Compensation Fund in shambles - DA

2015-05-18 16:52
(File: DA)

(File: DA)

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Johannesburg – The Compensation Fund is failing injured workers, failing to pay doctors and needs to be privatised, the DA said on Monday.

“The fund is in utter disarray and on the brink of administrative collapse,” said DA MP Ian Ollis.

The South African Medical Association’s (Sama) Gauteng members were currently owed R13.4m, according to figures provided by the DA. The Sama members indicated that despite the fund installing an electronic payment system in August 2014, in most cases the level of payments from the fund either stayed the same or had worsened. The fund, which falls under the department of labour, provides compensation to workers injured or disabled on duty.

The DA said it based its findings on surveys of about 1 200 people, including doctors, hospital staff and workers. They are members of organisations such as Sama, the National Employers Association of South Africa (Neasa), the Independent Practitioners Association Foundation (IPAF) and Qualicare.

“Some of these medical practitioners have been waiting for close to a decade to receive the amounts due to them,” Ollis said.

According to a Neasa survey of 646 of its members, many had been turned away by a doctor or private hospital as their case was Compensation Fund related. Cases of being turned away by a government hospital were slightly less prevalent.

For example, 36% (88) of 243 respondents surveyed in Gauteng said they had been turned away by a doctor, 33% (80) by a private hospital, and 13% (30) by a government hospital.

The figures for being turned away were worse in provinces such as Mpumalanga, Limpopo, North West, and Free State.

CPC/Qualicare, a network of GPs in the Western Cape with 600 members, said according to a survey it did in mid-2014, over 300 doctors had not received payment from the fund for a long time.

In a letter to the DA it said about 200 of its doctors would no longer treat Compensation Fund patients.

CompSol, an intermediary that handles between 40% and 60% of all medical claims against the fund, indicated that as of April 2015, unpaid debt owed to its members by the fund was R555 982 029. In March this year it was granted a court order of R16.3m for outstanding payments against the labour department and the Compensation Commissioner.   

The party said it would recommend to the labour minister that the fund’s medical aid section be privatised.

Compensation Commissioner Shadrack Mkhonto acknowledged in the fund’s 2013/14 annual report that it was facing problems. “Due to the current systems the fund has been using to process and pay claims, the fund was unable to meet the growing demands of clients,” he said in the report.

It was unable to detect and prevent fraud by both officials and service providers, he said.

Lack of internal controls

The auditor general gave the fund’s financial statements a disclaimer of opinion for reasons including poor accounting records and lack of internal controls.

“The financial statements as a whole are materially misstated due to the cumulative effect of numerous individually immaterial uncorrected misstatements in... the statement of financial position, the statement of financial performance and the notes to the financial statements,” he wrote in the report.

According to the financial statements, R2.7bn in benefits were paid in the 2013/14 financial year, and R1.9bn the previous year. The auditor general, however, cast doubt on the accuracy of these figures.

“The entity did not have adequate internal controls to maintain records of benefits paid. Therefore, I was unable to obtain sufficient appropriate audit evidence to substantiate whether management has correctly accounted for all the claims for the current and prior year,” he wrote.

Mkhonto could not immediately be reached for comment.

Read more on:    da  |  sama  |  ian ollis  |  labour

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