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DoH: Aaron Motsoaledi: Address by Minister of Health, during the Media briefing on National Health Insurance White Paper, Hatfield, Pretoria (29/06/2017)

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DoH: Aaron Motsoaledi: Address by Minister of Health, during the Media briefing on National Health Insurance White Paper, Hatfield, Pretoria (29/06/2017)

Health Minister Aaron Motsoaledi
Health Minister Aaron Motsoaledi

29th June 2017

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Members of the Media
My colleagues MECs present
Ladies and Gentlemen

We invited you here today to release to you and to the Nation, the policy document on the National Health Insurance (NHI), after its approval by the Cabinet on the 21st June 2017.

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But before I do so, I want to deal with other matters of National Importance in health, which have emerged over the past few weeks all over the media, both print and electronic.

We firmly believe that the people who raise these issues in the media, have no intention at all to inform the public, but have every intention to rubbish the public healthcare system in the country by systematic and incessant attacks.

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We are shocked by the verocity of some of the attacks and puzzled by the incredulity of some of the claims.

The extent to which people are even able to lie with straight faces in an attempt to put the Department under intense pressure through incessant media scrutiny, just to get what they want is actually unprecedented.

Let me deal with these issues one by one:

1. Unemployed Doctors

This issue of doctors who are looking for employment but are just sitting at home because the Government is not willing to employ them is repeated again and again and again, despite providing statistics on the matter almost everyday including already twice this morning.

We are told that there are doctors who are unable to do their internship because the State failed to place them into internship positions.

Every single day, a new and different number of unemployed interns is quoted by various media houses or various disgruntled individuals or groups. Two weeks ago, a TV Programme claimed 80 unemployed doctors.

This morning, the 1st radio station interviewing me quoted 6. An hour later a doctor phoned a second radio station interviewing me and quoted 80 then immediately 200.

I always prefer to work with statistics because numbers don't lie.

On demanding the list of these so-called unemployed doctors, I did receive a list from a TV presenter who had earlier claimed to have a list of 80. This list had 4 different attachments:

• The 1st attachment has a list of names of interns who are said to have completed their studies in December last year and were due for placement earlier this year.

We checked all the names against the information we have and this is what we discovered. Out of the 35:

(i) 11 (eleven) were offered posts but they declined because they said they were not interested in the hospitals or provinces where the posts were offered;

(ii) 8 (eight) refused to apply after the 3rd round placement because they said the hospitals they were interested in were all taken up in the 1st, 2nd and 3rd round placements;

(iii) 6 were actually still medical students at the time we received this list. This means they were not yet doctors, but are already appearing on the list of the unemployed;

(iv) 7 (seven) wrote their examinations only 3 days ago, i.e on Monday this week and they are waiting for results, but they too were already appearing on the list of unemployed doctors compiled two weeks ago;

(v)  2 (two) were actually placed in February and March this year. It is not clear to us why they are said to be unemployed;

(vi) 1 doctor said he did not apply because he is unaware of the application system.

• The second attachment has a list of 32 names. They are all foreign medical students who studied in South Africa:

(i) 3 (three) have been placed at Nelson Mandela Academic Hospital early this year. It is not clear what they are said to be unemployed;

(ii) 2 (two) have been placed at Bloemfontein Hospital Complex;

(iii) 7 (seven) have been placed at Mofumahadi Manapo Mopeli Regional Hospital, it has not been explained to us why that is called unemployment;

(iv)  15 (fifteen) are nationals from Lesotho and Botswana, and their respective countries have written to us to ask that they not be placed for internship in South Africa because their country needs them even more than South Africa does;

(v) The remaining 5 (five) are from Mauritius and their Minister of Labour told me that they are producing more doctors than they can employ and are requesting that South Africa help their doctors.

We never promised.

We always strive to place all South African interns first because this is a statutory function and the State is hence obliged to provide such internship positions.

But I am not going to appear in any press conference and claim that South Africa has the capacity to offer a job to each and every international student who wishes to be employed here. Please help me by pointing to one country, just one please, which has a capacity to do so.

•  The 3rd attachment has a list of 73 medical officers who are said to be unemployed. Medical officers are doctors who have completed internship and community service.

These are doctors who are in very high demand around the country because they can work without anybody supervising them, and unlike interns and community service, they can be sent to any hospital. Due to these reasons, their prospects are unlimited. They may go into private practice, they may choose to specialise, they may go overseas, they may choose to work for a medical aid scheme or a pharmaceutical company or any other industry for that matter.

The list I have received of doctors falling within that category, is of those who are actually individuals who wish to specialise. But they are presently employed as such   

At any rate I have just told you medical officers are doctors who are in high demand.

Give me 141 of them now as we are sitting here and I will send them all to Limpopo - all 141 of them will be employed immediately. The Limpopo MEC is here and can attest to that.

If you were to add another 67, I will send all of them to the Free State and they will employ them without hesitation. The Free State MEC is also here, he can also attest to that.

In January this year, when there was also a claim of unemployed doctors, Eastern Cape Province released on their website, 70 vacant posts all over the Province.

Guess what, no single South African doctor applied. The Province resorted to a group called Africa Health placements who recruited international medical doctors. Only 31 doctors were raised internationally.

It means there are still 39 vacant posts there, waiting for doctors.

Why it sounds to me that this claim of unemployment among doctors is some form of media status symbol?

• The last attachment sent to me has a huge list of unemployed university graduates, not doctors, but university graduates.

Ladies and gentlemen, the problem of unemployed graduates in South Africa is a known national crisis in all fields of study, except among doctors.

We have unemployment among graduates in Engineering, Accounting, Financial Management, ICT, Human Resources, Teaching, Social Work and many other fields due to the economic problems in the country.

All graduates, regardless of what they studied deserve to be employed and I believe that is what the whole country wishes for.

2.  The College of Medicine of South Africa.

The second major issue that emerged in the media this week is very painful for me. It is the rubbishing of the College of Medicine of South Africa on a TV Programme by some individuals.

I do not understand what type of people were are in this country. The College of Medicine of South Africa is one of the centres of excellence for which many a country envy South Africa. All South Africans of reasonable intent need to be very proud of this institution.

This College is respected continentally and indeed even globally. Anyone of the graduates of this College can anytime be employed as a lecturer in any medical school on the Continent or in any of the 52 Commonwealth Countries - that includes the UK, Australia, Canada, New Zealand, India etc.

To see the College being thrashed the way it was on TV on Monday will even shame the devil himself and I am saying shame on you South Africa.

The people who were attacking this College and those who gave them a public media platform to do so, claim that the College is untransformed and there is racism whereby blacks are targeted to fail.

I was not in the country when this programme was aired and I was phoned by very irate and distressed doctors who know how this College works. The programme was recorded for me and I watched it last night.

Never before in my life have I ever watched and listened to darkness attacking the light like that.

Yes, for mediocre people to attack such a centre of excellence is tantamount to darkness attacking light.

The College of Medicine is not a particular university. You may study to be a specialist in any one of the 8 medical schools in South Africa.

After 4 years of specialist training, you may then go to any one of the 3 designated centres called the College of Medicine of South Africa to write your examination. The 3 centres are Rondebosch in Cape Town, Park Town in Johannesburg and the last centre is in Durban.

All the 8 medical schools converge to examine students who are ready to tackle College examinations.

Is the College racist?

The College has a President and a Senate. The present President is Prof Mike Sathekge of the University of Pretoria Medical School and Head of Nuclear Medicine at Steve Biko Academic Hospital.

His Senate for 2014-2017 consists of 20 whites and 34 blacks. Judge for yourself whether you call this racism or what.

It is interesting to note that the doctors who attacked the College on TV all tried to study for senior degrees and failed.

There is then a claim that there is a higher failure rate in Obstetrics and Gynaecology. Well, in the 1st Semester examination of 2016, a total of 77% passed this College examinations and obtained the degree FCOS (SA), i.e Fellow of the College of Obstetricians and Gynaecologist.

Now ladies and gentlemen, if you struggle to climb a small hill in your village, but then go and try to tackle Mount Everest, that is very highly commendable.

But if you then do not make it, you do not attack the people of Nepal as racists and untransformed, nor do you demand on National TV that Mount Everest must kneel down to your level so that you may climb to the summit. Unfortunately this is exactly what I wish on this recorded programme last night.

I am here to inform you today, that we cannot encourage mediocrity in our medical training, and to hide mediocrity under the banner of racism and transformation is not going to help. Transformation and mediocrity are not one and the same thing.

I reject that and will not allow the College of Medicine in South Africa to be attacked by the mediocre. I am sending a challenge to the media house that paraded this individuals who are supposed to have been failed. Please go and get experts of your choice, especially in any of the Commonwealth countries or on the Continent, let them come here and review the scripts of these individuals. The College also records these proceedings of the 8 hour oral examination for each individual. They will present this audio records for scrutiny by these experts.

If anybody was found to have been failed unfairly, the Department of Health will pay for all the expenses. But if they are found to be lying, we will not pay a cent. We cannot reward mediocrity and we cannot reward dishonesty either.

3. Forensic Pathologists in Gauteng

The National Department was also bombarded with another unfortunate hyperbolic claim. During the strike by Forensic Pathology officers, we were told that drivers, cleaners and anybody else did post-mortems for the past 10 years in Gauteng.

Those of us who have ever done a post-mortem choked on our own saliva on hearing these claims.

People train for 13 years to become Forensic Pathologists to perform a professional post-mortem, and we are told that a driver and a cleaner can also do same.

I have no time to clarify this matter, one of the prominent Pathologists, Prof Gert Saayman, has done so.

I can inform you today, I am writing a letter to the Health Ombud to investigate this claim. All those that made this claim must appear in front of the Ombud to expantiate and prove that claim. The country wishes to know the truth. Should there be any truth to the claim, we shall take stern action on those responsible.

4. The last attack that emerged yesterday evening are the claims by the President of the South African Society of Psychiatrists (SASOP), Prof Bernard Janse van Rensburg.

Using the emotions generated by the unfortunate incidents of Life Esidimeni, the Professor made several disingenuous claims. He claimed that after 150 days after the Health Ombud releasing his report, nothing has changed. I do not have to respond to this. I note this morning the Health Ombud himself, through the Office of Health Standards Compliance, has responded.

As a Psychiatrist, Prof van Rensburg knows that there are only 680 Psychiatrists registered in South Africa, with 80% of them in the private sector. This has never been a secret.

In a very dishonest attempt to besmirch the Department, he quotes the tragedy of a nurse who was killed by a psychiatric patient in a Limpopo hospital. He claims that the nurse was killed because Hanyani Hospital did not have a Psychiatrist. The tragedy that befell the Hospital was just that, a tragedy. This patient is a known murderer who was sentenced by the courts for murder. But he would not be sent to jail due to his psychiatric condition.

The courts wrongly sent him to Hanyani Hospital when the only institution that can handle mentally ill patients who murder is in Grahamstown, in the Eastern Cape. This patient is now presently in Grahamstown.

I wish the Professor could be truthful to the Nation.

He further claims that out of 45 positions of Psychiatrists in KwaZulu Natal, only 20 have been filled.

The Head of Psychology at the KwaZulu Natal Medical School, Prof Chiliza, who is also in charge of all Psychiatric services in KwaZulu Natal, says he knows nothing about this claims by Prof van Rensburg.

Prof van Rensburg wants the country to believe that if the State is willing, it could fill 25 positions of Psychiatrists in KwaZulu Natal only. Prof, you and I know, there are no 25 Psychiatrists in South Africa waiting to fill any position.

I am challenging Prof van Rensburg, if you give me just 3 Psychiatrists, I will immediately send them to Sefako Makgatho University where they have been struggling to get some. Give me 15 qualified Psychiatrists now and I will sent them to Limpopo to be employed today.

In fact Prof van Rensburg, if you are listening wherever you are, the University of KwaZulu Natal Medical School know only 4 Psychiatrists who they can employ immediately. Of these four, two have chosen to do only locum and two have just completed their studies last month and we all wish and hope they apply for posts there.

I really appeal to South Africans not to start developing allergy to the truth. PLEASE!!

I thank you!

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