HPCSA "dysfunctional" according to ministerial task team, professional bodies

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The investigation led by University of Cape Town medicine department head, Professor Bongani Mayosi revealed “evidence of administrative irregularities, mismanagement and poor governance” at the HPCSA.

The South African Society of Anaesthesiologists (SASA), the Federation of South African Surgeons (FoSAS), the South African Medical Association (SAMA), the South African Private Practitioners Forum (SAPPF), the Association of Surgeons of South Africa (ASSA) and the South African Dental Association (SADA), are dismayed and concerned that there is currently “no consistency” in policies and procedures that would serve as effective guidance for the profession; nor is the HPCSA responsive to requests for such guidance.

Findings inconsistent

There are, for example, four enquiry panels investigating complaints under the Medical and Dental Board alone and their findings are not consistent across the different panels, even in similar circumstances. This makes it difficult for professionals to get clarity on the interpretation of the HPCSA ethical rules of conduct and to ensure that they abide by these.

They say the HPCSA has a “dual responsibility” in representing the healthcare profession, to protect the public and to guide the profession.

Doctors want strong regulator

“We want to make it clear that we want a strong regulator, in the interest of our own professions. Protecting the public and guiding the profession should work together. We expect the HPCSA to be more consistent, stronger and more sensible in the decisions they make,” says SASA chief executive officer, Natalie Zimmelman.

“We want our regulator to do a better job and to be accountable to the healthcare profession in order to effectively protect the public. Currently, it does not seem able to do this and there appears to be zero focus by the medical professionals nominated to the HPCSA on providing guidance,” she adds.

The bodies are calling on the HPCSA to be more effective, says FoSAS chairman, Brendan Bebbington. “We want a consistent message that has been clearly thought through by doctors, not lawyers. Where are the doctors we have nominated to the council?”

Failure to interpret regulations

Examples of its lack of accountability include the excessively long time the council takes to prosecute complaints of unethical behaviour, the “unreasonably” long waits for health professionals – and foreign doctors, in particular – to be registered, a lack of responsiveness to requests for clarity and a dire lack of governance.

“They are our self-regulators, but they’re not putting out any consistent policy statement,” states ASSA chairman, Dr Mike Klipin. “Where is the guidance?”

The HPCSA has the necessary ethical rules, but is failing in “the interpretation” of those rules, according to SAPPF chief executive officer, Dr Chris Archer.

Professional bodies pressing for implementation

The professional bodies are jointly pressing for the recommendations contained in the ministerial task team report to be implemented in full, including the separation of the Medical and Dental Board from the rest of the council.

Zimmelman says despite requests she has not seen the full 90-page report released in November 2015 and the council has referred SASA to the office of the minister in response to her request for feedback on progress. The medical profession has faith in Professor Mayosi and agrees with his findings, judging from the report’s executive summary.

In a January statement, SAMA noted “with extreme concern the reported intransigence of the HPCSA in implementing the recommendations of the ministerial task team”.

The HPCSA was formed 16 years ago from the historical South African Medical and Dental Council to a mega-organisation consisting of 12 professional boards and a council.