The sudden move by the Free State Department of Health to ban public sector doctors from working in the private sector is not only in breach of current Remunerative Work Outside the Public Service (RWOPS) agreements but also a threat to patients relying on the services of these doctors.

 RWOPS is a global public sector policy applicable to all employees appointed on a permanent basis in the Public Sector (Department of Health and Social Services).

The Free State Provincial Government has given notice that it has withdrawn the approval for RWOPS during office hours with immediate effect.

The SA Medical Association (SAMA) has reported that this was done without any prior consultation with the affected staff: ‘€œDue to the previous approved and supported group practice model in the Free State, many doctors in the public sector have patients booked well in advance in the part-time private group practice in which they participate,’€ an angry Dr Dr Deon Menge, President of the Free State branch of SAMA, said in his reactuion to the banning.

 ‘€œWithdrawal of their services will compromise the health care of these patients.   RWOPS,’€ Dr Menge stressed, ‘€œadds invaluable experience and exposure to interventions not available in the public sector. This contributes not only to the motivation, but also to the retention and improvement of the skills of these colleagues.   Doctors utilizing this model have to date never fallen foul of the required provisions’€

SEHDASA (Senior Hospital Doctors Association of South Africa), a specialist interest group of SAMA of which Dr Menge is an executive committee member, has also expressed ‘€œhorror’€ at the unilateral and immediate withdrawal of RWOPS in the Free State, ‘€œnotably because the doctors are bound by contracts currently held with the health care providers’€.

‘€œRWOPS,’€ Dr Menge added, ‘€œis seen as a mechanism for bridging the divide that exists between the public and private sectors, by encouarging health care workers to work across sectors. We believe that RWOPS is not the problem, it is the management thereof that poses a challenge.  The RWOPS model in the Free State is providing a necessary service ‘€“ the unilateral withdrawal thereof places patients care at risk. Furthermore RWOPS has added to the ability to retain necessary public sector skills. Loss thereof will reverse this’€

The organisation acknowledged that the recently highlighted abuse of RWOPS by some in other provinces is recognized and is not acceptable. However,  the deep failure of managing that process is at the root of allowing that problem to develop: The Free State actions are yet another example of failed management. The unilateral behaviour of the Free State Government can never be regarded as acceptable and undoes years of relationship building between doctors and the Provincial authorities.’€

SAMA upholds the principles of honesty, integrity and patient-centeredness and does not condone any unethical practice by its members. However, blanket allegations and rash decisions taken without consultation will not improve healthcare delivery in SA. Instead, the association warned, it will drive highly qualified and desperately needed clinicians out of the public sector.