Understanding the HPCSA’s Business Practices Policy: What Health Practitioners in South Africa Need to Know

Published: 23 April 2024 (HPCSA Corporate Affairs)
This policy responds to the evolving socio-economic environment impacting healthcare delivery in South Africa. - HPCSA Business Practices Policy -

1. Background & Applicability

The Health Professions Council of South Africa (HPCSA) introduced this policy to guide registered health practitioners toward ethical, professional conduct in their business practices, with the ultimate goal of protecting the public. It complements existing regulations and can trigger disciplinary action if breached.

2. Core Definitions

• Business Practice: The conduct of practitioners to fulfill professional objectives.

• Business Structures: Legally recognized forms such as solo practices, partnerships, associations, and personal liability companies.

• Corporate Involvement/Ownership: Defined as engagement with entities not registered under the Health Professions Act—either in services or financial interests.

3. Permitted Business Structures

Acceptable models include:

• Sole practitioners

• Partnerships or group practices

• Associations

• Personal liability companies (incorporated practices)

• Franchises, only when aligned with HPCSA ethical regulations

4. Restrictions on Corporate Involvement

• Individuals or entities not registered with the HPCSA may not share profits or income, nor hold ownership interests in professional practices.

• Agreements must be negotiated on an arm’s‑length basis, with fair market-related remuneration.

• Practitioners must maintain clinical independence, manage conflicts of interest, and uphold ethical norms.

5. Employment & Appointment Standards

• Health practitioners may employ other registered practitioners—but must ensure that any employment or appointment with unregistered entities is aligned with professional and public interests.

• Decisions should be guided by motives, service orientation, clinical independence, fair remuneration, peer review, and sound clinical governance.

6. Policy Appendices: Additional Insights

Key supplemental sections address:

• Franchises (advertising and branding constraints)

• Managed Care Models, Gatekeepers, Clinical Advisors

• Confidentiality, Accountability, Clinical Guidelines

• Contracts, Cost-Saving, Credentialing, Formularies

• Group Practices, Preferred Provider Networks, Quality of Care, Choice, Risk Sharing, Fee Sharing, Utilisation Management, Pre-authorisations, Case Management, Profiling

These reinforce that quality care, transparency, ethical incentives, and patient choice must remain paramount in all business decisions.

7. Why This Policy Matters for Health Practitioners and Healthcare Businesses

• Compliance Obligations: Understanding the policy ensures your business arrangements meet HPCSA ethical and legal requirements.

• Protecting Your Practice: Avoid agreements or corporate involvement that could lead to disciplinary action or reputational damage.

• Structuring for Success: Choose business models that maximise operational efficiency without compromising patient care or clinical independence.

• Risk Reduction: Anticipate and address potential conflicts of interest before they become regulatory issues.