A survey into the impact of HPCSA investigations on health practitioners’ mental health

The Health Professions Council of South Africa (HPCSA) performs an essential role in regulating healthcare professionals and ensuring public safety. However, HPCSA investigations into health practitioners can have a significant impact on the mental health and wellbeing of those physicians and dentists involved. Medical Protection recently surveyed its members who faced HPCSA investigations between 2018 and 2022 to gain insight into their experiences. The purpose of the survey was to assess the impact on their mental health, identify areas for improvement and provide recommendations for the HPCSA and the Department of Health to resolve these issue

Effectively addressing the health needs of South Africa’s population: The role of health professions education in the 21st century

The causes of the poor health status of the South African population are probably multifactorial, but to be socially accountable we must ensure that the education and training of health professionals continue to be aligned with the population’s health needs. The authors of a seminal report published in the Lancet in 2010 provide guidelines for the future training of health professionals. Since November 2010, this report, together with other guiding publications, informed a series of strategic initiatives undertaken by the Undergraduate Education and Training subcommittee of the Medical and Dental Professions Board of the Health Professions Council of South Africa (HPCSA). These initiatives seek to ensure alignment of the training of health professionals in South Africa (SA) with the health needs of the population and with international educational norms and standards. These initiatives are described and the role of the HPCSA in guiding the education and training of SA’s health professionals is explored

Encounters with problems and challenges and the formal complaints mechanism in public health: Accounts and perceptions of a set of junior health professionals during early employment experience

The South African health system consists of partly privatized and partly public health care. It is the latter that is responsible for the wellbeing of the majority of the South African population. It is also the latter however that faces multiple challenges. Of these are challenges relating to working hours, staff to patient ratio, and burnout, as well as the availability of resources / equipment; supervision and training and the experiences of bullying. Moreover, research shows that while the working conditions / contexts as well as the availability of supervision that junior healthcare professionals work in and have access to has been studied extensively in both Northern and Southern literature; the bullying experienced by junior doctors and other junior health professionals have been extensively studied in Western literature with very little being done to study this phenomenon. Further, very little has been done to study questions pertaining to the mechanisms of laying complaints about these challenges in the South. Against this background, the thesis was concerned to explore experiences and perceptions of laying complaints to supervisors and the largest health regulatory body in South Africa, the Health Professions Council of South Africa (HPCSA). The thesis used semi-structured interviews to interview six junior healthcare professionals who are registered and thus regulated by the HPCSA in South Africa and who are in the process of or who have recently completed their compulsory year/s of internship / community service in any public hospital in South Africa. This was done in order to explore their accounts and perceptions of challenges and complaints mechanisms pertaining to these challenges in their first postgraduate years. The public health system in South Africa is still rife with many challenges. My research found that according to their own accounts, junior healthcare workers encounter these as direct challenges in their everyday experience. They bear the brunt of these by having to deal with major burnout associated with long working hours and understaffing. It also shows that their account is that there is a lack of much needed resources and equipment and that challenges associated with this often have dire consequences for both them and their patients. Further, my research showed that they continue to feel that they are not being properly trained and supervised and that they do indeed face many challenges relating to bullying behavior by senior health professionals. Connected to this, my research showed that despite being aware of the complaints mechanisms in place, these junior healthcare workers often have had negative experiences with laying complaints and / or have negative perceptions about complaint mechanisms such as their supervisors and the HPCSA. In sum, the findings show that these challenges sustain and exacerbate each other in a vicious cycle in South Africa. While the sample used in this research was based in issues of access and availability and is not representative, these patterns and themes emerged consistently and thus warrant further investigation both in themselves and as possibly representative of what is happening in the medical profession in South Africa

Employer-generated complaints to the statutory registration authority: The regulatory framework for the supervision of employed health professionals in the South African public sector

Work as an employed health professional comes with a great number of challenges. Health professionals are often oblivious to the legal and regulatory framework that governs their employment situation. At least three legal frameworks are of relevance in each employer-employee relationship in the South African public healthcare sector, namely the Labour Relations Act, the Public Service Act and the profession-specific Acts such as the Health Professions Act, the Nursing Act or the Pharmacy Act, respectively. Starting with two cases where the professionspecific Act has been used by the employer against the employed health professional, rather than the legislation regulating the employer-employee relationship, it will be illustrated how the three Acts and their regulatory environment are structured. Based on this illustration, the impact that the creation of employer-generated complaints has on the employer-employee relationship, and on the system at large, will be discussed

A continuing professional development framework for medical laboratory technologists/technicians in South Africa

Thesis (D.Tech) - Central University of Technology, Free State, 2006Since 2002 all medical technologists and technicians have been obliged to participate in the compulsory continuing professional development (CPD) programme implemented by the Health Professions Council of South Africa (HPCSA). It was foreseen that CPD would not be equally accessible to medical technologists and technicians in urban and rural areas. The reason for this survey was to identify obstacles that might prevent medical technologists and technicians, especially those in rural areas from participating in CPD activities and to identify ways to overcome these obstacles. The survey was conducted in three phases. During the first phase quantitative information, concerning the profession of medical technology in South Africa, and CPD in general was obtained from registered medical technologists and technicians by means of a questionnaire. Information obtained from the questionnaire as well as that obtained from the literature led to the second phase in which an interview questionnaire was compiled. Structured interviews were conducted with medical technologists and technicians employed throughout South Africa, gathering mainly qualitative information regarding medical technology and CPD. Lack of time and financial constraints and to a lesser extent travelling were identified as the major obstacles to participating in CPD activities. The obstacles were an even bigger problem to those employed in rural areas. It was also confirmed that everybody involved in medical technology should be positively motivated to create and participate in CPD activities. A method suggested was to practise CPD activities during working hours which is cost effective but restricted, because of the workload. In addition medical technologists and technicians should participate in activities offered by the Society of Medical Laboratory Technologists of South Africa (SMLTSA) and attempt formal further qualifications. Being involved in research projects and identifying case studies could result in publishing in accredited journals. During the third phase of the survey a concept CPD framework was compiled. According to the framework all role players involved in the profession of medical technology must collaborate and contribute to making CPD activities accessible to all registered medical technologists and technicians and create a positive attitude to CPD. The role players include the HPCSA, employers and top management, the SMLTSA, medical companies, other health professionals, higher education institutions and the individual. It must be emphasised that the task of collecting CPD credits remains the responsibility of the medical technologist or medical technician. The framework offered suggestions for CPD activities whereby medical technologists and technicians could accumulate CPD credits. One major concern indicated in the framework, was that CPD should not only be measured by CPD credits but the outcomes of CPD should be reflected in the profession and the workplace and a system must be implemented to measure CPD outcomes. The CPD framework was evaluated by a panel of experts familiar with the profession of medical technology and the CPD programme, using the Delphi technique. This final CPD framework will be referred to the HPCSA for implementation in all South African pathology laboratories and the blood transfusion services. The aim of the framework is to assist the CPD guidelines currently under revision in establishing a usable CPD programme

Therapeutic recreation as a developing profession in South Africa

South Africa experiences socio-economic challenges with a high prevalence of poverty resulting in disability and non-communicable diseases affecting the health and welfare of communities. Health services are not always accessible or available to citizens, especially those of previously disadvantaged or rural communities. The South African National Plan for Development 2030 aims to address these inequality and health issues. One focus area of this plan is the inclusion of recreation, leisure and sport as an important service sector to improve the health and well-being of all individuals. Therapeutic recreation could play an important role in this regard. In South Africa, therapeutic recreation is in its developmental stages. This paper aims to provide the reader with an overview of therapeutic recreation in South Africa as a developing profession. An overview of the current status of the profession is discussed in terms of standard of practice and as it relates to health professions and recreation service providers, programmes with therapeutic value and training needs. The study concludes that there is still groundwork to be done, calling for interested parties to embark on an aggressive advocacy and strategic planning process to develop therapeutic recreation as a profession in South Africa.Scopu

Dental fraud in South Africa

Magister Scientiae Dentium - MSc(Dent) (Community Oral Health)Healthcare fraud wastes money that could be spent in the treatment of patients. The exact amount of healthcare fraud is very difficult to determine, especially in a two-tier healthcare system like South Africa. The amount and cost of dental fraud in South Africa has never been researched. If the amount and cost of fraud in a specific area can be determined, resources can be better used to combat healthcare fraud in the future

Environmental health practice in a South African metropolitan municipality: professional, ethical and legal responsibilities and challenges

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the requirements for the degree of Doctor of Philosophy, Johannesburg, 2017The purpose of this study on environmental health practices in South Africa was two-fold. It first attempted to articulate what the “ideal” ought to be regarding the legal, professional and ethical practice of Environmental Health Practitioners (EHPs) in South Africa. Thereafter, empirical research was undertaken comprising a case study of a group of EHPs practising in a metropolitan municipality to assess the “reality”, on the ground, in terms of the level of awareness and understanding among EHPs about their legal, professional and ethical responsibilities and related challenges. The ultimate aim was to perform a normative analysis in which the ideal was compared to the reality on the ground, in order to identify shortcomings and propose possible interventions or other actions to rectify the shortcomings. Another way to express this aim is to say that the “ideal” represents how things ought to be, and the “reality” represents how they actually are. The study had four objectives: First, to articulate the ideal in terms of the fulfilment of the professional, ethical and legal responsibilities of environmental health practitioners in South Africa. Second, to explore the awareness and understanding among environmental health practitioners regarding their professional, ethical and legal responsibilities in practice, using eThekwini Metropolitan municipality as a case study; Third, to examine challenges facing EHPs in fulfilling their professional responsibilities as found in the case study; and Fourth, to normatively compare the ideal versus the reality on the ground to identify shortcomings. A qualitative research design was employed using two methods of data collection. A normative approach was adopted involving a literature review and analysis of relevant legislation, policies and procedures to determine the current designation of legal, professional and ethical responsibilities of EHPs in South Africa. Thereafter, empirical data were collected using one-on-one interviews with a total of 35 EHPs employed in the metropolitan municipality that served as the site of the case study. This approach helped in gathering EHPs’ views on their understanding of the legal, professional and ethical aspects of environmental health practice and how they enacted these responsibilities “on the ground”. Findings from the study revealed that a combination of South African laws make provisions for the scope of the work of EHPs. However, whilst the laws promote enforcement and compliance, the qualitative data clearly show that many EHPs feel that they have not been adequately prepared and trained to handle complex situations, where legal measures fell short. EHPs interviewed in this study experienced difficulties in making decisions on non-technical issues, for example, in the investigation of environmental health complaints. They thus relied on their own discretion which often caused conflicts with their superiors. Professionalism of EHPs in South Africa is governed by the Health Professions Council of South Africa (HPCSA), through the professional Board of Environmental Health Practitioners. EHPs have been found to be aware of their professional responsibilities but are concerned about the lack of active engagement with their professional board. Moreover, the EHPs interviewed held general ideas about ethics but lacked specific environmental health guidelines at their workplaces as well as ethical support to assist them in handling ethical issues. The study noted the absence of a code of ethics for an environmental health ethics in South Africa and lack of ethics support programmes and ethics training for EHPs in the workplaces. Among the recommendations emanating from the study, was that support was needed to address challenges EHPs faced in enforcing laws and adopting strategies to sensitise them about people's rights. It is also important to help people to understand the reasons for compliance and the impact of non-compliance, coupled with advancing justice through the review of the laws. A better communication and engagement strategy between the professional board and EHPs needs to be developed. Moreover, an ethics infrastructure to promote a culture of ethics within the environmental health workplaces should be established. This programme should ideally be driven by an ethics structure with appointed lead agents.DH201

Will the patient benefit from the radiographers’ attendance of ethics presentations at continuous professional development (CPD) events? Results of an online survey

Published ArticleThe continuing professional development (CPD) guidelines of the Health Professions Council of South Africa (HPCSA) include ethics, human rights and medical law. Practitioners must obtain a specified number of ethics continuing education units (CEUs). Over the decades the Society of Radiographers of South Africa (SORSA) has offered on-going CPD activities for radiographers to obtain their mandatory ethics CEUs which include human rights and medical law. To date no studies have been undertaken in South Africa to determine whether the content of CPD activities meets the HPCSA ethics guidelines in terms of whether radiographers do apply knowledge gained in their interactions with patients and other practitioners. In view of this gap in the literature this study had two broad aims. The first was to determine whether South African radiographers are of the opinion that the content of ethics CPD activities over the past 10 years enabled them to apply the information to benefit patients. The second was that findings would highlight topics for future CPD ethics activities to address the HPCSA CPD guidelines in terms of focusing on patient care. There were eight broad objectives that related to the two aims of the study. Methodology: A questionnaire was used to conduct a quantitative, descriptive, and exploratory survey. Invitations to participate in the online survey were placed on regional branches’ SORSA Facebook pages, and the SORSA website. Members also received an automated text message (sms) to their cellphone (mobile) numbers on the current database. There were 292 respondents. There were three sections in the questionnaire: demographic information, ethics as offered at CPD activities to meet the HPCSA guidelines, and the definition of ethics. Respondents were asked to list topics for future CPD events in two open-ended questions. Results: There was a 41% response rate. The majority (86%) of respondents stated they were familiar with the HPCSA CPD guidelines. Forty-six percent (46%) stated they were familiar with the topic of ethics (moral philosophy) being concerned with human character and conduct; 46% stated they could apply the principles in their work place; and 27% were of the opinion they needed to learn more about the topic. Less than half of respondents agreed that CPD activities influence their daily practice in terms of patient care and rights, and medical law. In terms of the content of ethics presentations focussing on patient care the majority (64%) were of the opinion they did; while 22% were not sure; and 14% disagreed. Twenty-nine percent (29%) mostly agreed that the CPD events they had attended did address the principles of autonomy, beneficence, non-maleficence, justice and human dignity, and as such did focus on the responsibilities of professionals and the rights of patients. The majority (82%) agreed that more focus should be on ethics at CPD events in order to improve patient care. Topics to address this gap include informed consent, protection of patient records, and ethical dilemmas in the workplace. Conclusion: Most respondents were familiar with the ethics requirements of the HPCSA and agreed that CPD activities influenced their daily practice. However, there are gaps that should be addressed in future CPD events as evident in the proposed ethics topics. Hopefully SORSA will design CPD activities based on these topics

The perceptions of Durban physicians in the handling of impaired doctors.

Master of Laws. University of KwaZulu-Natal, Durban, 2018.No abstract provided