Dear Colleagues

The safety of our patients remains our responsibility. During the past 18 months we have seen a decrease in the six-monthly visits by patients for their treatment of chronic conditions. Understandably, keeping them away from practices or facilities to ensure they are not exposed to possible COVID-19 risks was a precaution measure we had to implement.

It is, however, now of utmost importance that we again start looking at the full spectrum of managing chronic patients with the required attention to detail, and start bringing in our patients to be fully assessed. We need to do this or may sit with a medico-legal ticking time bomb. We can’t continue renewing prescriptions without updating our patient records on a regular basis.

This past weekend saw yet another incident in the Northern Cape, where staff, including two female doctors and a patient were stabbed with a knife while performing their duties. Security at our facilities has previously been identified as problematic. Healthcare workers are soft targets for criminals due to the nature of the work and the hours they perform these duties in. SAMA will again interact with relevant institutions in this regard.

The importance of vaccine boosters for medical practitioners is currently receiving consideration, but it is important to also look at the potential need for, and optimal timing of, booster doses for vaccinated groups. The slow vaccination of our population receiving the initial dose is cause for concern. I came across an interesting article about this that you may find useful. It is available online at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02046-8/fulltext

For the past 20 years SAMA has been privileged to publish the Complete CPT for South Africa (CCSA). The American Medical Association however, decided to update the contract with SAMA to bring it in line with their latest business model. Because of this, the CPTs will not be licensed by any entity within South Africa, but only by the AAPC in the United States, who became the AMA’s only international licensing partner. AMA has agreed that the licensed format for South African use may be the SAMA CCSA file, but it will add millions to the cost of private healthcare as entities will no longer only pay for the number of internal users. Hospitals will also be required to pay an additional annual licensing fee per bed, and medical schemes an additional licensing fee per beneficiary.

As a result of this dire situation, SAMA has partnered with The Private Healthcare Information Standards Committee (PHISC) to obtain the opinions of major role-players in the industry. The collective opinion by hospital groups, as well as medical schemes is that CPT will become unaffordable for South African use when integrated into computer systems and therefore alternatives must be found.

As an interim measure, because there is no updated flat file available, the PHISC has decided to hold onto the use of the 2020 CCSA. There will therefore also not be a new CCSA book available. SAMA will keep our members informed in this regard as negotiations continue with the AMA.

There is a general perception that SAMA and BHF have withdrawn their support for Universal Health Coverage (UHC). I must, however, reiterate that we support UHC in South Africa but that certain aspects relating to the proposed NHI Bill will need to be addressed before we can fully support this in the interest of our members and to the benefit of all South Africans.

Be safe.

Yours in Solidarity

Dr Angelique Coetzee
SAMA: Chairperson

SAMA condemns lack of security at Kimberley hospital

The South African Medical Association (SAMA) says the stabbing of two doctors at the Robert Mangaliso Sobukwe Hospital in Kimberley on Friday night (17 September) is yet another example of where public hospitals in the country are failing to adequately protect staff.

According to reports a male patient at the hospital stabbed two female doctors and another patient with a knife before eventually being restrained by the hospital’s security personnel. The doctors were stabbed in their arms. It’s unknown where the other patient was stabbed. The incident occurred in the hospital’s casualty ward.

“Incidents such as these erode the confidence of doctors that they are able to perform their duties in a safe environment. For how long will provincial authorities stand by and watch innocent doctors and patients be subjected to these types of incidents? It’s unfair on them, and it’s unfair on the patients who need treatment. Something urgent is needed to address safety and security issues not only at this hospital but at all provincial facilities throughout the country,” says Dr Angelique Coetzee, Chairperson of SAMA.

Dr Coetzee says management at the hospital must explain how a patient was able to wander around the halls of the hospital unchecked with a knife, and why there weren't sufficient security personnel on duty at the casualty ward on Friday night.

“Doctors on duty in casualty wards are providing critical services to patients and they cannot be looking over their shoulders every minute, concerned that they might be the next victim. Hospital management has a duty to protect these healthcare workers, and when incidents such as this occur, they are obviously failing in that duty,” notes Dr Coetzee.

The man arrested in connection with the stabbing is scheduled to appear in the Kimberley Magistrate’s Court this week.

SAMA condemns the attack on a Soweto doctor

The South African Medical Association (SAMA) says the most recent attack on a doctor in a clinic in Soweto is yet another example of where the safety of medical professionals is being compromised. According to reports, Dr Mandisa Kubeka was assaulted by a patient at the Lillian Ngoyi Community Clinic in Soweto on Wednesday.

“This assault comes after two female doctors were assaulted, also by a patient, at the Robert Mangaliso Sobukwe Hospital in Kimberley on Friday night (17 September). We re-iterate that doctors in public health facilities are sitting ducks, and something urgent is needed to ensure their safety,” says Dr Angelique Coetzee, Chairperson of SAMA.

Dr Coetzee says in addition to raising the issues of safety and security with provincial Departments of Health, SAMA will also engage with the national Department of Health around this issue. “We have consulted and raised the issue of the safety of healthcare workers for many years. In some cases the situation has improved but there are still ongoing attacks in many places. The issue of safety and security, specifically in public institutions, requires urgent intervention which is implemented nationwide, and which lasts,” concludes Dr Coetzee.

South Africa’s Covid-19 daily vaccination rate plunges

South Africa’s daily Covid-19 vaccination rate plunged this week, indicating that the inoculation drive may be losing steam amid criticism of a lack of information about the shots among more remote and impoverished communities.

A call to move South Africa to a level 1 lockdown

Western Cape premier Alan Winde says the province must be moved to alert level 1 as soon as possible, as it becomes clear that it is exiting its third wave of Covid-19 infections.

The move would provide much-needed support to the economy and enable it to get the balance right in saving both lives and jobs in the province, he said in a statement on Wednesday (22 September).

COVID-19 data capturing is a challenge, says health dept

The national Department of Health is investigating the accuracy of its COVID-19 data capturing system, following numerous complaints from people who did not receive confirmation of vaccination via SMS after getting the jab.

Don’t overlook how much health care will cost you in retirement

MEDICAL costs during retirement can be high, because the older you get, the more medical attention you need. But this is often overlooked, making it very difficult for many South Africans to afford quality health care in their retirement years.

In 2019, Statistics South Africa (Stats SA) noted that 47 million South Africans were without medical cover.

SA's Covid infections seeing a sustained downward trend, says NICD: 2 197 new cases reported on Tuesday

ANOTHER 160 people have died as a result of Covid-19, while over 2197 more people have tested positive for the coronavirus in South Africa on Tuesday, the department of Health said.

Cancer in children: Early diagnosis, treatment key to survival

Currently, between 800 to 1 000 children in South Africa are diagnosed with cancer every year, however, the Cancer Association of South Africa (CANSA) estimates that half of children with cancer in the country are never diagnosed.

On a global scale, the World Health Organisation (WHO) reveals that more than 400 000 children and adolescents below the age of 20 are diagnosed with various types of cancer annually,

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