Klaus Rötzscher (ed.)Forensic and Legal Dentistry201410.1007/978-3-319-01330-5_11
© Springer International Publishing Switzerland 2014
11. Legal Aspects Related to Healthcare Insurance, Dental Practitioners, and Forensic Odontologists in South Africa
Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
Healthcare insurance providers, dental practitioners, and forensic odontologists are highly regulated in South Africa. Healthcare providers are regulated by the Council for Medical Schemes, CMS (Council for Medical Schemes), while dental practitioners and forensic odontologists are regulated by the Health Professions Council of South Africa (HPCSA) (Health Professions Council of South Africa).
11.1 Healthcare Insurance
Healthcare insurance providers, dental practitioners, and forensic odontologists are highly regulated in South Africa. Healthcare providers are regulated by the Council for Medical Schemes, CMS (Council for Medical Schemes 2010), while dental practitioners and forensic odontologists are regulated by the Health Professions Council of South Africa (HPCSA) (Health Professions Council of South Africa 2013).
The HPCSA and CMS are statutory bodies appointed by the government and are responsible for all aspects of professional and ethical practice by its members and the protection of the public which they serve. The information in this document has been copied verbatim from the relevant chapters published by the responsible councils.
A minority of South Africans have healthcare insurance, which is expensive and restrictive in relation to treatment protocols. The vast majority use government provided services, which are either free or rendered at a minimal cost to the patient. Practitioners have the choice of charging tariffs above the so-called medical aid rates, but patients are then responsible for the accounts rendered. A new health policy known as the National Health Insurance (NHI) (National Health Insurance 2013) is being formulated, but is as yet not in place. The NHI is a financing system that will make sure that all citizens of South Africa (and legal long-term residents) are provided with essential health care, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund. Health care is regarded as a basic human right – this is a widely accepted international principle. This right should not depend on how rich we are or where we happen to live. The right to obtain health care is written into the South African Constitution (Constitution of the Republic of South Africa no 108 of 1996).
11.2 Liability Insurance
It is a statutory requirement that all dental practitioners have some form of dental liability insurance. Insurance packages, related to the level of risk, are offered by the South African Dental Association (SADA) (South African Dental Association 2013). Practitioners may use private companies if they wish.
11.3 Patient Rights and Ethical Values
The patient’s rights and core ethical values and standards required of dental practitioners and forensic odontologists include the following:
Respect for persons: “Healthcare practitioners should respect patients as persons and acknowledge their intrinsic worth, dignity, and sense of value” (Health Professions Council of South Africa 2013).
Best interests or well-being: Non-maleficence: “Healthcare practitioners should not harm or act against the best interests of patients, even when the interests of the latter conflict with their own self-interest” (Health Professions Council of South Africa 2013).