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COMMUNIQUÉ TO THE SOUTH AFRICAN MEDICAL ASSOCIATION MEMBERSHIP
The future of SAMA is in our hands!
Dear SAMA Member,
With Covid-19 and its ramifications greatly affecting communities in South Africa and across the globe in recent weeks, we know that for you and your colleagues, this time during the national lockdown has been a particularly busy one as you ready yourselves to fight on the frontlines for your patients.
We honour your commitment and your dedication to your profession. Now, more than ever, is the time for us to band together and ensure that we speak with one voice, stronger together and working towards a common goal.
Introduction
The past years have been particularly challenging for SAMA, leaving the future existence of our association in a precarious position. We wish to thank you for your valued support throughout the various challenges SAMA has been facing. We reassure you of our outmost commitment to the vital role we play in upholding your interests, the interest of the profession, and ultimately the health of the nation. Accordingly, we request your careful consideration of this communication as it will be critical in determining the future of our association.
Background
At the heart of the challenges faced by SAMA over the years has been the unintended misalignment between SAMA, a non-profit company (SAMA NPC) established in terms of the Companies Act (71 of 2008), which is a professional association for both employed and self-employed medical practitioners, on the one hand, and the South African Medical Association Trade Union (SAMA Trade Union), a trade union registered in terms of the Labour Relations Act (66 of 1995), on the other. This unintended misalignment between SAMA NPC and SAMA Trade Union emanates from, among other factors, the following:
• The inability of both, in terms of the law, to co-exist and properly function as two legal entities in seamless governance
• Non-compliance of SAMA Trade Union with the Labour Relations Act (LRA) and its own constitution
• These two factors precipitating a real threat of possible division of the association
It is important to note that although the trade union was registered in 1996, up until 2013 its union functions were served through the Committee for Public Sector Doctors, a committee of the SAMA NPC. Despite it being a registered union, SAMA Trade Union needed to singularly comply with the LRA, but could not meet the requirements of the said act in that unions needed to be sovereign and independent. Furthermore, because of the employed doctors not being organised separately from the rest of the membership of SAMA, SAMA Trade Union could not satisfy the organisational structure prescribed by the LRA. Despite all of this, SAMA members continued to still receive labour representation and assistance through SAMA.
Corrective measures
Between 2013 and 2016, SAMA made several attempts to assist the achievement of compliance by the trade union, but without success. As a result, the SAMA board of directors took a decision, in 2016, to restructure its committees with the view to improve and optimise the representation of employed doctors and to better attend to issues that affected them. This decision included the disestablishment of the already non-compliant SAMA Trade Union’s leadership structure as the trade union ceased to function as an entity.
In the same year, an Interim Employed Doctors Committee (IEDC) was established, as a committee represented in the SAMA NPC board, mandated to assist with all employed doctors' matters, including those employed in the public sector.
In October 2018, a Trade Union Task Team (TUTT), also a committee of the SAMA NPC Board, was established at the National Council with the aim of once more assisting SAMA Trade Union to be compliant with the LRA and its constitution. During its term (October 2018 to August 2019), the TUTT embarked on a process of setting up legitimate membership structures, based on the bottoms-up approach, as prescribed by the Trade Union Constitution and the LRA. This process included, but was not limited to, the election of shop stewards in health facilities across all nine provinces. It, however, proved futile due to, inter alia, the disinterest and poor levels of participation by employed doctors related to organisational trade union affairs.
Terminal failure of compliance
The team then attempted to convene a National Congress during which leaders of the trade union would be elected. This, however, went against the principles guiding the achievement of legal legitimacy. The congress could therefore not proceed. Instead, an employed doctors membership consultative meeting was convened, wherein an interim committee was elected. This new committee was given the following mandate:
1. To review the concept of unionisation of the profession and explore the possibility of a professional advocacy entity for the profession
2. To concurrently provide ongoing and uninterrupted servicing of employed doctors in their workplace needs
This committee, operating as the Interim Committee of Unionisation (ICU), supports the Employee relations Unit of SAMA, catering for all the special needs of employed doctors, which include those employed in the public sector.
You are probably aware that SAMA Trade Union was placed under administration in October 2019. This was the culmination of a court process that was informed by the elements of legal misalignment mentioned earlier.
SAMA currently has over 16 000 members who are medical practitioners, both employed and self-employed. About 55% of these members are employed, with the overwhelming majority being in the service of the state. As a professional association, apart from ultimately being its members’ labour representative, SAMA also fulfills a variety of vital, value-adding functions on behalf of its members. These include:
Common for all members
• Stakeholder representation (the Colleges of Medicine of South Africa, the Health Professions Council of South Africa, the Presidency, the Health Ministry, the World Medical Association, the World Health Organization and other medical associations and interest groups across the globe), where trade unions do not get representation
• Publishing more than a dozen journals and publications, the primary one being the South African Medical Journal
• Continuous professional development activities and point accreditation
• Medico-legal assistance
• Society representation (specialists, GPs etc.)
• Health Policy Committee helps to position the association on policy matters affecting the profession
• Military doctors: as per regulations, military doctors cannot belong to a trade union. SAMA, however, has been able to hold meetings and engage with the South African National Defence Force as a professional association
• Foundation for Professional Development access to training and continuing professional development
• Advocacy (e.g. Covid-19), not just for members, but for the profession as a whole
• Member benefits
• Strength in Diversity (a broad church able to cater for all doctors' needs, including many of our members who, apart from being in public service, are also self-employed through the agreed remunerative work outside the public service [RWOPS] framework)
• Setting treatment codes
• Bursaries and scholarships
• Setting clinical guidelines (such as for the current Covid-19 pandemic)
• Research ethics oversight
• Benevolent Fund
Specific for employed doctors
• Legal assistance (labour law, employee relations, disciplinary enquiries, etc.)
• Special Interest groups (students, junior and senior doctors, registrars and academics)
• Strategic engagements with the Department of Health on the drafting of public sector policies. Historically, SAMA made a valuable contribution to policies on commuted overtime, RWOPS and occupational specific dispensation
For self-employed doctors
• Coding trademark
• Council of Medical Schemes representation
• Engagement with individual funders
• Engagement with the Commission of Occupational Injuries and Disability Act
• Strategic partnerships with the Board of Healthcare Funders
• Affiliation with most specialists disciplines
• Strategic partnerships with the Compensation Fund and the Road Accident Fund
• Strategic engagements with the South African Private Practitioners Forum
• Strategic partnership with GP groupings under the United Forum of Family Practitioners.
Both for the restrictive impositions of the LRA, and the confluence of several essential services to our members, the conventional trade union model as envisaged by the law has always proven to be an anathema to the collective medical profession. Doctors, who are essential services professionals, cannot ethically embark on strike action. Those who work in managerial positions, on the other hand, find themselves in the untenable position of being both accounting officers and a union members. This, therefore, poses a threat to the functioning of the profession in its primary duty of being stewards for health before being stewards for rights. As leaders, this calls for our collective engagement on these challenges.
The administration order
The court order imposing the current administration process over the union has a harsh financial and organisational impact on SAMA’s strategy with respect to serving state-employed doctors. Their membership fees get directly deducted as union subscription fees from their salaries on the PERSAL system.
We wish to enable uninterrupted membership of our colleagues with SAMA, as much as we have ensured the continuity of services throughout all the phases of these challenges. It has therefore become imperative that we embark on the process of migrating subscription membership payment from the PERSAL system to debit order. This disruption has been long coming, but all attempts to stem it have failed.
Way forward
In light of the above, if you are a state employed doctor contributing through the PERSAL deduction system, you are requested to partake in the process of migration by completing the attached debit order form authorising payment through debit order.Kindly find attached to this communication the debit order forms for your completion, or click here to submit.
Acknowledging that, in this time of lockdown, certain administrative challenges exist for some of us with regards to the printing and filling out of forms, we are in the process of creating a digital solution. Follow up communiques will include a link to this solution.
We thank you for your time in reading this communiqué and encourage you to contact us, should you have any queries, using the following contact details:
Email address: online@samedical.org
Tel: (012) 481-2000
Kind regards
SAMA Board of Directors
Office of the General Manager
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