SpesNews Volume 131
HPCSA DISCARDS TOP OFFICIALS
Nearly 6 months after a special ministerial task team probed allegations relating to maladministration, mismanagement and poor governance at the Health Professions Council of South Africa, the HPCSA parted ways with its CEO, COO and Head of legal services (HOLS). The HPCSA is responsible for the education, training, registration and practice of health professionals and the task team was appointed by Minister Aaron Motsoaledi last year following numerous complaints from doctors and industry associations.
Although the task team initially recommended that the CEO, COO and HOLS be suspended, Dr Motsoaledi indicated that it is up to the HPCSA to decide which recommendations they are willing to implement from this investigation. The minister purportedly received 30 anonymous complaints and there has gradually been an increase in the number of complaints against the HPCSA since 1997. One of the main complaints stems from the slow registration process foreign doctors were subjected to over the past decade.
The HPCSA wanted to set up an internal committee to investigate the complaints against it, but the Minister was adamant that “the weight of the allegations were such that an independent process would be more appropriate”.
The findings of the task team indicated that the HPCSA Registrar displayed a lack of leadership as well as possible insubordination for refusing to appear before the task team. The COO was allegedly implicated in acts of unauthorised, irregular or wasteful expenditure and the HOLS showed disregard for the gravity of the status of the HPCSA.
Task team recommendations (summary):
- Disciplinary/incapacity proceedings be instituted against the CEO and COO and HOL
- The appointment of an interim executive management team to address the dysfunctional areas of the HPCSA.
- Future councils of the HPCSA should have a structured induction process to ensure a clear understanding of their legal and governance obligations.
- A full organisational review and proposal of new governance and administrative structures going forward.
HPCSA NEW SPECIALIST REGISTRATION
In unrelated news, tension amidst a disagreement between the HPCSA and several doctors is escalating. The doctors who are currently waiting to be registered as specialists find themselves facing a brick wall as the HPCSA presumably indicated that they have to complete their MMed degree before they can be registered as specialists. The Council’s decision goes against a Durban High Court order in December, which compelled the Council to register 34 Durban doctors who had not completed their degrees as specialists. The order, which the Council agreed to, was granted with the condition that the doctors complete the degree in two years. While a significant number of doctors are affected by this stance from the Council, those affected in particular, are the doctors who registered for a specialist training programme in January 2011.
In 2010, the Council apparently resolved that doctors could only register as specialists if they completed their MMed degree, inclusive of the Research component. It further stated that the verdict of the December court order could not be seen as a substitute for the regulations of the applicable boards and that it would be improper to apply the ruling to other persons.
It further stated that the MMed requirements had been communicated to all the universities in a proper manner and had also been published on the university websites.
The Health Professions Council of South Africa (HPCSA) is a statutory body established by the Health Professions Act 56 of 1974. It works with twelve professional boards which deal with specific types of health care professionals. The HPCSA determines standards of professional education and training, and sets and maintains standards of ethical and professional practice.
All individuals who practise any of the health care professions incorporated in the scope of the HPCSA are obliged by the Act to register with the Council. Failure to do so constitutes a criminal offence.
About a ⅓ of cardiac patients who present at the Steve Biko Academic hospital are patients whose medical aid benefits are depleted or who cannot afford to be on a medical aid any longer. These patients are then dumped on the public sector. This is according to the faculty’s head of cardiology, Andrew Sarkin. In addition to this, Prof Sarkin further then extrapolated on the effects the lack of national planning had on the South African population as a whole. According to Prof Sarkin, not a day passes without a patient presenting at the department with a dead pacemaker battery. These pacemakers were inserted while the patient was still under medical scheme cover. More disconcerting however, was the fact that there are about 173 cardiologists in South Africa - 35 of these worked in the public sector. According to his calculations, in addition to the current number of cardiologists working in the state sector, a further 185-200 cardiologists are required to cater for the needs of the public sector. Currently only 6 cardiologists qualify on an annual basis. At this rate, it would take just over 30 years to get the required minimum number of cardiologists qualified.
The cost of treating a patient in the private sector is being highlighted and the current cost of procedures such as heart transplants often leave patients with massive co-payments. Prof Sarkin further questioned the private sector’s claims of efficacy drawing on the fact that there are no publicly available data available on the quality of care provided by doctors and hospitals.
SpesNet once again would like to urge specialists to ensure that comments on the NHI White paper are made and submitted to ensure that a full picture is obtained by the powers that be prior to the implementation of an NHI system.