Dear Members/Partners,

Survey Link: CLICK HERE

On 19 October, the Compensation Fund gazetted regulations for public comment which will only allow Compensation Fund payments to be made into the accounts of medical service providers. As you all know, without the services of third party administrators or pre-funders, it often takes the Compensation Fund over 2 years to pay for IOD claims, if ever.

If the regulations are passed, payments will no longer be able to be made directly into the accounts of third party pre-funders or administrators, even though MSP invoices have been ceded to the third party pre-funders or administrators. This will generate further administrative chaos and place a substantial burden on MSPs, whose focus is best directed at treating IODs. SAMA believes the ultimate effect of these regulations will be forced into a situation where they are no longer able to treat IODs.

The regulations are deeply problematic. As you may know, this year the Department of Employment and Labour introduced the COID Amendment Bill, which embedded a catastrophic and possibly unconstitutional clause that sought, for no given reason, to prevent medical service providers from ceding their claims to third-party pre-funders and administrators for payment by the Fund.

Although the offending clause was removed by Parliament, after SAMA and other affected parties made presentations to the Committee, the very day after the legislature rose, the Compensation Fund Commissioner published regulations that effectively by-passed our democratically elected representatives. After extensive public lobbying by affected parties, including SAMA, the Commissioner withdrew the regulations, only to re-publish them on 19 October 2021 for a 60-day period of public comment.

SAMA, in collaboration with workers, employers and a range of affected parties, will be opposing these regulations. As MSPs, we have until 17 December to submit our comments. I urge every one of you to do this.

We would like you, as members and partners, to participate in three ways:
1.Please complete our short, 10-question survey:  CLICK HERE
2.Submit your comment via email to commentsAVS@labour.gov.zaby Friday 17 December 2021.
3.Please share this message, the survey, and your call for comment, with your associates, members, partners and colleagues.

Dear Colleagues

As you are aware, the J&J Sisonke 2 Booster vaccinations are currently being administered to persons who have received the J&J vaccinations as part of the Sisonke Trail. The current Booster trial will run until 15 December 2021 and forms part of preparations being done in anticipation of a possible 4th wave. What is important is that the trial only allows for the J&J Boosters currently. All indications are that the Pfizer Booster will only be available in February 2022.

The National Department of Health (NDoH) has launched the Vax Champs campaign and has invited everyone living in South Africa to become an ambassador for vaccination against COVID-19. Vooma Vaccine Champions, commonly known as Vax Champs, encourage their patients, friends, family and neighbours to vaccinate. To become a Vax Champ please CLICK HERE

As per my previous communications in regard to the dissemination of vaccination misinformation and the use and promotion of Ivermectin, I again urge our members to not get involved. The HPCSA is currently investigating practitioners in this regard, and it could lead to hefty fines and possible de-registration as is currently the case in other countries. I am also including as an attachment a report on Fluvoxamine provided by the NDoH.  Please CLICK HERE to read the report.

Every year the World Antimicrobial Awareness Week (18-24 November) aims to increase awareness of global antimicrobial resistance (AMR), and to encourage best practices among the public, healthcare workers, and policy makers to stop the further emergence and spread of drug-resistant infections. As resistance grows to a wider range of drugs, the World Health Organization (WHO) has broadened the focus of this campaign from antibiotics to include all antimicrobials. Taking into account that antibiotics were widely prescribed during the treatment of COVID-19 infections, this matter will need careful monitoring going forward.

In regard to COID: After extensive public lobbying, the Commissioner withdrew the regulations, only to re-publish them on 19 October for a 60-day period of public comment. SAMA and our partners dealing with this issue have been actively lobbying within the public domain and received very good media coverage in this regard. We have sent out a membership survey to ensure our member comments are included in this new submission. I urge you to please have a look at this as the new 60-day period for comments will end after 16 December, typically the start of our traditional holiday season. Please CLICK HERE to view.

In conclusion, the end of the year is approaching fast. For those colleagues who are planning a well-deserved break, remember to have a look at the SAMA offering with Locumbase. A special discounted rate is applicable for SAMA members, both for practices, and individual members who would like to offer their services as a locum. Also do not forget to have a look at the SAMA Insider. This is available online and remains a very good read with very interesting articles. To read, CLICK HERE.

Until next time, stay safe.

Yours in solidarity,

Dr. Angelique Coetzee
SAMA: Chairperson

The South African Law Reform Commission (SALRC) have released Discussion Paper 154 on Project 141: Medico-legal Claims for general information and public comment and we wish to invite all SAMA members to submit your comments and input by Friday, 15 January 2022.

You are welcome to forward your submissions to Ms Karlien Pienaar on karlienp@samedical.org

The SALRC Media Statement as well as the relevant Discussion Paper can be accessed in the links below.

SA Medical Association bemoans teen pregnancy statistics
Association says government must act swiftly to manage the crisis

The South African Medical Association (SAMA) says the recent statistics released by Statistics South Africa of the 33 000 teenage mothers in 2020 is shocking, discouraging and disheartening. The Association says, though, that the findings that 660 babies were birthed to mothers aged 10 years and younger is extremely worrying, and that urgent intervention is required.

“These statistics are incredibly concerning; these girls are children themselves, and everything must be done to protect them. As medical professionals we have a responsibility to ensure these young girls’ safety and I would remind medical doctors that they also have a legal obligation in this regard,” says Dr Angelique Coetzee, Chairperson of SAMA.

The law stipulates that the age of consent in South Africa is 16 years of age, and, importantly, the law states that “… no child under the age of 12 can consent to sex, and therefore, sex with a pre-teen is rape or sexual assault.”

“It is clear from this, that if there are mothers under the age of 12 a rape or sexual assault has occurred, and the medical professional dealing with a such a case has not only an ethical obligation, but also a legal duty to report it authorities. We must be clear that we act in the interests of the patient, and reporting these events is absolutely necessary,” notes Dr Coetzee.

Dr Coetzee also points out that Section 110 of the Children’s Amendment Act “… compels certain professional sectors to report any child abuse, neglect or maltreatment that is suspected on reasonable grounds to a designated child protection organisation, the provincial department of social development, or a police official.

” Section 54 f the Sexual Offences and Related Matters Act compels a person “… who knows or who has a ‘reasonable belief or suspicion’ of any form of sexual abuse against a child or mentally challenged individual to report it to a police official.”

“We must also highlight the Children’s Amendment Act which mandates “… any correctional official, dentist, homeopath, immigration official, labour inspector, legal practitioner, medical practitioner, midwife, … to report when suspect that a child has been abused ‘in a manner causing physical injury, sexually abused, or deliberately neglected,” Dr Coetzee points out.

Dr Coetzee says the government must play a larger role in dealing with this problem in South Africa.

“Our government has committed itself to dealing more effectively with gender-based violence, and violence against minors. The statistics released earlier are a combination of both of these scourges, and it’s incumbent on the government to act quickly and decisively to deal with it. As always, medical professionals and SAMA stand ready to assist in any way we can, but it’s up to the government to provide a framework for such intervention,” Dr Coetzee concludes.

Gender-Based Violence

The South African Medical Association (SAMA) says while it supports the 16 Days of Activism against Gender-Based Violence (GBV), more must be done throughout the year to combat this scourge in South Africa.

The 16 Days Campaign is an annual international campaign starting on 25 November and ending on 10 December, International Human Rights Day. The theme for 2021 in South Africa is “the Year of Charlotte Mannya Maxeke – 16 Days of Activism – moving from awareness to accountability”.

SAMA says although the campaign forms the key focus of government’s “365 Days of Activism for No Violence Against Women and Children” more intensive efforts are needed to deal adequately with the problem.

“We have a massive problem with GBV in South Africa with some reports saying up to 51% of women are victims of violence. Any efforts to deal with this must be supported and applauded but we must also be honest with ourselves and admit that what we are doing is not enough. There is a great need for more education, and for a stronger legal framework to deal with these crimes,” says Dr Angelique Coetzee, Chairperson of SAMA.

In addition, says Dr Coetzee, the reporting of GBV crimes must be made easier, and police officers must be better trained to manage these cases. She says too often women face secondary abuse by authorities who don’t take their reports seriously, or who don’t properly investigate these cases.

“We have heard time and again from women who say police officers treat them with disdain, or who don’t want to get involved in these cases. It’s not good enough, and something urgent is needed. If we, as a nation, are to turn the tide on GBV, we have to ensure everyone is treated equally when they report these crimes,” she says.

Dear Branch Chairperson,

In my previous communication I noted that we need to remain vigilant in our efforts to curb the spread of COVID-19. I also urged you, as medical professionals, to encourage your families, friends, colleagues and patients to take every measure possible to protect themselves, including getting vaccinated. As I write this, our country stands at around 20% vaccination, which is a good start but not nearly good enough.

Experiences from around the world indicate that South Africa is on the verge of entering a fourth wave. In fact, in a recent article I read, the Actuarial Society of South Africa (ASSA) has warned that the country is in a race against time with the fourth wave of infections expected to hit South Africa in December and into January. This is a concerning development and means we cannot let our guard down in our fight against coronavirus. What this means is that we must maintain the strictest of protocols, and continue to advocate for vaccinations. If we are to win this fight, we have no choice but to be ultra-cautious in our dealings with each other and with patients, and we simply must set an example for others to follow.

In other news we are continuing our engagements with the Health Professions Council of South Africa (HPCSA) regarding the unbundling of the Medical and Dental Boards (MDB). There are many reasons why SAMA is in favour of such an approach which, by the way, was also a recommendation by a Ministerial Task Team under the leadership of Prof Mayosi. Our view is that medical professions require their own independent councils and that such a move is urgently needed. Discussions around this proposal are ongoing, and I will, naturally, keep you posted as developments unfold.

One of my first goals as the new CEO is to ensure the strategy we implemented aligns with all aspects of our business. As you are all aware, our strategy rests on four pillars: growing membership, amplifying the brand, enhancing member value, and forging strategic partnerships. We have already achieved significant successes since the adoption of the strategy but it’s important that we maintain this momentum. As we move into 2022, it will be our mission to build on these successes but also, critically, to ensure the sustainability of the association. We will do this by making sure all our activities and plans are linked and aligned to our strategy and the four pillars. In this way we are able to map our future against an effective metric which can evaluate our successes. We have, we believe, an incredibly important framework to maximise our business and service our members. It’s a plan in which we have placed our trust and I, for one, am extremely excited about the future.

With the relaxation in the lockdown regulations our Member Engagement Department has commenced with hospital visits, and engagement with our members on the ground.  We hope to revive the physical CPD events at hospitals and interacting more frequently with our members in their workplace. We believe this will enable our members, who do not always have the time, to directly connect with relevant SAMA staff, and at the same time address any of their concerns. Through this direct ‘outreach’ we hope to also physically reach our members situated in more rural regions; we did this in the past, and we hope to re-establish these relationships.

SAMA’s Employee Relations Department has also been busy; they visited several hospitals in Gauteng, the North West and in the Eastern Cape interacting with members there on issues affecting them. More such visits are planned for the coming months and into 2022 (yes, can you believe we are almost there?).  The ER Department has also been involved in meetings with the National Department of Health (NDoH) on matters such as Remunerative Work Outside of Public Service (RWOPS), and safety and staffing issues. The ER Department has also spent considerable time fighting on several fronts on behalf of doctors in terms of payment of overdue salaries, unblocking of PERSAL, and in disciplinary hearings. The work of this department is extremely important, and these are the type of interventions we believe form a critical component of our servicing offer to members.

In addition, all members would have received a communication from the HPCSA regarding the online portal created for CPD certificates and other self-help options being provided.  Our members making use of the MPC platform will currently still be able to use this as the HPCSA and the MPC platforms will be interlinked to supply the added service to them.  The way forward on this will be communicated to members in due course.

Currently SAMA is increasing our focus and activities on SAMA Student Membership. Students receive free SAMA membership from their first year of study. As a forward-thinking association, we believe the future of our organisation and profession depends on developing and mentoring our future leaders to ensure and develop healthcare in South Africa.

We are nearing the end of 2021 and, like 2020, it was a challenging year. We have faced many obstacles both personally and professionally and I have no doubt that we will be faced with similar challenges in the new year. Ours is not to predict the future, but we can plan for it. In this regard SAMA’s plans are well-established, and we have created an environment which will ensure we are successful in their implementation. While I am confident about our approach and the key role SAMA continues to play in society on behalf of its members, I remain concerned about the national health picture, especially in relation to COVID-19 and our responses to it. As representatives of the country’s largest medical association, we must do all we can to ensure the health of our nation. We are leaders in society, and we must not forget it is our obligation to honour that leadership role.

Until next time, stay safe, stay positive and stay committed.

 Yours,

Dr Vusumuzi Nhlapho
MSc BA MBBCh ACBOM DOccMed
Chief Executive Officer
The South African Medical Association

South Africa needs new approaches to end GBV

South Africa and the world will commence the Sixteen Days of Activism today on 25 November – International Day of No Violence Against Women. The Women’s Voice and Leadership partnership (WVL), coordinated by Gender Links, kicked off the annual campaign on 19 November, World Entrepreneurship Day.

As daily Covid-19 cases rise sharply, the question about the fourth wave is not if, but when

South Africa’s Covid-19 cases are ticking upward ahead of an expected fourth wave. New confirmed daily infections have risen exponentially, with 1 275 new cases reported on 24 November.  Data by the National Institute for Communicable Diseases (NICD) this week showed an increase in the seven-day moving average in new Covid cases in Gauteng.

COVID-19 comeback: Health Department identifies TWO hot-spots in SA

For the first time in weeks, South Africa has recorded more than 1 000 COVID-19 cases in a 24-hour period. Starting from a low base, case numbers have noticeably increased over the past few days – and the Department of Health has been able to pinpoint the origins of this resurgence to TWO hot-spots. WHERE ARE THE NEW COVID-19 HOT-SPOTS IN SOUTH AFRICA?

SA fathers: Mental health of dads often overlooked

A report titled ‘State of South Africa’s Fathers 2021‘ (SOSAF 2021) reveals that dads in SA need more access to mental healthcare services. The findings were published as a joint project between Sonke Gender Justice, the Human Sciences Research Council and Stellenbosch University. It linked the mental health of fathers to adverse effects on maternal and child health and development.

Regulator to consider use of Pfizer booster shots in South Africa

The South African Health Products Regulatory Authority (Sahpra) says it has received an application for the Pfizer booster shot on 17 November 2021. According to the local drug watchdog, it will commence with the assessment of data for the safety and efficacy of the third dose.

Cases of new Covid variant confirmed in South Africa

At least 10 cases have been identified in three countries and has raised concern among some researchers because a number of the mutations may help the virus evade immunity. The variant was first found in Botswana, where three cases have now been sequenced. Six more have been confirmed in South Africa, and one in Hong Kong in a traveller returning from South Africa.

The South African Medical Association - Postal Address-The South African Medical Association P O Box 74789,Lynnwood Ridge Pretoria 0040, South Africa
Physical address The South African Medical Association, Block F Castle Walk Corporate Park Nossob Street Erasmuskloof Ext3 Pretoria 0181, South Africa www.samedical.org

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