Damning findings against health council

The ministerial task team appointed to find the root cause of various allegations against the Health Professions Council of South Africa (HPCSA) want the “deeply dysfunctional” body unbundled into two entities. The task team also made four damning findings against the body in their 90-page report. Health Minister Aaron Motsoaledi made the findings public during a media briefing in Pretoria on Thursday. In recent years, the HPCSA was accused of poor communication with health professionals, excessive delays in processing applications, and introducing registration rules that discriminated against foreign-qualified practitioners from developing countries. It was also accused of failing to respond meaningfully to questions from the public. Motsoaledi declared on March 10 that he had appointed the six-member task team – headed by Professor Bongani Mayosi – to investigate allegations of administrative irregularities, mismanagement and poor governance.

The council is a statutory body established under the Health Professions Act, 1974 (Act No 56 of 1974). It serves 12 professional boards, each representing a particular profession within the broader family of health professions. And that was part of the problem. The task team revealed “deep systematic dysfunction of the organisation which was extended from the single professional board (as the South African Medical and Dental Council and Dental Council for medical and dental practitioners) to a mega organisation of 12 professional boards”. “The time has come to review the value of the HPCSA after 15 years of its establishment. This report reveals there is a lack of coherence and cohesion in this large dysfunctional multi-professional organisation,” it stated. The two entities suggested would be the Medical and Dental Council and a Health and Rehabilitation Council.

The team also found evidence of administrative irregularities, mismanagement and poor governance at the council. This is documented in the forensic investigation done by auditing firm KPMG in 2011 on the procurement followed in the acquisition of the Oracle information system. “The forensic investigation had found that a former CEO/ registrar and executive committee member of the council approved a contract which eventually cost over R30 million without following tender procedures, and thus appointed a contract company in an irregular manner.” The task team found that the chief executive/registrar and the chief operating officer were unfit to run the council and failed to perform to the required standard in most of the key functions. Practitioners and professional associations and other organisations also complained of mismanagement, maladministration and irregularities in the conduct of the council’s general manager of legal services, who was also slated for showing complete disregard for the task team by refusing to assist in the investigations.

The chief executive also refused to take part in the investigations despite being written to three times by the task team. The task team have recommended they both, as well as the legal services manager, be suspended. They also recommended the appointment of an interim management team to address the 10 dysfunctional areas identified by them. Reacting to the findings, Motsoaledi said: “The recommendations are quite impactful and extensive. I view them in a very serious light. It’s almost an overhaul of the whole system (that is recommended), and it’s a very serious job ahead of us. Now we know the disease and can prescribe a remedy.” Motsoaledi has given the council a week to respond and to provide feedback on how they plan to implement the recommendations.