Human Resource Development in Dept of Health: briefing

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Health

17 February 2000
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Meeting report

PORTFOLIO COMMITTEE ON HEALTH

PORTFOLIO COMMITTEE ON HEALTH
18 February 2000
HUMAN RESOURCE DEVELOPMENT IN DEPARTMENT OF HEALTH

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SUMMARY
The Department of Health made a slide presentation on various topics. The following points emerged:
-They plan to establish a council for traditional healers. They did not recommend that spiritual healers form part of this council, as they are too difficult to regulate.
-The performance of community service for doctors is mandatory.
- Foreign doctors will only be employed where there are no South Africans available for the position.
- The Department is involved in campaigns to promote a caring ethos in respect of human resources.

MINUTES
Professor R Gumbi made the following presentation:
A council for traditional healers
The Department planned to establish a council for traditional healers. They had made various recommendations including the establishment of an interim council for three years and full legal recognition for the council. The Department did not recommend the inclusion of ''spiritual healers'' under the category of traditional healers.

Community Service
Community service placement depends on the service needs of the particular community. An essential characteristic of the concept is that the doctor must work in a multi-disciplinary team and not function as a solo-practitioner. The performance of community service after internship is essential, and there is no way of getting around it.

Foreign doctors
South African doctors are the Department's first priority; foreign doctors will only be employed where there are no South African's available for the position. Foreign doctors are not employed openly, but in terms of a fixed contract.

Human resource policy
The Department is focused on issues relating to multi-disciplinary health care teams. Professor Gumbi said that the Department had adopted a ''caring ethos''. This kind of training was essential as it related to the way health professionals, specifically nurses, dealt with their patients. The Department told the committee that this kind of training would show results at ''ground level'', which was where it really counted.


Discussion by the committee
1) Situation regarding traditional healers
Bishop Mokgoba (PAC) commented that the area of traditional healing is a very important one, and the fact that it was ignored in the past, was to the peril of the nation. He asked why ''spiritual healing'' was not included under the concept of ''traditional healing'' and said that if it was included, this would bring in an element of 'morality' to the proposed council. He advised that the patients of traditional healers should be subjected to rigorous testing before and after their treatment, to compare the two results, for the purpose of determining the effectiveness of that particular type of healing.

Professor Gumbi replied that they had not recommended that ''faith healers'' be included in the category of ''traditional healers''. Accordingly they would not form part of the proposed council. She said the existence of faith healers is recognised and it is accepted that they provide good counselling and are important systems of support (this is particularly true in the case of families where a member is suffering from HIV or AIDS). The problem is that this category of ''healing'' is difficult to regulate in respect of areas such as training and accreditation. It was because they are too hard to monitor that the Department had not recommended that they form part of the council.

Dr E Jassat (ANC) added that another problem with the inclusion of faith healers in the council is that it is almost impossible to establish the training of ''diviners''. Any person could simply claim that he was born with the gift, and there is no scientific way to prove or to disprove the claim. With other types of healing, the healer's training can be established.

Dr R Rabinowitz (IFP) asked what the position was regarding the inclusion of traditional healers in medical aid schemes.

Professor Gumbi replied that once the group of traditional healers becomes fully regulated, they would be recognised by medical aid schemes.

Ms M Madumise (ANC) asked whether there was any agreement regarding the consultancy fee.

Professor Gumbi said that the interim co-ordinating committee would look at other existing councils for guidelines. Also, once registered, everyone will pay an annual registration fee. Once the council is established, all the norms will be set. The Department hopes to table the relevant Bill in Parliament before the end of the year.

2) Community service and foreign doctors
Dr Rabinowitz asked what training was given to prepare students before they began their community service. She also commented that the presentation seemed to indicate that government was tough on foreign doctors and asked why the Government does not want to encourage these well-trained professionals to serve this country.

Professor Gumbi said that before doctors start their community service, they go through an orientation programme. This programme includes treatment guidelines, an essential drug list, and a multi-disciplinary support group. Where they are unable to deal with a situation, they may contact a consultant. The Department assured the committee that, after the orientation process, the doctors feel quite independent. Responding to the second question, she said that foreign doctors cannot be accommodated permanently, as local doctors are the Department's first priority.

Dr Jassat referred to a comment made during the presentation that foreigners who train here as doctors are not allowed to do community service here. In principle he agreed with this sentiment but, on the other hand, since those doctors had spent all those years studying here, they may be expected to do community service as they ''owe [this country] something''.

Ms Madumise asked whether there had been any racial problems regarding, for instance, white doctors who had been placed in predominantly black institutions or areas and vice versa.

The Department said that doctors who had completed their community service in an area where they have been exposed to a culture completely different from what they are accustomed to, have said that they found the experience enriching.

Professor Gumbi stressed that medical students who have completed their internship, cannot ''climb the career ladder'' in any way, until they have completed their community service. They will not be allowed to enter into a private practice or even to complete postgraduate studies. Even if they leave the country, upon their return, they will have to complete the requisite community service before opening up their own practice. Thus there is no escaping community service.

3) Transformation process
The Chairperson asked whether mathematics was a requirement for admission to medical school. He commented that he was concerned with the existence of impediments to students obtaining degrees. He compared the requirement of mathematics to that of Latin for a law degree, and said that these subjects were not necessary for the students to obtain that degree or to practice that profession. Latin had been dropped as a requirement for obtaining a law degree and he asked if it was part of the human resources policy to look at dropping mathematics as a requirement for obtaining a medical degree.

Professor R Gumbi said that mathematics was not required by the Health Council for admission to medical school. However, medical schools have a right to decide on their own selection criteria. This means that medical schools have a right to require or not to require mathematics for admission.

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