New HPCSA CEO/Registrar intent on restoring trust in the Council

Photo: Dr Magome Masike, the HPCSA’s new Registrar/CEO 

The appointment last week of Dr Magome Masike as the new Registrar/CEO of the Health Professions Council of SA elicited a lot of attention, with healthcare professionals expressing the hope that it will bring stability to the Council. In the past few years, the regulatory body has stumbled from crisis to crisis – the most recent one being the much-publicized suspension of the previous Registrar/CEO, Dr Boikhutso Motau three months after his appointment following allegations of fraud and corruption relating to his tenure as the head of the Health Department in the Free State.

Dr Masike is a medical doctor turned politician and was MEC for Health in North West from 2010 to 2018. He holds an MBChB and a Masters in Business Administration (MBA). He was also President of SAMA in North West, a member of the Provincial Legislature in the province and chairperson of the Portfolio Committee for Finance in the Office of the Premier.

 AxessHealth editor, Marietjie van den Berg, put 10 questions to the new Registrar/CEO, which he answered by email.

Q: You are taking over as Registrar/CEO of the HPCSA at a very turbulent time, given the history of your predecessor Dr Motau and many other allegations against the HPCSA regarding corruption, bribery inefficiency, etc. What made you decide to take over the reins at such a difficult time, given the many challenges the regulator is facing?

Dr Masike: While the background above could be realistic, I felt I have a responsibility to make my own contribution to the institution with the aim of improving its service offering and the overall image. I am confident that with the kind of experience I have gained from both the public and private sector, I will be able to add value thereby improving the image of the organisation. As a health practitioner myself, I think I do have a duty to contribute to the betterment and improvement of the HPCSA to ensure that the organization is able to execute its legal mandate as provided for in the Health Professions Act, 56 of 1974.

Q: Looking at the environment that you are going into, what do you want to change?

Dr Masike: As part of my priority, I want to focus on the improvement of the HPCSA ‘s service offering. Through my short, medium and long-term strategy, I am confident that the HPCSA will reclaim its historical position as a trusted regulator of the health professions.

Q: South Africa’s health system is entering a new phase with the imminent introduction of NHI. What is your opinion about NHI and what do you think the role of the HPCSA will be in ensuring that it fulfils its mandate as protecting the public and guiding the profession in a system that aims to improve access to healthcare irrespective of ability to pay, free at the point of access?

Dr Masike: As the HPCSA, we are supportive of government ‘s initiative of the NHI, and ours will be to partner with the Health Department to ensure that different stakeholders and communities embrace NHI so that they can derive its maximum benefits.

Q: In 2015 an investigation by a task team appointed by the then Health Minister, Dr Aaron Motsoaledi found the HPCSA to be in a “dysfunctional” state following allegations of maladministration, poor governance, corruption, and other irregularities. Do you think since that report came out that the HPCSA has acted sufficiently to address these problems because from the outside, it doesn’t seem as if much has been done.

Dr Masike: All five recommendations as cited in the Ministerial Task Team (MTT) report have been attended to by the Council between 2015 and 2019 and various reports in this regard have been submitted to the Office of the Minister of Health.

Council has embarked on a turn-around strategy to enhance the organisation ‘s effectiveness and efficiencies through streamlined services. The HPCSA has since moved towards building a new organisation which is reputable for its innovation, professionalism, and excellence in service delivery.

Key turnaround times for core and enablement processes were developed with the aim of reducing the overall process time and variability. Council has also completed the design of a new functional and organisational structure to improve efficiencies. The registration process was also reviewed resulting in a significant reduction in turnaround time of this core customer-facing service.

The MTT Report is a Ministerial matter and Council has submitted its reports to the Office of the Honourable Minister of Health for consideration and implementation.

Q: In the MTT report, it was recommended that the HPCSA split in two with separate councils for doctors and dentists and another one for allied and other health professionals. This never happened and there are attempts by doctors to establish their own regulator. What do you think should happen as far as that is concerned, particularly at such a critical time?

Dr Masike: I do not have an opinion on this matter or process as this remains a government matter which only the Minister will be able to pronounce upon once he has made up his mind and considered all available options on the matter. These are issues I need to familiarise myself with in line with resolutions of Council.

Q: Medical negligence claims are exhausting the health budget and it seems as if the number and amounts of these claims are escalating with the HPCSA seemingly unable to intervene in ensuring that doctors who are guilty are punished appropriately. What do you think the HPCSA’s role should be to stem this?

Dr Masike: The HPCSA as a regulator of the health professions only investigates issues of professional negligence through disciplinary hearing without necessarily focusing on the claims. Issue relating to the claims are matters which are handled by the Courts which are institutions capacitated and mandated to deal with such issues as per the law.

Q: The HPCSA has been accused of turning a blind eye to the circumstances trainee doctors and those who are doing community service have to work udner. The HPCSA is responsible for accrediting the facilities that these individuals are sent to work in.

However, it doesn’t seem as if the HPCSA is doing enough to ensure that these facilities and the standard of training are adequate with many of these trainee doctors working unsupervised without the necessary equipment etc. Any idea how this is currently being addressed and will be addressed under your leadership?

Dr Masike: In this regard, we have started to engage the relevant partners and stakeholders to ensure that all role players clearly understand and execute their roles. To address these concerns, the HPCSA is engaging all the relevant stakeholders and partners who are part of the value chain to ensure that all parties play their rightful role to ensure that we collectively contribute to the improvement of the overall working conditions of the health practitioners, irrespective of whether they are training or qualified.

Q: The Health Market Inquiry found the HPCSA seriously wanting and recommended a number of things especially regarding its oversight role where private healthcare professionals are concerned because current regulation is preventing innovation and models of care that could make private care less expensive. These include fee-sharing, allowing multidisciplinary group practices and the employment of doctors by private hospitals. Do you know if anything has been done about this and are you in favour of the recommendations? 

Dr Masike: All innovative ideas will always be welcome, particularly those that are aimed at improving our healthcare services or system both in the public and private sector. The HPCSA took the recommendations very serious and initiated the process to review some of its ethical rules and guideline to ensure that they are aligned to the HM ((Health Marketing Inquiry) recommendations.

Q: Another problem is the registration of South African doctors who have studied abroad apart from Cuba and the registration of doctors from other countries who want to work in SA. Given the need in SA for more healthcare professionals, how do you see think current regulations should be changed to allow more of them to work in SA?

Dr Masike: This issue remains one of national concern… I will work with the relevant professional Board to relook at our regulations and policies to establish how this matter could be amicably resolved. Of importance will be to mention that all applications for registration will always be looked into on their merit, and should the application meet all the requisite requirements, those applications will definitely be considered for registration.

 Q: Restoring trust in the HPCSA is going to be  challenging. Your ideas around this and how it should and could be done?

Dr Masike: My starting point will be to ensure that that all our operations are capacitated enough to provide or render a good service. Where there are issues of lack of capacity and training needs, I will ensure that the organisation is properly capacitated to provide an improved service to both practitioners and the public. This might not be a quick fix, but a process which I will endeavour to go into working with both the Executive and Non-executive officials to ensure that we restore the public trust.