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SOCIAL SERVICES SELECT COMMITTEE
10 November 1999
PHARMACY AMENDMENT BILL: DISCUSSION
South African Pharmaceutical Students' Federation: Community Service 2001
Mr J Moolman and Mr Chetty, President and Vice President of the South African Pharmacy Students Federation (SAPSF), made a presentation to the Committee (see Appendix 1).
Questions and comments
Committee member: I subscribe to the fact that married couples should not be separated. Was this submission made regardless of whether the spouse is a housewife or a professional, taking into account that the period of community service is only for one year?
Response (Mr J Moolman): If both spouses are pharmacy students there is no question about it, they must be placed together.
A Committee member asked how was the suggested salary of R70 000 per student arrived at.
Response (Mr Chetty): The figure represents a salary of a newly qualified pharmacist in the public sector.
A member of the Eastern Cape Legislature said he would argue a pregnant student should do the community service and finish it.
Response (Mr Chetty): There is no question of cutting back community service. A woman would come back and finish the service after she has delivered.
Dr E Saloojee (ANC) asked the students to explain exactly what do they want as it has been heard they would like to be paid R60 000 and be exempted from tax. He asked them whether they want the R60 000 payment with no tax implications or the R70 000.
Response (Mr Chetty) That came from students who are not eligible for community service. What is correct is what is on the document now.
Dr E Saloojee: I also heard that since the majority of students eligible for the service come from Gauteng, you proposed that community service be done in Gauteng.
Response (Mr Chetty): That would be ridiculous. We will do community service in any province. The question was, how are we going to be deployed.
Dr P Nel (NNP) said he would like to hear from the students themselves whether when the Department visited the various institutions the students were consulted.
Response (Mr Chetty): What happened was not consultation. We were just told we would be contacted when a decision was made.
Chairperson Ms L Jacobus assured the students leaders that in future there will be consultation. She said the principle was whether they accept community service which she believed they do.
Both Mr Moolman and Mr Chetty agreed.
Committee Member: If you accept community service, why then was the comment "â€¦why give another year of your life to this countryâ€¦" made.
Response (Mr Chetty): We represent all students. Some of them have done military training so we have to address their concerns.
Comments by the Department
Dr Zokufa from the Department assured the committee that an attempt to involve the students in all the preparations is being done. He mentioned in particular the meeting to be held on 6 December 1999 which will be representative of all stakeholders.
Dr Zokufa said persons who will be performing Community Pharmaceutical Services will be employees of the Provincial Departments responsible for Health. Such Departments will therefore remunerate them for their services. All the arrangements to employ these persons in the year 2001 should be well on the way. "The accommodation may or may not be hospitableâ€¦we are not looking at five star accommodation but we are looking at hospitable accommodation", he warned.
Mr M Surty (ANC) made a comment that a distorted situation could arise should the provinces be allowed to have different priorities. He warned that students would want to go to certain provinces as against others depending on what a province offers. He suggested National Government in consultation with provinces should handle the matter.
Dr Zokufa said he appreciated the comment.
The Chairperson apologised for the absence of the Department of Home Affairs due to give a briefing to the committee on their priorities for the next five years.
The meeting was adjourned.
SOUTH AFRICAN PHARMACEUTICAL STUDENTS' FEDERATION
COMMUNITY SERVICE 2001
About three to four years ago community service for pharmacy students was mentioned for the first time. Immediately the South African Pharmacy Students Federation (SAPSF), the representative of all pharmacy students in South Africa, started to make a study of this subject. At the annual SAPSF conference in Durban 1997, the situation and the concept of community service was explained and debated, but no set dates where, when and how this would be implemented were available.
Soon after the doctors were introduced to the concept and the process of community service. The process was carefully studied by SAPSF and many concerns were raised. The next step that was to study the doctors' community service, the community services for dentists and after the dentists the pharmacists. When this subject of discussion was still in the early stages, our Past President Mr Joao Carapinha made contact with the Department of Health (DOH) as well as with the South African Pharmacy Council (SAPC) to get more details about this subject. Unfortunately no details could be given, the only promise and I quote "You will definitely be informed a long time before you have to do it and definitely not in your final year."
On March 31999 an article was placed in Beeld and Die Burger with the heading: "Tandartse an aptekers doen vir eers nie gemeenskapsdiens'. Dr Ayanda Ntsaluba placed the article. This created a wrong perception amongst the students. A month after this article was published, roomers but no official documentation were circulated that community service for pharmacy students was to commence on the 1st January 2001. Students honestly did not know what to believe, until July 1999 when the SAPSF annual conference was addressed by Pharmacy Council and DOH. Students knew for the first time when community service was scheduled for. The first written report by DOH was received last week after several attempts.
Soon after this the amendment to the Pharmacy act, 1974, insertion of section 14A in Act 53 of 1974 was announced on 13 August 1999. I Quote:
14A. 1. Notwithstanding section 14, a person registering for the first time as a pharmacist in terms of the Act after the commencement of section 14 of the Pharmacy Amendment Act, 1997, must perform remunerated pharmaceutical community service of one year in terms of the regulations contemplated in subsection (2) and shall, on the completion of such service, be entitled to practise the profession of a pharmacist.
2. The Minister may, after consultation with the council make regulations concerning the performance of the service contemplated in subsection (1), including but not limited to
(I) the place or places at which it is to be performed
(ii) the conditions of employment.
Reaction of the students:
The SAPSF follow a democratic principle of consultation. Task groups were formed at each branch of SAPSF with monthly report back on the concerns of the students. A national survey was done as well, seeing that DOH and Pharmacy council was using statistics Of 1996 to 1998, in other words people who will not be affected by the proposed community service. The SAPSF wanted to know how the people who will be directly affected by the community service felt.
The following concerns were raised:
* Can we do locum whilst doing community service?
* Can we do community service in private clinics or hospitals that serves underserviced areas?
* Will there be concessions made by banks to repay student loans?
* what happens if a lady falls pregnant and need to lake maternity leave during community service, will her community service time be extended?
* What professional support will be provided?
* Where will we be placed to do the community service?
* If the internship is done in the industry, how will community service be done?
* Will we work in public sector clinics or only public sectoral hospitals?
* Will marital status of individuals be considered favorably for placement?
* Will there be assured accommodation, DSTV and Internet access to community service pharmacists?
* How will we be paid and will we be taxed on accommodation and other privileges, leaving us with basically nothing to live with after tax.
* How will the government afford approximately 450 students each year?
* why give another year of your life to this country if you already did national service?
* Fourth year students would like to know why they are only now being informed, August 1999, during their last year of study?
* What is the registration status as pharmacists before and after community service in 2001?
* What happens to contracts already signed with the private sector that gave us financial support on condition we work for the various financial supporters on completion of our studies and training?
What happens to contracts made with public sector to work in rural hospital areas after completing their internship in an urban hospital?
* Will we be orientated after doing our internship in the private sector?
* How will students doing academic internship be affected especially if they intend to further their education to for instance a PhD?
Will we be sure of a safe environment, taken into consideration that most of us are female students?
* If we have to stay far away from where we work will our traveling expenses be covered?
* Being away from our loved ones will we get a telephone allowance to keep in contact?
* Exactly what will our working hours be?
This sounds fairly negative. When surveys were done by Pharmacy Council the question is not clearly asked whether the students are negative in principle towards community service or are they concerned about not being informed and not being taken into consideration regarding their future. A definite separation must be made between these points. An uninformed student is a dangerous student. On numerous occasions had the SAPSF made contact with Department of Health. SAPSF asked for a roadshow from DOH. This was done. All concerns were raised but no answers were given. Only empty promises were made that we will be consulted and our concerns here mentioned, addressed.
I have asked for monthly reports from DOH at the beginning of August, unfortunately this was met by no response. Four different meetings were scheduled and constantly changed. The last meeting scheduled for 15 November 1999 was in the middle of our Exams. DOH was informed about the unavailability of students for this day, when a week later SAPSF was informed that the meeting will continue regardless of the fact that the students will not be able to attend this meeting. Students were very unhappy with this and petitions were drawn up stating that students are not negative towards community service but would like to be consulted in the whole process and should they be excluded they would sharply react against this. After the report was given to DOH, an agreement was reached for a separate meeting with the students. One can only ask if we as students would have been consulted if we did not demand to be part of the process.
From there the standpoint of SAPSF. In principle we are not against community service, but we strongly believe that the consultation process should be followed through carefully and all needs and services finalized before community service can be started. We do not believe that a law should be passed through parliament before consultation has been finalized, completed and everything in place in order to do community service. If it is done the other way around, one could ask what the purpose of a meeting like today is for? Is it only a formality that has to be done? Will the government only follow their own agenda in order to get community service for students started?
If one looks at the Bill as published in the government gazette of 13 August 1999, it is stated that, I quote "The minister may, after consultation with the council, make regulations concerning the performance of the service contemplated in subsection (1), including but not limited to
(1) the place or places at which it is to be performed
(ii) the conditions of employment
The opinion of SAPSF is that from the viewpoint of a student the wording of this is very dangerous. The wording "after consultation' does not include agreement which is essential in the process of negotiation and consultation. Therefore we propose that the wording be changed to "agreement and consultation with council." What is the role of Pharmacy council, could also be questioned as representative of the public as a government body. Students strongly believe that they should also be given the chance to give definite input on the making of these regulations, as we are the ones that will be affected by it and not the public.
what do the latest statistics say?
The SAPSF strongly believe that the latest statistics shown by students whom this will definitely affect by this new law and not those who have already completed their studies, internships and the last of them registered by the end of 1999. The survey by SAPSF was done during September and October
The statistics show the following from fourth years to second year.
1. willingness to do community service:
4th 31% 3rd 47% 2nd 65% overall 47%
This shows dearly that final year students are more opposed
to the idea. This can be due to the fact that they were informed so late in their studies. Consultation will only start on 6 December 1999 which means that the final years are on the doorstep of their internship and already have completed their studies under the current law as it is, four years theory and one year practical. All of a sudden another year has been added on to this. This was not part of the agreement when they started to study Pharmacy.
The SAPSF strongly feels that a student should be consulted from their first or second year or at the latest in their third year. Most fourth year students have already arranged work for 2000 and 2001. Some are bound by contracts including bursaries and loans which can increase dramatically should community service be implemented. The SAPSF also has written proof that some loans will be increased by R 10000.00, which puts the students under tremendous pressure. R 10 000.00 is an enormous and unignorable amount of money. More details of the survey can be obtained from the SAPSF but for the purposes of today, showing the decrease in the positive attitude from the second to the fourth year students will suffice.
This dearly shows the dilemma students find themselves in should community service be forced onto us too fast.
It normally takes about two years for someone to come to terms with a mind paradigm shift to press on people and force them to get used to the idea can only cause damage to the process with a snowball effect.
2. what do students want in order to perform community service?
* Security of salaries
* Salaries according to scaling
* +- R 70000.00 with the influence of inflation taken into consideration.
* Study loans and the interest should be looked at. The proposal is that the government should take over the interest for the time the people are doing the community service year.
* Salaries should be confirmed and bound by contract
* No salary-no work!!!
* Accommodation and other privileges should be tax-free.
* What is meant by the minimum for any public sector servant?
* Students should be able to locum according to locum tariffs in their free time, which is surely our own.
* Transport expenses should be covered if long distances must be traveled.
* Students should be informed early enough meaning not later than May 2000 where they will perform community service.
* Meals and accommodation should be provided
* In rural areas access to Internet and DSTV is essential.
* what about single parents?
* Special merit should be given to married couples with a legal marital certificate, these couples should not be separated.
* If a lady should fall pregnant during her term of community service she should fall under the normal laws concerning maternity Ieave.
* Holiday and sick leave must be accounted for.
* Extra privileges like pension, medical aid, life insurance and AIDS insurance must be accounted for.
* where contracts is already signed, the government should give special merits.
The government should take responsibility where contracts are broken and students are left workless.
* After hours and special request to locum with normal locum fees must be agreed to.
* Working hours defined clearly as well as over time payment
* Students must be placed according to own preference of placement and must obtain the right of mutual transfer.
6. Work description
A detailed work description must be set up before the consultation are completed including the following aspects:
* a prototype contract between the government and the pharmacist must be set up and revised though consultation
* salaries and other privileges
* where services will be performed
* Lay out of services that must be performed by the pharmacist
For the interns of 2000 the option of a shortened community service should be taken into consideration.
* Security is an absolute requirement and guarantees must be given in writing.
*Anti-AIDS insurance is also an absolute requirement
* AZT must be available in the working environment at all times, should the possibility occur that a student becomes infected by accident through needles or direct contact with blood or other body fluids during their work.
8. Industry and academic interns
* How will it be implemented in the industry and academic environment?
* Students in the industrial sector must be accommodated to do community service in this sector of pharmacy.
* Students finishing their internships before the end of December 2000 and registered before 1 January 2001 must be excluded from community service. The law can not work backwards in time.
* Motor loans and telephonic expenses must be taken into consideration.
If a student or intern should perform the work of a pharmacist he or she should be considered a qualified pharmacist and not only as a registerable pharmacist in a training process. The process of registration is also debatable. Community service should not be seen as cheap labour to fill the posts of senior pharmacists in the public sector in order to save on the costs of these pharmacists. Community service is not part of the training process and therefore the pharmacist can not be kept from registering and being a fully registered pharmacist.
The SAPSF is of the opinion that community service can benefit pharmacy and the public, if the right steps are followed and completed before implementation.
I thank you
SAPSF President 1999/2000
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