Synapse News - March 2018                                                                        View this email in your browser
Dear Colleague
This has been an exciting month for anyone interested in law. The High Court has ruled in favour of Foschini and Mr Price, against the Minister of Trade and Industry and the National Credit Regulator and set aside regulation 23A(4) which amended the National Credit Act. In short: A company offering credit no longer needs to collect any specific document proving that the person can afford the debt. Indeed, our strict credit requirements protected us from the bubble 10 years ago, but it has also had the unintended effect of preventing the informal sector, entrepreneurs and micro enterprises, who are unlikely to have financial statements, from obtaining credit.
Foschini argued that 'the requirement was unreasonable and unfairly discriminates against the section of the population that largely consists of the poorer and less privileged members of society.' Gross and discretionary income must still be considered - the judgment has not affected that - but the impractical administrative burden of proof has been set aside. Requirements for authenticating identity remain in place. Credit will be easier to get, giving consumers more responsibility to decide what they can afford rather than having it calculated for them. As we celebrate Human Rights Day, that's a step in the right direction. 
Of course, those making use of credit do risk being exploited, but any regulator must balance its responsibility to protect with our freedom to decide for ourselves. The Credit Regulator does seem to be carrying out its mandate.  Last year, for example, it referred Foschini and Mr Price to the National Consumer Tribunal for charging a membership fee on credit agreements.

Meanwhile, our inboxes are overflowing with opinions on whether our products should be regulated as medical devices or not. I, for one, wouldn't miss the buy-one-get-one-free offers that are proliferating in our professions. I have little in common with anyone professing to represent me when they call my practice a store, and my patient a consumer. 

There has been much less noise about the Competition Amendment Bill, published for public comment in December 2017 and now closed, and containing proposed amendments to the Competition Act. Some of these changes include that Competition Commission would issue excessive pricing guidelines and any body interpreting or applying the Act would be required to consider these guidelines. Section 8, which deals with market dominance, would be significantly overhauled to include a list of exclusionary acts:
  • buying goods or services on condition that the seller accepts an unreasonable condition unrelated to the object of a contract;
  • engaging in a margin squeeze; 
  • requiring a supplier to sell at an excessively low price.

The onus would shift to the dominant firm to show that pricing is reasonable. 

Pharma news

It's officially autumn (yes, really!) meaning allergies should decrease now.        If your patients like Zyrtec for their allergies, they will be pleased to hear that Zerviate (cetirizine 0.24%, the active ingredient in Zyrtec) is on its way. FDA approved last year, due for launch this year, it's a second generation antihistamine (H1 receptor antagonist) that binds competitively to histamine receptor sites to reduce swelling, itching and vasodilation. 

The same company, Nicox, also brings us Vyzulta (latanoprostene bunod 0.024%). What's new about this drug is that it breaks down into latanaprost - which we know - and butanediol mononitrate, which forms nitric oxide (NO).  NO generally controls vascular tone by relaxing endothelin-1, so opens the trabecular meshwork to increase outflow. NO also controls inflammation by controlling C-reactive protein. It's the first new class of glaucoma drug in ages. 

Nothing new, unfortunately, in Massachusetts, which remains the only US state where optometrists are not allowed to treat glaucoma. The state has had therapeutic privileges for decades, but glaucoma is excluded. According to this video, $20 million/ year could have been saved by allowing optometrists to treat glaucoma. Parts of this video may seem oddly familiar. Problems with healthcare costs are not unique to the USA.  

Synapse Academy 2017 members
Your access to the CPD portal will be discontinued at the end of March, unless you have subscribed for 2018. Please ensure that you have downloaded your CPD certificates for your records, and in case of audit. Please  contact us on should you need any assistance with certificates in future.  

Synapse Academy 2018: Registration
Registration is R700 for 30 CPD points, including at least 5 ethics points. Should you wish to join/ rejoin for this year, please email

New article: Locum Tenens
Please visit to download the current article on the legal obligations of employers and employees in the locum relationship. Accredited for 2 ethics/ patients' rights points,
 LocumBase members have free access to this article. Please contact our office to request it.
Yoda was your most liked Facebook post this month. 
We also celebrate awareness days for Human Rights and Down Syndrome, libraries and optometry... Wait, what? Yes, Friday 23 March is World Optometry Day.  
Follow us on 
Facebook for content to share to your practice pages. 
I can't believe I forgot about Sir Winston Churchill in last month's section on the eyewear of states-men! A pair of his reading glasses fetched over R120 000 on auction recently. With the film Darkest Hour's great reviews I suspect we are in for a resurgence of round dark frames. 'The farther back you can look, the farther forward you are likely to see.'
Back next month.   
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