Aaron Motsoaledi, the health minister, has denied allegations by members of the Health Professions Council of South Africa that he is trying to “hijack” the appointment of a new registrar to “serve his own agenda”.
Council members last week accused him of trying to “prescribe” what private doctors could charge for their services and of “forcing” his choice of registrar on the council.
The council regulates the country’s private and public health professions, making sure that health workers, including doctors, are properly trained, practise ethically and are legally registered. The council is also supposed to monitor the fees charged by private health workers.
Last week, after interviewing candidates for the position of registrar, the council forwarded the name of advocate Tshepo Boikanyo to Motsoaledi. Legal requirements governing the council require the minister, after consulting the council, to approve its candidate.
But Motsoaledi said it was “unacceptable” that only Boikanyo’s name was sent to him. “All other councils forward me three names, from which I can choose, but in this case I was expected to rubberstamp a name, which I wasn’t prepared to do.”
But council members said they had written to the minister in March and told him they would be handling the selection process, after which they would provide him with the name of their preferred candidate. Motsoaledi said he had not received the letter and, even if he had, “I would have let them know immediately that I found the process unacceptable”.
The minister said he was unhappy with the council’s choice of Boikanyo, who was a “legal person”. He “strongly” believed that a health professional should lead the council.
“When it comes to ethical matters, such as unregistered doctors and health professionals being found guilty of misconduct but continuing to practise [illegally], a health professional will understand the implications of that far better than someone who hasn’t practised in the field,” Motsoaledi said. He has reopened applications for the post.
Both the minister and the director general of health, Precious Matsoso, denied that it was a foregone conclusion that Dumisani Bomela, a former South African Medical Association official, would get the position.
Council members said Bomela was “Motsoaledi’s man”, who the minister wanted to “use” to prescribe the fees they would be allowed to charge for their services, and Matsoso and Bomela were “close”. But Matsoso said the claim was “outrageous”.
“I don’t know Dr Bomela and I’ve never spoken to him. I’m not even part of the [registrar] selection process — it’s a ministerial process.
“Motsoaledi confirmed that he and the HPCSA had indeed clashed on a number of occasions regarding the prices that private sector health practitioners are charging.
At present, the Council will only take action against a health professional if the person is found to have charged more than 300% of prescribed medical aid rates for a particular medical procedure.
The minister described this as “scandalous,” saying: “It needs to change How can it be ethical that nothing happens to a (HPCSA) member that overcharges a member of the public by 299%, which is already way too excessive?”
Motsoaledi said “it’s a bit rich” that Council members are now accusing him of trying to erode the HPCSA’s independence, when their past actions and decisions had resulted in exactly that. He explained: “When I became minister in 2009, I found the president of the Council to be (a then health deputy-director general) Nic Padayachee I asked them: ‘How can this happen that you choose someone from the government to head your council?'”
Motsoaledi said he had immediately set about ensuring that the HPCSA’s next, and current, president (Prof. Sam Mokgokong) was someone “truly independent” and not linked to government.
However, Council members have also accused Mokgokong of “incompetence,” by failing to suspend one of their HPCSA colleagues, Nandi Madiba. She is facing several corruption probes, including one by Hawks investigators, but continues to serve on the Council.
Reacting to the issue, Motsoaledi said: “The Health Professions Council is supposed to uphold the highest ethical standards so it’s an issue if one of its council members doesnt adhere to that. Though I’m not legally allowed to prescribe to the president what to do, I see it as my duty to follow-up with him and discuss this matter in detail.”