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

The 16 Days of Activism against Gender-Based Violence is an annual international campaign that kicked off on 25 November, the International Day for the Elimination of Violence against Women, and runs until 10 December. It is used as an organizing strategy by individuals and organizations around the world to call for the prevention and elimination of violence against women and girls.

A shocking statistic from a StatsSA report from 2020 shows that there were 33 0000 teenage mothers in the year, among them there were 660 babies birthed by mothers aged 10 years and younger. As medical professionals we have a responsibility to ensure these young girls’ safety and I would remind colleagues that we also have a legal obligation in this regard. 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.”

Non-compliance with mandatory reporting legislation on the part of professionals is just one of the challenges faced in the quest to protect and safeguard the children of SA. This requires urgent intervention as some of these challenges include the lack of human resources, facilities and knowledge. With the prolonged strain on resources owing to COVID-19, and the imminent 4th wave, one would think that we will be able to alleviate some of these challenges if we could place our Medical Interns sufficiently in positions where they could be of assistance immediately. This again seems to be another challenge as it has been for many years.

Recent court cases have demonstrated the deficiencies the current legal framework has in regard to culpable homicide law, and its application in healthcare settings. Magistrates are often placed in the unenviable position of adjudicating exceedingly complex clinical interventions, without possessing the necessary training or medical expertise. Without proper legal judgement on medical cases, doctors will increasingly become afraid to perform certain procedures, a serious situation which will have negative consequences for patients. The setting up of a special court to deal with this issue may be required and is something we will be suggesting.

The detection of the new Omicron variant again emphasizes the urgency to get vaccinated. The more people we have vaccinated, the less chance the virus has of mutating. Early signs from diagnostic laboratories that B.1.1.529 has rapidly increased in Gauteng and may already be present in most provinces. We can make some predictions about the impact of mutations in this variant, but the full significance remains uncertain. We will keep an eye on this during the next few weeks and months.

In closing, some good news in regard to the HPCSA conducting off-site registrations this year. Teams will be visiting provinces between 22 November and 24 December to register Interns and Community Service colleagues to ensure that they are registered before 1 January when they need to report for duty.

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.

World AIDS Day- 1 December 2021

The South African Medical Association (SAMA) joins the millions of people around the world in commemorating the 33rd World AIDS Day – a day observed to bring greater awareness to HIV, and to remember those affected by the disease. The theme of this year’s World AIDS Day is “End inequalities. End AIDS”, and is intended to reach those who are left behind, and to end disparities against those affected most by the disease: young women, men who have sex with men, transgender women, sex workers, people who inject drugs, as well as children and orphans.

“Since the start of the pandemic AIDS-related illnesses have killed approximately 36 million globally. In 2020, as many as 37.7 million people were living with HIV and AIDS, with approximately 1.5 million becoming newly-infected since then. Our response to the pandemic must ramp up, and disparities in dealing with those affected is causing us to fall behind in terms of AIDS control,” says Dr Angelique Coetzee, Chairperson of SAMA.

Dr Coetzee says what is encouraging is that 28.2 million people are accessing antiretroviral therapy. At the same time, however, two-thirds of people living with HIV are in sub-Saharan Africa with South Africa accounting for 7.7 million people living with HIV. South Africa has the largest antiretroviral programme in the world.

The Global AIDS Strategy 2021-2026 is a significant step forward for the global community and people affected by HIV and AIDS, as it places dealing with inequalities at the centre piece of HIV responses. The relationship between societal inequalities and HIV and AIDS is of huge concern. Decades of experience and evidence from the HIV response show that intersecting inequalities are preventing progress towards ending AIDS. Experience shows that the COVID-19 pandemic has deepened these inequalities. 

 “Despite the availability of scientific capability, proven tools and approaches for responding to HIV and AIDS, and despite the epidemic no longer being a death sentence, many countries, including South Africa are still far from reaching AIDS control, thanks to a number of obstructions, including inequality,” says Dr Coetzee.

She says SAMA urges the public, scientists, health professionals, people affected by HIV and AIDS, and policymakers, to heed global calls to end the inequalities that present as barriers against ending AIDS.
 
 “In an era of enhanced human rights protections, nobody affected by HIV and AIDS should suffer needless discrimination and stigma. SAMA supports all campaigns that are aimed at preventing disparities that drive the burden of AIDS on the population, we urge all South Africans to do likewise. Together let’s end inequalities, let’s end AIDS,” concludes Dr Coetzee.

To view our webinar to commemorate World Aids Day, please click here.

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

Omicron variant and the fourth wave

Dear Colleagues

You are invited to a webinar on the Omicron variant and the fourth wave on Tuesday the 7th of December

While the 4th wave of the pandemic has been anticipated, the evolution of the new, more complex variant is cause for concern. In this webinar, we will hear from the experts leading the genomic surveillance who identified the Omicron variant. Due to the urgent need to update colleagues on this issue, we have moved this webinar slot to Tuesday evening rather than our usual Thursday evening timeslot.

We all have a role to play in reducing vaccine hesitancy

Although the evidence is still emerging, it appears that the current vaccines available in this country confer significant protection against severe disease and death from the Omicron variant. Unfortunately, vaccine uptake remains low, largely due to vaccine hesitancy. There is a pressing need to continue to drive vaccination among colleagues, patients, and our broader communities to ensure the safety of the population, and your overall wellbeing. As a trusted voice, please play your role in making our society safer by advocating for vaccination among colleagues and the public at large.

It has never been more important to get your booster shot

Qualifying participants in the Sisonke trial are eligible to receive a booster shot. We encourage you to visit a vaccination site to receive your booster and protect yourself during this fourth wave. We would be delighted to accommodate you at one of the Discovery vaccination sites providing these boosters.

Join us this Tuesday evening for a CPD accredited webinar.

Details for the upcoming webinar

Date:      Tuesday 7 December 2021
Time:      19:00
Topic:     Omicron variant and the fourth wave

This webinar will be led by Professor Tulio de Oliveira and Dr Richard Lessells

Professor Tulio de Oliveira is the Director of the KwaZulu-Natal Research and Innovation Sequencing Platform (KRISP), Research Professor in the College of Health Sciences, UKZN and the principal Investigator of the Network for Genomic Surveillance South Africa (NGS-SA).

Dr Richard Lessells is a senior Infectious Diseases Specialist at KwaZulu-Natal Research and Innovation Sequencing Platform (KRISP), UKZN.

Queries regarding CPD points

This webinar is CPD accredited. If you have any questions about CPD points, please email cpd@discovery.co.za

Did you miss any of our previous COVID-19 webinars?

You can view and listen to all previous webinars and podcasts here.

Medical Practice Consulting has partnered with Discovery to make previously aired webinars viewable for CPD points. You can register here if you missed the opportunity to earn CPD points at live webinars.

We hope to remain a trusted source of support for your personal wellbeing and practice sustainability. Please email MGoodman@discovery.co.za for more details. We wish you strength and assure you of our ongoing support during these challenging times.

Regards

Dr Maurice Goodman
Chief Medical Officer Discovery Health

Omicron variant fuelling ‘exponential’ rise in Covid cases, say South Africa officials

The Omicron variant has fuelled a “worrying” surge in coronavirus cases in South Africa and is rapidly becoming the dominant strain, local health officials have said, as more countries including the US detected their first cases.

The omicron variant was in Europe a week before South Africa reported it

The omicron coronavirus variant was already in the Netherlands a week before South Africa reported the new variant to the World Health Organization, according to a Dutch health agency.

The lockdown restrictions that do and don’t work in South Africa: expert

South Africans planning to travel domestically over the December holiday period should continue going ahead as planned, says professor Shabir Madhi, professor of vaccinology at the University of the Witwatersrand.

Vaccination rates have been increasing, but more needed - health expert

The Covid-19 vaccination rate, which had slowed down, started rising again this week. With news of the new variant, Omicron, spreading fast, more people have been showing up at vaccination sites.

Mabuza: Empowering women and girls crucial to HIV fight

Speaking at the World Aids Day event in Limpopo on Wednesday, Deputy President David Mabuza said women and girls must be empowered to take charge of their sexual and reproductive rights.

COVID-19 continues to overshadow fight against HIV

More needs to be done to end the inequality, stigma and discrimination faced by those living with HIV/AIDS. And, unfortunately, the COVID-19 pandemic has seen efforts to fight HIV take a backseat..

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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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