The African National Congress in the Western Cape has organised a march for Friday February 6, the opening of Parliament, to celebrate 10 years of freedom. In their statement they have mentioned the South African Medical Association (Sama) march. Do you think this is an opportunity for the ANC to drown out the voices of doctors?
It might be. It might also be related to the significance of 10 years of freedom. We have members in the Western Cape who are members of the ANC and we encourage our members to join in those celebrations. We are not marching against 10 years of freedom. We are raising issues of serious concern in the health sector.
Why are you marching?
We are marching because we are concerned about the serious threat to health care in this country. It is the inability to pay doctors better — we are losing our experienced doctors. The inability to provide facilities and equipment [and the lack of] access to quality health care. Our life expectancy has dropped from the mid- to lower 70s to the 50s. Infant mortality has not come down at the rate we want it to come down.
The Health Ministry said it is ironic that you are marching when you welcomed the announcement last week of R500-million to provide incentives to attract and retain skills in the public sector.
The march is on a multitude of issues. The R500-million is not part of this march — it is a separate issue. The march is about pay progression — about young people who have four-year degrees and two years of experience [who then] move into a directorate and get paid more than a doctor who has 35 years’ experience.
Why march now?
Do you suggest a better time? The march happens now because the problems are becoming exacerbated. We had a meeting with the minister of health in August 2002 — the last time the minister ever met the medical association, despite countless attempts from us to speak to her. We now have dispensing legislation that is compromising access to care and affordability of care. We now have the certificate of need [regulating where doctors may practise], which has profound implications for the private sector in health care delivery. You can’t say the situation now is the same as two years ago — it is getting worse.
Is the certificate the key aspect of the march?
There is a multitude of factors, but that is one of the current issues going through Parliament now. The certificate of need does not outweigh any of the other issues. The public sector is meant to serve 80% of the population and the private sector 20%, but the private sector actually serves up to 60%.
The department says the certificate of need will redress serious problems in the distribution of health resources.
There are better, democratic and more effective ways of looking at the redistribution of health services. You must look into why there is a problem with redistribution of doctors. You must incentivise people to go there [to rural areas]. We are battling to retain doctors in this country. We do not want doctors to leave the country because of draconian laws. That Bill violates our Constitution. It violates our rights of where to live and work in this country.
This march is seen as illegal and a failure to report for duty will result in normal disciplinary action being taken. The department is standing by the principle of ”No work no pay”. How are your members responding?
That is intimidation of the highest order. That is misinformation. The protest march is legal and has been approved by the South African Police Service. We have never encouraged doctors to abandon their patients. We have said to doctors that the march is not about numbers but about issues. So even if there are only seven of us that have made proper provision for our patients then we will march. Patients come first.
What do you want the ministry to do?
We want the Bill to be stopped. We want the certificate of need not to apply to individuals. We want to build, with the department, a strong, efficient, affordable and reliable health care sector. We want to work together with the ministry. We want the government, at the time they are planning legislation on particular issues, to involve those industries they want to reform. We want to cooperate with the government to build a strong health care service.
Does Cosatu support the march?
Ask Cosatu.
Cosatu said on Thursday that it fully supports Sama’s right to protest action, which is guaranteed under the Constitution