Annual Report

1. Annual Report Presentation by Adv. Boyce Mkhize Registrar and CEO to Parliamentary Portfolio Committee: Health 19 October 2004

2. Structure of Presentation • HPCSA and its Mandate • Structure and Current Leadership • Staff Structure and Equity Profile • Key Strategic Focus Areas: • Registration • Professional Conduct • Continuing Professional Development • Finances • Broader Challenges

3. Founded for Public Protection Vision Quality healthcare standards for all Mission To enhance the quality of health by developing strategic policy frameworks for effective co-ordination and guidance of the professional boards in: • Setting health care standards for training and discipline in the professions registered with Council • Ensuring on-going professional competence; and • Fostering compliance with those standards

4. Founded for Public Protection • Statutory body established in terms of the Health Professions Act (Act No.56 of 1974) • HPCSA has 12 Professional Boards operating under its auspices • The Professional Boards control the professions within their ambit under the overarching coordination and guidance of the HPCSA

5. Founded for Public Protection • To ensure quality of life for all South Africans by: • Promoting the health of South African population • Determining and upholding standards of education & training • Determining and maintaining standards of professional practice and conduct • Advising Minister of Health on matters pertaining to Act

6. Functions of Professional Boards • Operate as Standards Generating Body (SGB), developing education and training outcomes • Develop professional practice framework • Develop national strategy and action plans re. training, supervision and career path development (including Internship) • Evaluate registration applications • Exercise Education, Training and Quality Assurance (ETQA) functions on behalf of HPCSA

7. Functions of Professional Boards • Evaluate education and training courses and academic facilities • Recognise courses for registration and additional qualifications purposes • Develop policy documents and issue rulings to guide professions • Conduct prelim & professional conduct inquiries • Formulate regulations and rules of conduct and professional practice • Assess non-compliant applications for registration, including foreign applications

8. HPCSA Structure HPCSA 52 Members Executive Committee 10 Members Management Committee 4 Members Finance & Investment Committee Audit Committee Human Rights and Ethics Committee CPD Committee Health Committee Professional Conduct Review Committee Committee on Undesirable Business Practices 12 Professional Boards Occupational Therapy & Medical Orthotics /Prosthetics Dental Therapy & Oral Hygiene Environmental Health Practitioners Speech, Language & Hearing Professions Optometry & Dispensing Opticians Physiotherapy, Podiatry & Biokinetics Radiography & Clinical Technology Medical Technology Medical & Dental Psychology Dietetics Emergency Care Personnel HPCSA Administration

9. Composition of HPCSA • 25 Persons designated by Professional Boards (At least one per Professional Board, the rest proportional to the number of registered practitioners within each Professional Board) • 1 Person employed by Dept of Health, appointed by Minister • 1 Person employed by Dept of Education, appointed by Minister • 9 Registered persons appointed by Minister of Health • 1 Person employed by SA Military Health Services, appointed by Minister of Defense • 3 Persons appointed by the Committee of University Principals (SAUVCA) • 2 Persons appointed by the Committee of Technikon Principals • 9 Public representatives who are not registered with Council (one for each province), appointed by the MEC’s responsible for Health in each province • 1 Person versed in Law, appointed by Minister of Health • 52 Total

10. Transformation : HPCSA Demographic Profile • First elections according to new requirements took place end 2003 • Council now reflects 63% of individuals from historically disadvantaged communities and a much significant representation of women • Comparator previous term: 54% Black vs 46% White

11. Transformation : HPCSA Old New MDB 27%/62% 60%/40% DTB 33%/67% 60%/40% EMC 35%/65% 55%/45% Psy 43%/56% 63%/27% Optom 28%/61% 46%/63% MedTech 38%/61% 70%/30%

12. Transformation HPCSA Governance Issues • Charter for Councillors---covenanting to good professional and ethical behaviour of Councillors • Financial Policies and new procurement procedures • Audit & Risk Management Committee; Finance and Investment Committee, HR and Remuneration Committee---Governance Structures • Annual report & independent auditors

13. Current Leadership Prof. Nicky Padayachee President Prof. Letticia Moja Vice President Adv. Boyce Mkhize Registrar/CEO

14. Administration Structure Registrar/CEO Adv. Boyce Mkhize COO (Vacant) Senior Manager: Legal Services Adv. Tshepo Boikanyo Senior Manager: Professional Boards Johann Coetzer Senior Manager: CPD, Registration & Records Barbara van Stade Senior Manager: Finance Nathaniel Seleka Manager: Information Technology Walter Maphosa Manager: PR and Service Delivery Anina Steele Manger: Support Services Anton Swanepoel Manager: Human Resources Nthabiseng Mphuthi

15. Administration Equity Profile

16. Administration Equity Profile

17. Registration with HPCSA • Registration with HPCSA is a legislative requirement and precondition for the practice of any profession registrable in terms of the Act • Performance of professional acts for reward without such registration attracts criminal sanctions

18. Registration - Statistics As at 31 March 2004: 105 441 practitioners • Dental Therapy & Oral Hygiene 1311 • Dietetics 1511 • Environmental Health Practitioners 2536 • Emergency Care Practitioners 26726 • Medical & Dental 36995 • Medical Technology 5921 • Occupational Therapy & Medical Orthotics/Prosthetics 3604 • Optometry & Dispensing Opticians 2509 • Physiotherapy, Podiatry & Biokinetics 5630 • Psychology 7724 • Radiography & Clinical Technology 5974 • Speech, Language & Hearing Professions 1709

19. Registration - Challenges Erasures • More than 8000 erased due to non-payment of annual fees • Tracking of practitioners-- challenge Foreign Qualified Practitioners • Policy framework being revised to streamline and harmonize with National Health Department policy eg. No private practice registration except for RSA citizens

20. Professional Conduct - Statistics • Received 1341 complaints previous year – increase of 27 % • Unable to finalise new cases and backlog of old cases: • Increased Legal Services’ in-house capacity • Outsourced 108 old cases to external legal firms – 23 cases have been finalised in 3 months; 33 hearing dates

21. Professional Conduct - Statistics • As at 31 March 2004 finalised 203 professional conduct cases (14 per month) • Conviction rate: 86 % • 54 % of guilty verdicts in Dishonesty/Criminality category • 22 % of guilty verdicts in Practice Issues • 19 % of guilty verdicts in Treatment • 5 % of guilty verdicts in Personal Behaviour • As at 30 September 2004 finalised 132 cases (22 per month)

22. Professional Conduct - Challenges • System of Peer Review creates perception of professional and not public protection • Perceptions about light/inconsistent sentences • Professional Conduct Review Committee to Council level to monitor processes and issue guidelines • This Committee is developing guidelines to improve consistency and tightening of sentences • Creating ombudsperson to facilate processing of minor complaints & drafting charge sheets

23. Professional Conduct - Challenges • Introducing categorisation of complaints • Empowering Committees of Preliminary Inquiry to finalise “lesser” complaints • Council proposing inclusion of community representatives on Professional Conduct Committees • Initiatives can only be realised through revision of the Act

24. Continuing Professional Development • Council Committee appointed to re-configure current CPD system • Current system is time based, practitioners earn points for related (or non-related) CPD activities • Proposed system is outcome based, practitioners earn units only for related, measurable outcomes

25. Sustaining the HPCSA • Favourable Audit Opinion • Generated about R63 million Gross Revenue compared to R45million previous year • Net surplus from Operations – R402 980 • Provisions for post-retirement medical benefits, leave and legal services costs • Revised HR benefits and conditions

26. Broader Challenges • Over-exerting power of private health care establishments over practitioners • Disintegrated regulatory processes between HPCSA and other structures like Council for Medical Schemes • Interference by Medical Aid Schemes on practitioners’ autonomy/ independence

27. Broader Challenges • Barriers to quality health-care access manifested through inadequate infrastructure, equipment and capacity [ Council sometimes forced to withdraw internship status for certain internship sites] • Barriers to education and training opportunities in health-care---stringent admission criteria which are sometimes indirectly discriminatory—notion of independence of institutions needs review in this regard

28. HPCSA Contact Details • Physical Address: 553 Vermeulen Street, Arcadia, (Cnr Vermeulen & Hamilton Streets) • Postal Address: P O Box 205, Pretoria, 0001 • Telephone : (012) 338 9300/01 Fax: (012) 328 5120 • Website: www.hpcsa.co.za • E-mail: hpcsa@hpcsa.co.za

29. Thank you for your attention