Annual Report

Presentation by

Adv. Boyce Mkhize Registrar and CEO

to

Parliamentary Portfolio Committee: Health19 October 2004

Structure of Presentation

• HPCSA and its Mandate• Structure and Current Leadership• Staff Structure and Equity Profile• Key Strategic Focus Areas:

– Registration– Professional Conduct– Continuing Professional Development– Finances

• Broader Challenges

Founded for Public Protection

VisionQuality healthcare standards for all

Mission To enhance the quality of health by developing strategic policy

frameworks for effective co-ordination and guidance of the professional boards in:

• Setting health care standards for training and discipline in the professions registered with Council

• Ensuring on-going professional competence; and

• Fostering compliance with those standards

Founded for Public Protection

• Statutory body established in terms of the Health Professions Act (Act No.56 of 1974)

• HPCSA has 12 Professional Boards operating under its auspices

• The Professional Boards control the professions within their ambit under the overarching coordination and guidance of the HPCSA

Founded for Public Protection

• To ensure quality of life for all South Africans by:

Promoting the health of South African population

Determining and upholding standards of education & training

Determining and maintaining standards of professional practice and conduct

Advising Minister of Health on matters pertaining to Act

Functions of Professional Boards

• Operate as Standards Generating Body (SGB), developing education and training outcomes

• Develop professional practice framework

• Develop national strategy and action plans re. training, supervision and career path development (including Internship)

• Evaluate registration applications

• Exercise Education, Training and Quality Assurance (ETQA) functions on behalf of HPCSA

Functions of Professional Boards

• Evaluate education and training courses and academic facilities

• Recognise courses for registration and additional qualifications purposes

• Develop policy documents and issue rulings to guide professions

• Conduct prelim & professional conduct inquiries

• Formulate regulations and rules of conduct and professional practice

• Assess non-compliant applications for registration, including foreign applications

HPCSA52 Members

Management Committee4 Members

Finance & Investment Committee

Audit Committee

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HPCSA Administration

Executive Committee10 Members

Human Rights andEthics Committee

CPDCommittee

Health Committee

12 Professional Boards

Professional ConductReview Committee

Committee on UndesirableBusiness Practices

Composition of HPCSA• 25 Persons designated by Professional Boards

(At least one per Professional Board, the rest proportional to the number of registered practitioners within each Professional Board)

• 1 Person employed by Dept of Health, appointed by Minister • 1 Person employed by Dept of Education, appointed by

Minister• 9 Registered persons appointed by Minister of Health• 1 Person employed by SA Military Health Services, appointed

byMinister of Defense

• 3 Persons appointed by the Committee of University Principals(SAUVCA)

• 2 Persons appointed by the Committee of Technikon Principals• 9 Public representatives who are not registered with Council

(one for each province), appointed by the MEC’s responsiblefor Health in each province

• 1 Person versed in Law, appointed by Minister of Health• 52 Total

Transformation : HPCSA

Demographic Profile• First elections according to new

requirements took place end 2003 • Council now reflects 63% of individuals

from historically disadvantaged communities and a much significant representation of women

• Comparator previous term: 54% Black vs 46% White

Transformation : HPCSA

Old New

MDB 27%/62% 60%/40%

DTB 33%/67% 60%/40%

EMC 35%/65% 55%/45%

Psy 43%/56% 63%/27%

Optom28%/61% 46%/63%

MedTech 38%/61% 70%/30%

Transformation HPCSA

Governance Issues• Charter for Councillors---covenanting to good

professional and ethical behaviour of Councillors• Financial Policies and new procurement

procedures• Audit & Risk Management Committee; Finance

and Investment Committee, HR and Remuneration Committee---Governance Structures

• Annual report & independent auditors

Current Leadership

Prof. Nicky Padayachee

President

Prof. Letticia Moja

Vice President

Adv. Boyce Mkhize

Registrar/CEO

Administration Structure

Registrar/CEOAdv. Boyce Mkhize

COO(Vacant)

Senior Manager: Legal Services

Adv. Tshepo Boikanyo

Senior Manager: Professional Boards

Johann Coetzer

Senior Manager: CPD, Registration & Records

Barbara van Stade

Senior Manager: Finance

Nathaniel Seleka

Manager: PR andService Delivery

Anina Steele

Manager: InformationTechnology

Walter Maphosa

Manager: Human Resources

Nthabiseng Mphuthi

Manger: Support Services

Anton Swanepoel

Administration Equity Profile

OccupationalCategory

Male Female Total

African Coloured Asian White African Coloured Asian White

Senior Officials & Managers

4 2 2 87 %

Professionals 6 2 3 2 1310 %

Technicians & Associated Professions

7 1 1 5 2 6 2218 %

Clerks 16 3 30 9 1 18 7762 %

Maintenance Workers

2 2 43 %

Total 3528 %

32 %

11 %

54 %

4032 %

119 %

11 %

2823 %

124

44 (35 %) 80 (65 %)

Administration Equity Profile

OccupationalCategory

Black White Total

African Coloured Asian

Senior Officials & Managers

4 0 0 4 8

Professionals 9 0 0 4 13

Technicians & Associated Professions

12 2 1 7 22

Clerks 46 12 1 18 77

Maintenance Workers 4 0 0 0 4

Total 57 32 2 33 124

73 % 27 %

Registration with HPCSA

• Registration with HPCSA is a legislative requirement and precondition for the practice of any profession registrable in terms of the Act

• Performance of professional acts for reward without such registration attracts criminal sanctions

Registration - StatisticsAs at 31 March 2004: 105 441 practitioners

Dental Therapy & Oral Hygiene 1311 Dietetics 1511 Environmental Health Practitioners 2536 Emergency Care Practitioners 26726 Medical & Dental 36995 Medical Technology 5921 Occupational Therapy & Medical Orthotics/Prosthetics 3604 Optometry & Dispensing Opticians 2509 Physiotherapy, Podiatry & Biokinetics 5630 Psychology 7724 Radiography & Clinical Technology 5974 Speech, Language & Hearing Professions 1709

Registration - Challenges

Erasures• More than 8000 erased due to non-payment of

annual fees• Tracking of practitioners-- challenge

Foreign Qualified Practitioners• Policy framework being revised to streamline

and harmonize with National Health Department policy eg. No private practice registration except for RSA citizens

Professional Conduct - Statistics

• Received 1341 complaints previous year – increase of 27 %

• Unable to finalise new cases and backlog of old cases:– Increased Legal Services’ in-house

capacity– Outsourced 108 old cases to external

legal firms – 23 cases have been finalised in 3 months; 33 hearing dates

Professional Conduct - Statistics

• As at 31 March 2004 finalised 203 professional conduct cases (14 per month)

• Conviction rate: 86 %• 54 % of guilty verdicts in Dishonesty/Criminality

category• 22 % of guilty verdicts in Practice Issues• 19 % of guilty verdicts in Treatment• 5 % of guilty verdicts in Personal Behaviour• As at 30 September 2004 finalised 132 cases

(22 per month)

Professional Conduct - Challenges• System of Peer Review creates perception of

professional and not public protection• Perceptions about light/inconsistent sentences • Professional Conduct Review Committee to

Council level to monitor processes and issue guidelines

• This Committee is developing guidelines to improve consistency and tightening of sentences

• Creating ombudsperson to facilate processing of minor complaints & drafting charge sheets

Professional Conduct - Challenges

• Introducing categorisation of complaints• Empowering Committees of Preliminary Inquiry

to finalise “lesser” complaints• Council proposing inclusion of community

representatives on Professional Conduct Committees

• Initiatives can only be realised through revision of the Act

Continuing Professional Development

• Council Committee appointed to re-configure current CPD system

• Current system is time based, practitioners earn points for related (or non-related) CPD activities

• Proposed system is outcome based, practitioners earn units only for related, measurable outcomes

Sustaining the HPCSA

• Favourable Audit Opinion• Generated about R63 million Gross

Revenue compared to R45million previous year

• Net surplus from Operations – R402 980• Provisions for post-retirement medical

benefits, leave and legal services costs• Revised HR benefits and conditions

Broader Challenges

• Over-exerting power of private health care establishments over practitioners

• Disintegrated regulatory processes between HPCSA and other structures like Council for Medical Schemes

• Interference by Medical Aid Schemes on practitioners’ autonomy/ independence

Broader Challenges

• Barriers to quality health-care access manifested through inadequate infrastructure, equipment and capacity [ Council sometimes forced to withdraw internship status for certain internship sites]

• Barriers to education and training opportunities in health-care---stringent admission criteria which are sometimes indirectly discriminatory—notion of independence of institutions needs review in this regard

HPCSA Contact Details

• Physical Address:553 Vermeulen Street, Arcadia, (Cnr Vermeulen & Hamilton Streets)

• Postal Address:P O Box 205, Pretoria, 0001

• Telephone : (012) 338 9300/01 Fax: (012) 328 5120

• Website: www.hpcsa.co.za

• E-mail: hpcsa@hpcsa.co.za

Thank you for your attention