Policy and Legislation

‘Grave dangers to proposal’ – Health Professions Amendment Bill

The Health Professions Council of South Africa [HPCSA] has always been the last to come to the rescue of the public. This is according to the South African Medical Doctors Association [SAMA].
SAMA is opposing the proposed Health Professions Amendment Bill which would give the Health minister powers to appoint members to the council and its professional boards.

THOMAS JANTJIES: I’€™ve been taking it to different lawyers but once it gets to Bisho [provincial government] ‘€“ it just always fails. [In IsiXhosa]

YOLISA: Thomas Jantjies says he has left no stone unturned while trying to alleviate his wife’€™s suffering. Jantjies’€™ wife is paralysed. According to Jantjies, his 30 year – old wife suffered as a result of a dental procedure gone wrong. He says his wife had gone to get a tooth extracted at Cecilia Makiwane Hospital in East London. But the operation went wrong and since then, she has not been able to do anything for herself. By consulting with other doctors, Jantjies says he was told the dentist had hit a nerve leading to his wife’€™s paralysis. Jantjies was advised to consult the Health Professions Council of South Africa [HPCSA] for assistance. Tow years later, he’€™s had no joy in dealing with them.

THOMAS JANTJIES: All these lawyers, more than six of them, I’€™ve had to give them R500 each time; to consult with them. [In IsiXhosa]

YOLISA: Jantjies says he’€™s had to deal with a variety of lawyers trying to get some justice. HPCSA is a statutory body mandated to protect the public and to provide guidance on educational and ethical issues to practitioners. Ever since Jantjies contacted them in 2004, he has only received letters acknowledging receipt of his correspondence and no other help. These are the kind of issues that the South African Medical Association [SAMA] fear could worsen.

DR KGOSI LETLAPE: Even before this tinkering was put on the table, the Health Professions council was always the last to come to the rescue of the public. If you look at our policy framework vis-à-vis access to treatment for HIV and AIDS, it fell short of providing antiretrovirals and one of the groups that were less outspoken about the danger to society of that type of policy was the Health Professions Council.

YOLISA: Dr Kgosi Letlape is the chairperson of SAMA. SAMA is opposing the proposed Health Professions Amendment Bill which would give the Health minister the authority to appoint members to the council and its professional boards. Currently; the Health Professions Act states that the majority of members of a professional board must be elected by members of the profession involved. Should the bill be passed, it would mean health professionals forfeit their rights to elect their own board members. Reason? The election process is costly.

DR KGOSI LETLAPE: Apartheid was an economic policy and the reason they maintained it for years was because they thought it would be costly to be fair and just to everyone.

JONATHAN BERGER: Elections always cost money. Democracy is not a cheap thing to run. It’€™s much cheaper not to have elections. It’€™s much cheaper not to have accountability mechanisms. Courts costs money. Review processes cost money. Consultation costs money. You know if you want to save money then you have a dictatorship.

YOLISA: Jonathan Berger is the AIDS Law Project’€™s [ALP] head of policy and research. The Project together with Treatment Action Campaign [TAC] made a joint submission ‘€“ alongside SAMA – to parliament opposing some aspects of the draft bill.

JONATHAN BERGER: There has to be a sense among the public and amongst the users of public health care services that people sitting on the Health Professions Council are independent of government and the profession. Their job is not to do the minister’€™s bidding but their job is to protect the public’€™s interest.

YOLISA: The draft bill also proposes that the council be shrunk from 25 members to 16. Berger says there’€™s a worrying trend to this.

JONATHAN BERGER: I’€™ve been tracking this for a while now looking at how health legislation, medicines legislation has been developing over the last few years and it’€™s a consistent theme. If you look even quite recently at the Nursing Bill ‘€“ it’€™s now the Nursing Act ‘€“ pretty similar provisions went through there. So they also got rid of elections to the Nursing Council. If one looks at the Medicines Act itself and how the independence of the Medicines Control’€™s Council has been undermined over the years through legislative amendments, it’€™s very clear.

YOLISA: The South African Medical Association fears that, should the Bill be drafted into an Act, the council’€™s independence would be completely compromised and the public will have no alternative at all. Dr Letlape’€¦

DR KGOSI LETLAPE: We’€™ll lose two things. We’€™re going to lose the independence of the Health Professions Council and secondly and more gravely, we’€™re going to lose the independence of the department, so that in case of discourse; there is a place where we can go for shelter. So people must understand that there are grave dangers for all of us in terms of what is being proposed.

YOLISA: Dr Letlape says public confidence in the council has not been strong over the years.

DR KGOSI LETLAPE: When they now become appointed; I mean; not only will they become less outspoken; they’€™ll be completely silent on these issues.

YOLISA: Aids Law Project’€™s Jonathan Berger

JONATHAN BERGER: Certainly from our side, as an organisation that’€™s spent many years engaged in many battles with the Health Professions Council, in particular trying to get them to take complaints against health professionals seriously and not to act as a, almost a guild of health professionals who kind of come to each others defence, when really their job is effectively to police the various health professionals.

YOLISA: The Health Professions Council administers training and practice of health professionals represented by 12 professional boards. According to newspaper reports, in the past year, the council received just over 1000 complaints. Out of that, only 304 were finalised. Clearly Thomas Jantjies’€™ case is not one of these.  

HPCSA declined to comment. Spokesperson Anina Steel said they are currently involved in the process of legislation formulation and would not like to ‘€œpre-empt’€ the outcome.

The bill is currently being considered in Parliament by the Portfolio Committee.

Health department spokesperson Charity Bhengu said her department would prefer to comment only after they know which aspects [from the submissions] have been considered.  

For now, everyone will have to wait and see

DR KGOSI LETLAPE: We don’€™t make rules and it might be promulgated. We’€™re glad there’€™s due process and we were given an opportunity to give input and we will await whether our input has informed the process or not and we will deal with it at the time.

YOLISA: SAMA’€™s Dr Kgosi Letlape. AIDS Law project’€™s Jonathan Berger believes it is already a done deal.

JONATHAN BERGER: I think by and large the bill will go through pretty much the way it’€™s been drafted. There’€™ll be a little bit of tweaking here and there. But by and large it will go through, the notes that I took [While attending the submission hearings] I said the elections issue is dead. That seems to be a done deal, there are not going to be any elections.


About the author

Yolisa Njamela