Date: 27/06/2003
Source: Department of Health
Title: Tshabalala-Msimang: South African Nursing Council


SPEECH BY THE MINISTER OF HEALTH, DR MANTO TSHABALALA-MSIMANG, AT THE MEETING OF THE NEW SOUTH AFRICAN NURSING COUNCIL, Pretoria, 27 June 2003

Outgoing President,
Prof R V Gumbi,
the Registrar,

I would like to thank you and the Council for having invited me to participate at this first meeting of the second democratically elected Nursing Council.

I have been informed that your elections were declared free and fair and I am also told that you made use of the Independent Electoral Commission (IEC), which to me was a wise move towards saving costs and ensuring the credibility of the whole process. I congratulate each and every one of you for being elected or nominated to serve in this honourable body and through it, to serve the people of this country.

It is opportune for me to clearly spell out what I understand to be the role of Health Professional Councils. I think it is important to do this early in your term of office so that we are able to forge our way forward with a common understanding of the framework in which we operate.

In a democratic country such as ours, government sets macro policy for governance within the framework of the Constitution. Thus it is the responsibility of the Ministry and the Department of Health to set the policy framework within which councils should carry out their responsibilities.

As a country, we have preferred to separate councils from the administrative structures of the Department of Health. This is to allow the Department to tap expertise from councils, allow the councils to operate independently from the day-to-day pressures of the health department's management and promote impartiality and objectivity.

While stating this, it must be noted that the councils must be accountable to the public through the public-elected bodies.

The key role of councils is to protect and promote public interest, including ensuring delivery of quality health care. They are not there to serve the interests of health professionals, in your case nurses. The interests of nurses are best served by the unions or professional associations.

This brings me to the next point that some of the members of councils do hold certain offices in unions, employee organisations and associations or represent interests of specific group of stakeholders within the health sector. It should be emphasised that when serving on a council, these members must act solely to promote the integrity of the council and its primary objective of serving the interest of the public.

It is important to separate the role of a councillor from that of an employee representative, board member of a specific health entity. In some cases you might be called upon to apply sanctions to your own comrades or colleagues. We must not shy away or be apologetic in carrying out our duties as councillors.

We have seen councils in the past deteriorating to a state where they were perceived as becoming a law unto themselves and protecting their own. In other words they were not being receptive to the interests of the community and general public. We do not want that situation to rear its ugly head again in our councils.

There have been a number of developments in councils since that pre-1994 period. The then existing councils were replaced by interim councils with an aim of putting legislative processes in place for the establishment of democratic councils. This was applicable to all five health professions councils.

The Ministry and the Department of Health noted that although some transformation had taken place, it was not fast enough or had not reached a level where we would be confident that our transformation objectives have been met.

We than appointed a task team consisting of members of different councils, including the Nursing Council, to look at the issue of transformation more closely and to come up with recommendations. I must say I was happy with the work done by the task team, which demonstrated that within our councils we do have the capacity to move the process of transformation forward. I will not mention all the recommendations of the task team, but I will just highlight a few.

The first major recommendation was that councils should protect the public, which I have already mentioned. This was strongly supported and endorsed by all councils.

The second major recommendation was the development of a charter for councillors. I am aware that there is a draft that has been developed by the Forum of Statutory Councils, which needs to be finalised as soon as possible for implementation. This charter reminds us that that as councillors, we are servants of the public at large and we play an advisory and supportive role to the profession. It cautions us against using our privilege to satisfy our own personal ambitions and aspirations and other unbecoming behaviour.

To this end, I have been saddened to learn that in the past, some councillors have abused their positions for self-benefit. Let me state that I will not tolerate a situation where councillors defraud the council by demanding payment for the work that is not done. I will take decisive action against this and ensure that the funds are used for the benefit of the public.

The other recommendation was that membership of councils and council staff should reflect the demographics of the country and strengthen empowerment of the historically disadvantaged. The task team further recommended that, to ensure the credibility of the council, it would be prudent for council to have a balance between elected representatives and nominated community representatives.

The task team recommended that councils should not be too big as this will impact on their efficiency and cost effectiveness. We must remember that the funds of the councils should be spent more on meeting the objectives of the councils and general service delivery rather than on administering massive councils.

I understand that this council has increased the number of representatives from 39 to 40 instead of reducing it as recommended. I hope this will be rectified in line with the report of the task team.

To follow the trend in public governance, the task team advised that no member should serve more than two consecutive terms of office. However, mechanisms should be put in place that some of the members remain to ensure continuity.

Lastly, the task team called for effective communication between the council and the Department of Health as of paramount importance. To this end, I have committed myself to meet with the council chairpersons at least twice a year. The registrars will also meet with the Director-General at least twice a year.

Chairperson, let me now turn to the Forum of Statutory Health Councils. I am sure you are aware that we are formalising the Forum by including it in the National Health Bill. A week ago I had a meeting with the Forum and urged them to start implementing some of the decisions taken by making use of the protocol developed and accepted by almost all members of the Forum.

I was disturbed when informed that one council has not yet signed the protocol and to my surprise I was told that this was the Nursing Council. I urge this council to sign the protocol as soon as possible in order for the forum to begin to play its role.

The Forum will promote interprofessional liaison and communication between councils. It will ensure consistency in the actions and decisions of health professional councils. It will also make it easy for the Ministry to meet with one structure to discuss issues of common interest rather than meeting individual councils on one and the same issue.

There are priority areas and challenges that we need to work on. Most of you will be aware that we have just attended the Pre-World Health Assembly Commonwealth Health Minister's Meeting where we signed a Code of Practice for International Recruitment of Health Workers. I am sure that this is an issue that is close your heart as we all feel the impact of migration of health workers, especially nurses, from South Africa to developed countries.

The signing of this important document is but one of the strategies that we are working on to reduce what is called brain drain. In the code and other agreements within SADC and with other African countries, we agreed that we would not recruit from other developing countries particularly in Africa. It is our responsibility as part of NEPAD to ensure that South Africa, including the private health sector, does not actively recruit outside of a government-to-government agreement with a fellow African country. One of the strategies to stop this kind of recruitment is to create opportunities for our nurses to get exposure within an agreed upon exchange programme. SADC Health Ministers are pursuing this kind of an exchange programme and I am sure I can count on this council for support.

The other important task ahead of us is to ensure that standards and ethics are maintained within our profession. You need to ensure that poor service, negligence and unethical behaviour are dealt with decisively and in a transparent manner.

In the past, the public was dissatisfied with the handling of disciplinary cases against council members. Council either took too long to finalise the cases or penalties were too lenient. I want to encourage you as the new council to review what happened in the past and ensure that future actions are bold and decisive.

We also have a duty improve our ability to communicate with the public. I mentioned this last week when I met with the Forum that councils are very quiet on many topical issues that are of interest to health. We need to be creative and make the public to be more aware of the core business of our council through an effective communication programme. This programme should inform ordinary people of their rights that should be protected by our council.

I am aware that you have already submitted the Draft Nursing Bill to the Department and I encourage you to ensure that the Bill is in line with the recommendations of the task team. Once these amendments have been made, I shall make sure that the legal unit finalise it as speedily as possible.

As part of our legislative reforms, we need to improve the election legislative framework in order to make the council more representative of the demographics of this country. We need to also encourage more participation in the election process. I am told the percentage poll for registered nurses was about 4%; for enrolled nurses and nursing assistants, it was little more than 2%. I know that the election had to be done within a short space of time. But we need to review this and find ways of encouraging more participation in the election process amongst nurses.

In conclusion, I would like to highlight the role of nurses in health promotion and prevention of ill health. In this regard, I want to stress the importance of good nutrition and healthy lifestyles in improving the health status of our people. I encourage the council to ensure that nurses play an active role in health promotion and integrated nutrition strategy of the Department of Health.

I have just touched on a few issues that you have to face. There is no doubt that you have a very important role to play in the health care system. I am confident that you will take this role seriously and contribute in improving the lives our people.

With these few words, I wish well in your new challenges. Together, we will achieve the goal of a better health for all.

Thank you.

Source: Department of Health (http://www.doh.gov.za)