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Break down barriers before skills make the lucrative journey

25 February 2015 Jonathan Faurie

South Africa has always been known for its medical profession and its excellence in the field. On 3 December 1967, Professor Chris Barnard performed the world’s first human heart transplant which made the world sit up and take notice of the country as a significant role player in the world of medical science.

Since then, South Africa has made a number of other advancements in the field of medicine which has made the country the foremost African country in the world of medical science. Medical students and doctors from around the world flock to South Africa to gain practical experience in our hospitals and to learn from some of the best trauma doctors in the world.

However, The South African medical industry has been through significant change over the past few years, and a Constitutional Court’s recent ruling against sections 36 to 40 of the National Health Act may see a significant migration of valuable medical skills leaving the country.

Focusing skills

South Africa has a duty to supply high quality healthcare to the greatest potion of the population possible. This is embedded in the constitution and has been a corner stone of the African National Congress’ drive to win the 1994 elections, and to stay in power.

The provisions in the National Health Act – which was passed in 1994 - were designed to control the geographical areas in which South African healthcare professionals are allowed to work. Graham Anderson, Profmed CEO and Principal Officer says that this was a noble ideal and has worked for 20 years.

“The act was signed into law with the intention of spreading healthcare access to under-serviced rural and outlying areas; however, an unintended consequence was that it may have acted as a catalyst for the exodus of vital healthcare workers out of the country,” says Anderson.

Making the journey

South Africa is also seen as a world leader in developing a progressive democracy. Many countries look at South Africa as a shining example of inclusion and how a culturally diverse nation can be a significant role player on the world stage.

There are many laws which aid this. However, there is a real threat of over regulation and with that comes the creation of unintended consequences. Anderson points out that according to the provisions of the Health Act, in order to practice within a certain area healthcare professionals such as dentists and doctors would require specific permission from the Department of Health via a certificate of need, to prove that their operation in an area was justifiable.

“One of the key flaws in the Act was that it automatically categorised all healthcare professionals and establishments as retrospective criminal offenders, as they did not already possess the required certificate,” says Anderson. “However, the compulsory document was not even available to professionals as it hadn’t been developed, meaning they were unable to comply with the Act regardless.”

Anderson notes that the contentious law had introduced a wave of uncertainty among various healthcare professionals, many of whom were beginning to consider their options outside of South African borders.

“This spreading sentiment was deeply concerning, as these professionals’ skills are vital,” says Anderson, who adds that the Act was also proving to be a massive barrier to international healthcare professionals bringing their expertise into South Africa.  This is concerning in the sense that South Africa is in the midst of a significant skills crisis, and any opportunity to learn from international skills should be taken with open arms and encouraged as it can benefit an industry which government is trying to reshape in preparation for the National Health Insurance model which will in itself change the face of the industry.

A necessary reprieve

Anderson notes, however, that the objective of the Act is by no means off of the legislative table, and he expects in the near future that government will find alternative – albeit less harsh – sanctions, such as fines, to achieve its ideals.

“There is undoubtedly an urgent need for proper healthcare services to be provided in South Africa’s under-served areas. This is a situation that needs to be taken seriously by both the government and the industry at large,” says Anderson.

“It is all of our responsibility to work towards finding a solution such as incentivisation structures, rather than penalties, which may encourage qualified professionals to deliver crucial healthcare services in these areas while still enabling other healthcare professionals to access a reasonable income.”

Editor’s Thoughts:
Government needs to relook at this as a matter of urgency. If it wants to continue to rest on past laurels of providing quality healthcare to the masses, it simply cannot afford to create barriers as it currently doing. Please comment below, interact with us on Twitter at @fanews_online or email me your thoughts jonathan@fanews.co.za.

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