Health Professions Council of SA: briefing

Meeting report

HEALTH PORTFOLIO COMMITTEE
19 October 2004
HEALTH PROFESSIONS COUNCIL OF SA: BRIEFING

Chairperson: Mr L Ngculu (ANC)

Documents handed out:
Health Professional Council of South Africa: Annual Report presentation
Health Professional Council of South Africa: Annual Report (offsite link)

SUMMARY
The Health Professions Council of South Africa (HPCSA) presented an overall synopsis of its Annual Report with emphasis on the HPCSA's structure and composition, transformation and governance. The HPCSA proposed the revision of the 1974 Act to allow Professional Conduct Committees to be constituted of community representatives as well. In ensuing discussion, the Committee asked many questions, including about the racial demographic breakdown of practitioners; for a sectoral breakdown of deregistered professionals; onprogress in addressing the backlog of complaints; about foreign doctors practising in South Africa, and about medical school curricula and admissions criteria.

MINUTES
The Health Professions Council of South Africa (HPCSA) briefed the Committee on its Annual Report. The delegation comprised of Advocate B Mkhize, Registrar and Chief Executive Officer, Professor N Padayachee, President, and Mr P Mokgoke, Communications Officer.

Adv Mkhize presented the Committee with an overall synopsis of the Annual Report and touched on the HPCSA's structure and composition, transformation and governance. He emphasised the importance of professional conduct management, given the increased numbers of complaints received about health professionals. The HPCSA wished to correct the public perception that health professionals belonged to an 'old boys club' where peer misconduct was overlooked. The HPCSA proposed the revision of the current Act to allow Professional Conduct Committees to be constituted of community representatives as well. This would allow for greater transparency in the investigation of complaints. Broader challenges included the over-exertion of private health establishment power over practitioners, and the interference of medical aid schemes on the autonomy of practitioners.

Discussion
Mr I Cachalia (ANC) asked how community representatives would be represented on such Committees. He also asked why the Department was not represented. Mr Cachalia was concerned why the Act had remained unchanged since 1974.

Adv Mkhize said that the Minister was empowered to appoint community representatives, as could the Provinces. He agreed that amending the existing Act was long overdue. One of the amendments could be the addition of the Department to boards.

Ms B Ngcobo (ANC) asked whether the HPCSA had engaged in other marketing activities, other than 'roadshows'. She asked about the specific role of community representatives.

Adv Mkhize conceded that greater efforts were needed to increase awareness of the HPCSA. Pamphlets in all official languages had been distributed. He could not elaborate on the specific role of community representatives, but said that they had equal voting powers as other board members. Professor Padayachee added that the proposed amendments to the Act could clarify the role of community representatives.

Mr Steyn (ANC) asked how the 8 000 de-registered health professionals were broken down into categories. He also asked about the total figure for the backlog of complaints. How were complaints prioritised?

Adv Mkhize said that the bulk of the 8 000 de-registered members were made up of emergency care professionals. A total 273 complaints were backlogged and 22 matters were finalised per month. Certain high profile matters had been prioritised, and a classified register was kept of this.

Ms Baaidjies (ANC) asked whether nurses and doctors would receive allowances for working in rural areas.

Adv Mkhize said that he could not comment as to whether nurses would be receiving allowances. That it was an issue to be dealt with by the Department.

Ms R Mashigo (ANC) asked whether the HPCSA was involved in granting 'Certificates of Need' to doctors. She also asked whether the HPCSA had a 'Hotline' to receive complaints, and what efforts were being made to address the shortage of health professionals. Ms Mashigo asked about the ratio for patients per medical practitioner in mainly black African residential areas.

Adv Mkhize said that Certificates of Need were an issue dealt with by the Department. The HPCSA was only involved in the designation of the dispensary course. The HPCSA had a call centre, fax and email service to receive complaints. Shortages in health personnel were a human resource issue to be dealt with by the Department. There were 37 000 doctors and dentists - a ratio could simply be obtained by dividing the population by the number of medical professionals available.

Professor Padayachee said that complaints needed to be submitted in written form. This was required from a legal point of view. The HPCSA was taking a hard stance on offences to discourage practitioners from misconduct. Some 90% of doctors and dentists were in the private sector. It was less that more doctors were needed, and more that existing doctors should be incentivised to work in rural areas.

Dr A Luthuli (ANC) was concerned about the interference of medical aid schemes on the autonomy of medical practitioners. She also asked what measures were in place to identify fake training institutions.

Adv Mkhize said that discussions were taking place with the Council for Medical Schemes in order to reach agreement on certain issues. The HPCSA had standard practices and did not accredit fake training institutions.

Mr R Coetzee asked for elaboration on Adv Mkhize's earlier suggestion that certain tertiary institutions had discriminatory admission criteria.

Professor Padayachee said that admission criteria of tertiary institutions were not discriminatory per se. The demographics in various professions needed to be examined, as there was still a tendency for certain professions to be dominated by certain races. Inequalities of the past needed to be addressed, but targets should not be set because these could unduly impact on admission criteria. However, admission criteria should not be unnecessarily exclusive.

Ms M Manana (ANC) asked for a breakdown of the numbers of registered practitioners in terms of racial demographics. Ms Manana raised concerns over the growing numbers of unregistered foreign doctors practising in South Africa.

Adv Mkhize said that he would provide the requested information to the Committee. Foreign practitioners were obliged to take a final examination in order to practise in South Africa, but there was no community posting of foreign doctors. He felt that in instances where foreign doctors were employed in the public sector, they should be posted to those areas where they were most needed.

Ms M Madumise (ANC) asked how South African doctors practising overseas were monitored by the HPCSA. She also asked from where community representatives would be recruited.

Adv Mkhize said that it was difficult to track doctors who had emigrated. Community representatives would be broadly recruited. Training of community representatives would be mandatory.

A Committee Member asked whether HIV/AIDS studies were included in medical faculty curricula. Professor Padayachee replied that it was included from first year until final year.

Dr Cachalia asked if the continuous training and development of practitioners was recognised. He also asked if the outsourcing of professional conduct statistics placed a financial strain on the HPCSA.

Adv Mkhise stated that the ongoing training of practitioners was recognised by the HPCSA. The outsourcing of professional conduct statistics was a financial strain, but that doing this in-house was not practical as the process would soon be completed. It was mainly historical backlogs that were being cleared.

The meeting was adjourned.