Special Hearings — Health Sector Hearings — 1997-06-17

DR RANDERA: Can I just follow up on that one.  With respect of course Dr Becker maybe you are right that you didn't have that on your register but as I understand it many of your members were based in tertiary institutions, are you saying that no discussion took place at any time until recently on this issue?

LEN BECKER: I have just consulted with Mr Prinsloo, we had no formal discussion at Council, ever, during my term when I was there until recently about this whole matter.

DR RANDERA: Dr Becker my last question is to do with something that Mr Prinsloo commented on in terms of amnesty.  I understand the position that the Interim Council has taken but many submissions have named, will have named people who have been involved in human rights violations, health professionals, what would the attitude of the SAMDC or the Interim Medical and Dental Council be now if all that information was made available to the Medical Council in terms of future action that you may take?

LEN BECKER: I think Mr Prinsloo explained earlier this afternoon what the procedure of Council would be.  In other words those complaints would be handled firstly by the Committee of Preliminary Inquiry which would then decide either on having an inquiry or not.  If an inquiry is advised, the Council is advised to hold an inquiry then a disciplinary committee which is the normal procedure for Council would be appointed, an inquiry would be held and that Committee would then decide on whether this person is guilty or not, as charged.  And then also decide on a penalty.
 Now Council has said quite unequivocally that it does not accept that a doctor can have amnesty, complete amnesty for any action between himself and his patient.  He must always remain responsible for that.  Although the mere fact that a person may have come here and have admitted to everything, and have in some words pleaded guilty to his actions, that that may be considered by the disciplinary committee as a mitigating factor in imposing a penalty.  But surely that will make no difference whether he is found guilty or not guilty. 
 So the short answer is the Council will act in its normal manner with those complaints if it's received by Council.

DR RANDERA: Thank you Chairperson, I have no further questions.

WENDY ORR: Before I ask my fellow panellists if they have questions and I am sure they do, I am going to abuse the position of the Chair by asking a question myself.  And that is that if, as according to the objects and aims of the Council, if one of your aims is to assist in the promotion of the health of the population of the Republic, and the promotion and maintenance of proper professional conduct, is it adequate that a body with these aims and objects sits and waits for complaints to come to it?
 And swaddles itself in cotton wool or an ivory tower or I don't know how best to describe it and adopt a kind-of a no news is good news policy rather than actually reaching out to that population, to that profession and ensuring that good standards are maintained?

LEN BECKER: We've been discussing this unofficially amongst Council members of late and even previously, even during my term of office this was discussed and we have not found the solution to that situation.  How do you handle this?  Do you have Council members go around to hospitals and do inspections?  Do you have Council members going to prisons and inspect and see what is happening there?  Or do you appoint inspectors of the Council to go around and look at these areas?   Of course the easy answer is that if you have the obvious ones, you read in a newspaper report or hear of things that Council may then react on those, and that I think Council can do.
 But the other means a much more sophisticated Council activity which can be done.  But one must also bear in mind that the Council is supported by the funds of the practitioners who are registered with the Council.  It doesn't use any State funds.  So there is a real danger that there will be objections from that side if this activity of Council is expanded to the extent where it involves all those inspections, etc.  But that is a possibility.

WENDY ORR: Looking towards the future and future recommendations would it not be possible for Council to interact much more dynamically with those organisations which do exist, non-governmental organisations and other bodies in order for there to be an exchange of information which Council could then use to act upon, rather than waiting for specific complaints about individuals from individuals?

LEN BECKER: I will ask Mr Prinsloo to respond to that.

NICO PRINSLOO: Professor Karachiram, the President of Council asked me before she left to indicate to the Commission that this was in fact one of the issues specifically being addressed by the Interim Council.  You will appreciate that the primary objective of the Interim Council was to advise the Minister and Parliament as to the process of transformation, and that has occupied the Council during the last 18 months.  The Council has made a recommendation and legislation is now before Parliament to decide on the future structure and functions of the Council.  And the time is perhaps now opportune for the Council to look outwards in terms of the transformation process.  And therefore one of the recommendations is that in its composition there will be at least a 20% community representation on Council, and it is hoped that that will strengthen the role of the Council in being more in touch with the communities.  But in addition to that it will be discussed as a formal item as to how these functions of Council can be improved on a more pro-active basis.

WENDY ORR: Thank you.  Are there any questions from other panellists?  Glenda, Miss Wildschut.

GLENDA WILDSCHUT: My question is related to the issue of autonomy.  In your submission and recommendations with regard to the future you suggest that future Councils should maintain autonomy and act in a way that demonstrates that autonomy.  Earlier in your submission you talked about the fact that the Council was influenced or operated within a particular milieu.  Now given those two scenarios how is it possible then that future Councils can in fact practise their autonomy despite the milieu as it were, and act autonomously and act ethically even though the environment is not conducive to practising ethically?

NICO PRINSLOO: Yes I think that is the crux of the matter and the major difference is probably the total different situation in South Africa in terms of the Constitution; in terms of the transparency required of bodies like the Council; and being held accountable.  And although it will still operate in terms of an environment created by Parliament and by the social structures, those will probably be of such a nature that whatever decisions are taken by Council that it will be held accountable for that.

LEN BECKER: If I may just come in on that.  I think we notice the - someone referred earlier to the submissiveness of the population, we notice now that whereas previously Council decisions were accepted generally and there was silence about that by members of the profession, these days is being questioned, and I think that is now the safeguard which I think you are looking for in the future.

GLENDA WILDSCHUT: Precisely.  I was looking at how we can, in a sense, fortify individual practitioners and the collective itself that it would practice independently and ethically despite any milieu.  We don't have the guarantee that in future we will have an environment which fosters or - I mean I hope that we will continue to, but there isn't that guarantee, whereas the profession can actually make steps and actually develop ways in which that guarantee can occur within the profession, and that's really what I was trying to question you about.