for further investigation,” Dasoo said.
He said this was because the scheme's board of trustees and management were warned that the project would result in abuse and wastage of public resources.
“In most cases storage of these products for five months in the SA environment would result in the degradation of the products.
“The warnings also included that the cost to the scheme, i.e. the members, was much higher than the price at which patients could acquire these vitamins if they were ethically prescribed and dispensed.
“The Health Professionals Council of SA, HPCSA, as well as the SA Pharmacy Council, should convene an inquiry into the obvious breach of the ethical rules of medical practice by those health professionals in GEMS and among its various service providers and take the relevant disciplinary measures against them,” Dasoo added.
The Pretoria News reported on Monday that GEMS had awarded the contract to Activo Health through the quotation system even though the Public Finance Management Act (PFMA) required state contracts above R500 000 to be advertised and subjected to competitive bidding.
The contract, signed by GEMS principal officer Dr Stan Moloabi, was awarded on Christmas Eve for the provision of multivitamins A-Z to 1 million GEMS members for five months, starting from January this year. GEMS appointed Medscheme to source the quotations and adjudicate the process.
Medscheme in turn recommended its sister company, Activo Health, for appointment.
Dasoo said it was not possible for GEMS and Activo Health to contend that they were acting contractually or under instruction, because the “Life Esidimeni disaster inquiry put paid to that defence”.
“GEMS are not authorised to prescribe medicines to their members. The distribution of these products by GEMS does not fall within the definition of relevant health services, as defined in the Medical Schemes Act.
“Medical schemes are meant to reimburse the expenses associated with diagnosis, i.e. the expense flows from the intermediation of healthcare professionals.
“It must be noted that a medical scheme may only provide benefits in accordance with the registered rules of the scheme.
“These rules may not be inconsistent with the Act. It appears that GEMS has acted in contravention of its own rules,” added Dasoo.
Frikkie de Bruin, the general secretary of the Public Service Co-Ordinating Bargaining Council (PSCBC), said they had written to GEMS demanding answers.
“As healthcare is a condition of service, we will always find it important to protect members' interest in ensuring that those conditions of service are not placed at risk.
“We requested the board to address the perceptions created, furthermore that it is their duty to protect the integrity of the scheme” said De Bruin.
Other doctors also weighed in on the matter in their Whatsapp groups. According to a message posted in one of the groups by Professor Alex van den Heever, from the Wits University School of Governance, the contract had to be probed as it involved the irregular transfer of funds from GEMS.
“As this may involve an irregular transfer of funds from the scheme, it is somewhat mystifying that an inspection was not immediately initiated. Why is the CMS so “soft touch”, Van den Heever asked. He did not respond to a request for comment yesterday.
Moloabi last night rejected claims that the multivitamin contract was a scheme to defraud GEMS.
“The rollout of the MultiVitamin Project was as a result of the GEMS members requesting the Scheme through various forums and platforms, particularly during the height of the Covid-19 to procure vitamins on their behalf.
“The requests were made amongst others at the Scheme’s AGM and through the Public Service Coordinating Bargaining Council (PSCBC) which represents a lot of GEMS members.
“GEMS is a medical scheme registered in terms of the Medical Scheme Act 131 of 1998 and is therefore not subject to the PFMA,” Moloabi said.
He also denied that GEMS had been warned by the Progressive Health Forum and others against awarding the contract.
“These allegations are unfounded. The GEMS Board has never had any interaction with the Progressive Health Forum relating to this matter.”
The chairperson of the GEMS board of trustees, Dr Millie Hlatshwayo, acknowledged our questions and promised to respond later.
The Department of Public Service and Administration, which is responsible for policy aspects of GEMS, said it had not received complaints of irregularity regarding the procurement of the multivitamins.
“GEMS is a full operating entity that is accountable to the board of trustees," said spokesperson Moses Mushi.
The Council for Medical Schemes (CMS) said yesterday it had launched a probe into the contract. The regulatory body said it had “decided to lodge a section 43 enquiry on the reported allegations against GEMS” to “get to the bottom of this”.
The CMS said it had not received any complaints or tip-offs about the contract.
“The CMS only became aware of the allegations after reading these news articles as there were no complaints or allegations laid through a tip-off about this incident.
“Now that the CMS is aware of the incident, it has decided to lodge a section 43 enquiry on the reported allegations against GEMS and, as such, cannot comment on the specifics to avoid pre-empting the outcome of the enquiry.
“The aim of the enquiry and any subsequent processes is to get to the bottom of this and ensure that all the parties that are regulated by the CMS are compliant with the Medical Schemes Act (131 of 1998),” said Mmatsie Mpshane, the CMS’s acting general manager for stakeholder relations.
Pretoria News