protecting the public, guiding the professions Annual Report

Transcription

1 guiding the professions Annual Report 2009/2010

2 HPCSA The Health Professions Council of South Africa (HPCSA) is a statutory body established under the Health Professions Act 56 of 1974 and is mandated to regulate the health professions in the Republic of South Africa in aspects pertaining to registration, education and training (including the setting of healthcare standards for training), ethics and ethical behavior, ensuring continuing professional development, and fostering compliance with healthcare standards. MISSION Quality healthcare standards for all VISION The HPCSA's vision is to enhance the quality of health by developing strategic policy frameworks for effective co-ordination and guidance of our 12 Professional Boards in: Setting healthcare standards for training and discipline in the professionals registered with the HPCSA; Ensuring on-going professional competence; and Fostering compliance with those standards.

3 TABLE OF CONTENTS SECTION ONE: PRESIDENT S REPORT 2 SECTION TWO: REGISTRAR S REPORT 5 SECTION THREE: EXECUTIVE OVERVIEW CPD, Registrations and Records 8 Finance 15 Human Resources 17 Information Technology 24 Legal Services 25 Public Relations and Service Delivery 29 Professional Boards 32 Support Services 34 SECTION FOUR: PROFESSIONAL BOARDS OVERVIEW Dental Therapy and Oral Hygiene 36 Dietetics and Nutrition 39 Emergency Care 45 Environmental Health 46 Medical and Dental 48 Medical Technology 52 Occupational Therapy, Medical Orthotics/Prosthetics and Arts Therapy 58 Optometry and Dispensing Opticians 61 Physiotherapy, Podiatry and Biokinetics 64 Psychology 67 Radiography and Clinical Technology 69 Speech/Language and Hearing 77 SECTION FIVE: CORPORATE OVERVIEW Corporate Governance 79 Administration and Management 81 SECTION SIX: FINANCIAL OVERVIEW 82 Report of the Independent Auditors 83 Councillors Report 84 Statement of Financial Position 86 Statement of Comprehensive Income 87 Statement of Changes in Equity 88 Statement of Cash Flows 89 Accounting Policies 90 Notes to the Financial Statements 96 1

4 PRESIDENT S REPORT Prof Nicky Padayachee, President HPCSA The healthcare professions are about life: helping to give birth to it, preserving it, healing and caring for it. Healthcare professionals are the bridge between science and society, bringing scientific knowledge to human health. They are about humanity and healing; integrity and compassion; competence and compliance. They are about gaining trust when people are most vulnerable. It is these professional values which drive our healthcare practitioners to go above and beyond the call of duty. It is said that Life is not measured by the number of breaths we take, but the moments that take our breath away (unknown). I applaud and celebrate the healthcare professionals who attended to patients during public sector strikes, or who alleviated the workloads of colleagues burdened by staff shortages in under-resourced facilities. I want to celebrate as heroes the emergency care practitioners who face life-threatening situations and suffer assault in the line of duty. While the HPCSA is committed to promoting ethical behaviour among its professionals, Council will also speak out about atrocities against its practitioners, reminding the public that all life is precious and is a gift; that all people deserve dignity and respect. Our healthcare professionals have sworn to uplift and promote the health of our people; let us celebrate life as together we strive to ensure quality healthcare for all. Do your little bit of good where you are; it s those little bits of good put together that overwhelm the world. Archbishop Desmond Tutu HPCSA website. Although Ethics, Medicine Law and Human Rights content has been integrated into the undergraduate curriculum, the Committee resolved not to insist on the 10% minimum of Human Rights and Ethics incorporated in the curriculum, following the concerns raised by the Medical and Dental Professions Board. Human Rights and Ethics are integrated into the entire curriculum and so cannot be considered as a stand-alone component. Over two dozen doctors signed a draft memorandum to the HPCSA on ethical conflicts and dilemmas regarding abortions following the Termination of Pregnancy (TOP) Amendment Bill, who have conscientious objection to any involvement with TOP. While the Committee initially resolved not to support any negligence or violation of patients rights by a professional practitioner registered with the HPCSA, the Registrar raised concerns regarding the resolution. Following lengthy discussions, the Committee resolved to place a statement on the HPCSA website to the following effect: Conscientious objection can be upheld if the practitioner has made a proper referral to the appropriate doctor; An incomplete abortion must be treated as an emergency; If a patient presents in an emergency without any referral, it is incumbent on the doctor to treat the patient and practitioners need to know that the patient s needs must be addressed; If practitioners are aware of other doctors acting unethically, they should report them to the HPCSA. 2 Human Rights and Ethics Council s Human Rights, Ethics and Professional Practice Committee had a busy year in 2009/10. Guidelines on Reproductive Health Ethics were developed and circulated for comment to all 12 Professional Boards. The Guidelines have been adopted and are on the Following an urgent request by a healthcare practitioner to review documents from the Free State Department of Health which aimed to curtail costs and consequently severely limited his ability to render a service, the Committee resolved that it was unacceptable for any structure to make decisions to curtail services, and that the HPCSA should be consulted before introducing

5 service restrictions. The Committee resolved to write to the National Department of Health and Heads of Department, re-advising the Minister on this matter. An ethical issue was posed to the Committee regarding the testing of a patient for infective agents in the event of occupational exposure of a healthcare worker, where the patient is unable to give informed consent. The Committee resolved that if the patient is under anaesthesia and cannot provide consent, the practitioner should wait for the patient to regain consciousness and seek his consent. If the patient gives consent, the test can be conducted. However, if the patient refuses to give consent, the practitioner may test the blood after obtaining written permission from the hospital s CEO, if s/he has a reasonable belief that there are clinical indications suggesting possibility of infection. Such a blood test must be based on the suspected clinical condition and be justified by the patient s signs and symptoms. The Committee resolved to appoint a Task Team to draw up terms of reference to increase the scope of discussion on this matter. Impaired Practitioners The Health Committee engages a non-punitive intervention approach for the voluntary treatment and/ or rehabilitation of impaired practitioners. It manages the compliance of practitioners suffering from mental or physical conditions or the abuse of or dependence on chemical substances which affect their competence, attitude, judgment or performance in a supportive way, while also protecting the public. Meetings with practitioners in four provinces over the year revealed their perception that the Health Committee was punitive towards reported practitioners. To correct this belief, national road shows profiled the Health Committee, and the HPCSA website now features its objectives and functions and allows easy access to information on the Health Committee by the public and practitioners. This has reaped rewards as healthcare employers and colleagues are more aware of the role of the Health Committee and are reporting more cases. As a result of the awareness campaign, the Health Committee reported an increase in impaired practitioners over the previous period, from 336 to 363 in 2009/10, particularly related to alcohol abuse, physical problems, mental illness and substance abuse. This is also a reflection of the accurate reporting of the Secretariat which has been mandated to audit the files twice a year to ensure the most up to date information regarding practitioners under its management. Impaired practitioners and students continue to cooperate with the Health Committee, and 15 cases were revoked. However, 37 new cases were reported during the period under review in categories ranging from schizophrenia, alcohol abuse, depression, mental illness, bipolar disorder, substance abuse, and pethidine abuse. The overall record of practitioner impairment for the year was as follows: Practitioners reported due to substance/drug abuse: 45 cases Practitioners reported due to alcohol dependency: 48 cases Practitioners with bipolar disorder: 28 cases Practitioners with Schizophrenia: 12 cases Practitioners with physical problems: 5 cases Practitioners reported due to pethidine abuse: 25 cases Practitioners with depression: 30 cases Practitioners who abuse Opiates : 8 cases Practitioners who abuse Benzodiazepine : 6 cases Practitioners who abuse Morphine : 1 cases Practitioners who abuse Cocaine : 6 cases Practitioners who abuse Mandrax : 1 case Practitioners who abuse Heroin : 1 case Practitioners who abuse Sleeping tablets: 1 case We are pleased to report that no impaired practitioners were referred back to institutions, 24 cases had conditions lifted, in 63 cases practitioners were declared not impaired, and four practitioners had their suspension lifted. Regrettably, six practitioners were suspended from the register, 17 practitioners relapsed, and we are saddened that 32 impaired practitioners passed away over this period. No kind action ever stops with itself. One kind action leads to another. Good example is followed. A single act 3

6 of kindness throws out roots in all directions, and the roots spring up and make new trees. The greatest work that kindness does to others is that it makes them kind themselves. Amelia Earhart Professional Conduct The HPCSA is committed to promote and protect South Africans right to quality healthcare. Concerted and collaborative efforts to remind the public of their right to complain about healthcare services and have their complaints investigated appear to be paying off. The Legal Department registered an increase of nearly 400 complaints over the previous period, from 2310 to 2703 in the 2009/10 financial year. The Office of the Ombudsman has also seen a rise in the number of matters referred for mediation, from 450 in 2008/09 to 491. In addition, the trend for finalised matters has increased over the past three years, with 199 matters finalised at the disciplinary inquiry level. These complaints were largely related to overcharging and charging for services not rendered, followed by insufficient care/mismanagement of patients. Complaints on incompetence, fraud and theft increased over this period. The Preliminary Committees finalised 631 matters and referred 203 matters for inquiry. Embracing Governance Principles The HPCSA continues to uphold excellent stewardship and governance principles as determined by the King III Report in executing its responsibilities. I particularly wish to commend and thank the members of the Council and the management of the HPCSA who were highly dedicated in their efforts to promote strict governance. I am pleased to refer you to the independent auditor s opinion on page 83 of this report. I wish to thank the Honourable Minister of Health, Dr Aaron Motsoaledi, for his confidence in and support of the HPCSA since he assumed office in May In particular, I extend my heartfelt thanks to all Professional Boards, Committees and Sub-Committees for their dedication to continue serving in their leadership positions while the process of appointing new members was being finalised. This ensured that the HPCSA could continue to deliver on its mandate of protecting the public and upholding and promoting quality healthcare standards for all through its guidance on educational, professional and ethical issues to all health professionals in the country. I also convey a special word of thanks to the former CEO and Registrar of the Council, Advocate Boyce Mkhize, who skillfully led the organisation for nine years. Advocate Mkhize resigned in January 2010, and his interim successor, Mrs Marella O Reilly, deserves a specific accolade for steering the HPCSA so competently as Acting Chief Executive Officer and Registrar. Prof Nicky Padayachee President, HPCSA 4

7 REGISTRAR S REPORT Marella O Reilly, Acting Chief Executive Officer and Registrar This report coincides with a significant period in South Africa s history, when the country unified to put on the best World Cup Soccer Tournament and the first on African soil. It was a time of exhilaration, pride and celebration when we pulled off what the world said could not be done. As Dale Carnegie said, Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all. The World Cup showed us what we as a nation could achieve when we all work together for a common goal, when we had hope and when everything was alive with possibility. This year, the HPCSA report celebrates that spirit of life - our assets: our people. Engaging With Stakeholders Efforts to continue raising the bar on excellent service delivery resulted in a number of initiatives which saw the HPCSA stepping up its engagement with stakeholders during 2009/10. This included highly successful and proactive media engagement which resulted in significantly improved coverage, and the strategic utilisation of the media through a database of media professionals which is continually updated to ensure the HPCSA s message and brand are maximised. A national road show campaign informed students of the requirements and the process of registering with Council, the latest ethical rules as well as information on the HPCSA s Health Committee which deals with impairment of practitioners. appointed to keep information on the site current. It s a funny thing about life; if you refuse to accept anything but the best, you very often get it. Somerset Maugham The HPCSA strives to deliver the best possible service and serving all the professionals on our register is a key priority. Council has duly noted the challenges experienced by staff shortages in dealing with complaints and queries, as well as the teething problems due to the implementation of the new ERS operating system which impacted on service delivery turnaround times. The HPCSA has appointed a dedicated Customer Service Officer to manage critical complaints and four additional call centre agents, and anticipates that these measures will substantially improve service delivery efficiency. New Rulings The HPCSA has issued new rulings on teeth whitening and the jejunoilleal bypass procedure, used historically for weight loss. Teeth whitening services by inappropriately qualified persons could result in loss of tooth sensitivity and in effective gum functioning. The rise in demand for this procedure prompted the Medical and Dental Board to consider the matter and review the scope of the dental professions. The Board resolved that only dentists, dental therapists and oral hygienists may perform teeth whitening procedures. To enhance inter-departmental communication within the Administration, an innovative daily communiqué was developed and circulated to all staff, while bimonthly staff newsletters kept employees abreast of the latest news and system developments. The HPCSA s website was redesigned to ensure that this key information channel to the world is user friendly and accessible, and a dedicated information specialist was The jejunoilleal bypass procedure, also known as small bowel bypass, involves the bypass of the jejunoilleum by more than 90%, leaving about 35 cm of the jejunum and 10 cm of the ileum with ingested food. This operation was associated with severe and occasionally life threatening situations such as acute hepatic failure, cirrhosis and chronic renal failure, and the HPCSA has banned the operation with immediate effect. 5

8 Undesirable Business Practices The matters put before the Committee on Undesirable Business Practices this year reflect a willingness by practitioners on its register to engage with the HPCSA, particularly with regard to approval of business practice models. Several matters served to highlight the integrated nature of Council and availability of expertise within HPCSA s various Committees and Professional Boards as opinions were sought and referrals made across these structures. A matter was received for the Committee on Undesirable Business Practices regarding a telephone-based family practitioner locum consultant service. Following representations by TELADOC, the Committee resolved to advise the service provider to revise their business model in alignment with the Ethical rules, inter alia that: They would not offer this service to persons under the age of 18 years, they may not issue prescriptions for dependenceproducing drugs, participating practitioners should disclose their details to the patient and accept liability for misdiagnosis or errors, services would be limited to common ailments, medical history taking would be a precondition for consultations, where possible, such consultations would occur with a patient s existing practitioner, an appropriate referral mechanism for physical examinations be established. Furthermore, the Committee will seek the opinion from the Human Rights, Ethics and Practice Management Committee on the acceptability of this business model, given the challenges raised by the development of the Booklet on Telemedicine. The Committee considered a query regarding the legality of establishing an informal medical scheme whereby patients would pay a General Practitioner R100 per person per month for free consultation regardless of the patient visits to the surgery. The motivation for this proposal was that it would enable poor patients access to private consultations. However, the Committee did not approve the proposal as it was in conflict with the HPCSA s ethical rules on the levying of fees for services not rendered. The Committee turned down an application for the supply of medical devices for use within a surgical environment which required 20 medical practitioners to purchase shares in the company. This conflicts with Ethical Rule 23 which prohibits practitioners from participating in the manufacture for commercial purposes, or in the sale, advertising or promotion of any medicine or medical device that amounts to selling medicine or medical devices to the public. Together with the Executive Committee of the Medical and Dental Professions Board, the Committee confirmed that medical practitioners may not erect signs in their practices to inform patients to visit the nearest hospital in an emergency. The two committees concurred that medical practitioners have an obligation to treat or manage patients in an emergency and that failure to do so contravened Council s guidelines and would be subject to professional misconduct processes. Several rulings by the Committee again serve to remind practitioners seeking group practice numbers that they are required to become an incorporated company before group practice numbers can be considered, and that only group practices, not independent practices, can receive group practice numbers. The matter was referred to the Professional Board for Optometry and Dispensing Opticians for finalisation. 6

9 Excellence Awards The National Excellence in Healthcare Awards is a prominent event on South Africa s health calendar, providing an opportunity to publicly acknowledge exceptional people in the health system. Appreciate everything your associates do for the business. Nothing else can quite substitute for a few well-chosen, well-timed, sincere words of praise. They re absolutely free and worth a fortune. Sam Walton This year the HPCSA again participated enthusiastically to honour practitioners who distinguished themselves in healthcare delivery, particularly by enhancing access to healthcare in previously disadvantaged communities, dedication to quality healthcare and outstanding performance, going beyond the call of duty, being ambassadors in promoting healthcare and committed to the Patient Charter principles, and contributing to sound professional behaviour and regulation. One group and three individuals received the 2009 Excellence in Healthcare Awards at the national ceremony. The multidisciplinary team of CBR Developmental Clinic received the group award for outstanding performance in enhancing access to quality healthcare of physically disabled children from disadvantaged communities in the Makana district. About 50 children are registered on the programme, which has empowered caregivers to provide quality care for the children, making concerns of negligence, poor mental health or coping skills of the caregivers a thing of the past. Mrs June McIntyre, Dr Paul Roux and Mr Robert Senkubuge were honoured for their superb efforts to promote health, professional ethics, their dedication to quality healthcare delivery and sound professional behaviour and regulation in the areas of wheelchair access, paediatric AIDS treatment for Africa, and caregiver involvement in rehabilitation of patients undergoing occupational therapy. When I assumed the leadership of the HPCSA as Acting CEO during the interim period of the appointment of the new Registrar, my task was greatly facilitated by the invaluable support I received from the HPCSA President, members of the Council, the 12 Professional Boards, Management and the Administrative staff. To all, I extend my heartfelt thanks for your professionalism and dedication to maintain and improve our services to our healthcare professionals and your commitment to quality healthcare provision. The HPCSA has a high calibre team which is driven by the desire for performance excellence in service of the country and its healthcare professionals. Over the period under review, we experienced significant leadership changes on the healthcare landscape, both nationally and locally here at the HPCSA. Nearly years ago, the Greek philosopher, Heraclitus said Change is the only constant in life. We embrace change as it is our ability to adapt to changing circumstances that defines our success. Healthcare is one of the most complex and varied sectors. Yet as we grapple with the challenges it presents and press on, we are rewarded with quiet satisfaction when we see the impact of patient empowerment, continuing professional development and high standards for training and discipline within the professions under our ambit. In closing, I remember the words of Earl Nightingale who said: Our attitude towards life determines life s attitude towards us. Live and celebrate this life we have at the HPCSA, which provides us with real opportunities and the privilege to make a meaningful difference in the lives of our people. Ms Marella O Reilly Acting Chief Executive Officer and Registrar 7

10 CPD, REGISTRATIONS AND RECORDS Barbara van Stade, General Manager Strategic objectives The Department CPD, Registrations and Records aims to provide an efficient process of practitioner registration, record management and effective management and implementation of the Continuing Professional Development (CPD) programme as part of its strategic objectives. Overview Continuing Professional Development The Health Professions Act (Act No. 56 of 1974) endorses Continuing Professional Development (CPD) as a means for practitioners to maintain and update their professional competence. This programme aims to address the emerging health needs of the country by promoting and protecting the public s interest as well as by ensuring the best possible delivery of healthcare service to the community. Each Professional Board with the exception of Psychology and Environmental Health has appointed external Accreditors to approve activities for CPD purposes. A performance assessment model was approved by the Council s CPD Committee with the recommendation that it be forwarded to all Professional Boards for their input. Furthermore, guidelines for the learning portfolio and practice audit were finalised during the year as an alternative option for practitioners to obtain and comply with CPD requirements. To ensure compliance, compulsory audits were initiated from February 2009 and five audits have been undertaken since then. Finalised audits have revealed that insufficient development in ethics, human rights and medical law remains the leading contributor to noncompliance. In the event of non-compliance, practitioners are granted a period of six months in which to comply with the requirements. Following this period, the practitioner is again audited and should the practitioner still not meet the necessary requirements, the Professional Board, in conjunction with the CPD Committee, has the option to amend the practitioner s registration status to work under supervision, or suspend the practitioner from practising their profession or have their name erased from the register until such time as proof of compliance is obtained. Ensuring safe records One of the benefits of the new ERS system is that all documentation, including client records will be electronically accessible. Consequently, all current client files need to be scanned into the new system, for storage off site. The scanning of all newly received applications has begun and despite initial teething problems, the process is now running smoothly. Following a successful campaign reminding clients of the importance of updating their contact details and the implementation of a dedicated address records@hpcsa.co.za, the Records section received a massive influx of address change requests. Council remains committed to ensuring changes of address and other contact details are constantly updated in order to effectively and efficiently communicate with clients. A total of 8188 requests for change of address and other personal details were successfully received and attended to. Registration and certificate services During the review period, 1714 certificates/letters of good standing, 1154 certified extracts, 381 intern duty certificates and 468 credential verifications were processed and issued. 8

11 On 5 December 2009, the department went live on the ERS system, and due to advanced training and coaching, Registration Officials were able to professionally and efficiently handle high volumes of walk-in clients. Officials worked after hours and weekends to deal with backlogs and minimise waiting periods for clients. Improved security is one of the key benefits of the new system. Registrations can now only be processed with the accurate allocation of registration fees. The registration certificate also boasts a watermark effect and a security border to deter forgery. Additional benefits of the new system are the efficient calculation of restoration fees, automated correspondence letters to clients for voluntary erasures, annual fee invoices and automatic exemption of practitioners who by virtue of their age, are no longer liable for the payment of annual fees. Total No of Practitioners Registered per Professional Board (As at 31 March 2010) Board Name Register Name Total DENTAL THERAPY AND ORAL HYGIENE DENTAL ASSISTANT (SUPPLEMENTARY REGISTER) 1,989 DENTAL ASSISTANTS 3,035 DENTAL THERAPISTS 974 ORAL HYGIENISTS 2,056 DENTAL THERAPY AND ORAL HYGIENE Total 8,054 DIETETICS DIETITIANS 4,049 NUTRITIONIST 56 SUPPLEMENTARY DIETITIANS 1 DIETETICS Total 4,106 EMERGENCY CARE PRACTITIONERS AMBULANCE EMERGENCY ASSISTANTS 10,606 BASIC AMBULANCE ASSISTANTS 88,031 EMERGENCY CARE ASSISTANTS 12 EMERGENCY CARE PRACTITIONERS 91 EMERGENCY CARE TECHNICIANS 111 OPERATIONAL EMERGENCY CARE ORDERLYS 781 PARAMEDICS 1,621 EMERGENCY CARE PRACTITIONERS Total 101,253 9

12 ENVIRONMENTAL HEALTH OFFICERS ENVIRONMENTAL HEALTH PRACTITIONERS 7,456 FOOD INSPECTORS 44 ENVIRONMENTAL HEALTH OFFICERS Total 7,500 MEDICAL AND DENTAL PROFESSIONS ANAESTHETIST S ASSISTANTS 8 BOARD BIOMEDICAL ENGINEERS 14 CLINICAL ASSOSCIATES 8 CLINICAL BIOCHEMISTS 36 DENTISTS 10,465 GENETIC COUNSELLOR 1 GENETIC COUNSELLORS 30 HEALTH ASSISTANTS 29 INTERN GENETIC COUNSELLORS 1 INTERN MEDICAL BIOLOGICAL SCIENTISTS 54 INTERN MEDICAL PHYSICIST 7 INTERN MEDICAL SCIENTIST 9 INTERNS 16,024 MEDICAL PHYSICISTS 183 MEDICAL PRACTITIONERS 83,975 MEDICAL SCIENTIST 8 MEDICAL SCIENTISTS 1,073 SUPPLEMENTARY MEDICAL SCIENTISTS 5 MEDICAL AND DENTAL PROFESSIONS BOARD Total 111,930 MEDICAL TECHNOLOGY BLOOD TRANSFUSION TECHNICIANS 1 CYTO-TECHNICIANS 4 MEDICAL TECHNICIANS 3,252 MEDICAL TECHNOLOGISTS 10,204 MEDICAL TECHNOLOGY INTERN 3 SUPPLEMENTARY LABORATORY ASSISTANTS 254 SUPPLEMENTARY MEDICAL TECHNICIANS 196 MEDICAL TECHNOLOGY Total 13,914 10

13 OCCUPATIONAL THERAPY MEDICAL ARTS THERAPISTS 63 ORTHOTICS & PROSTHETICS & ARTS ASST MED ORTH PROST & LEATHERWORKERS 15 THERAPY INTERN MEDICAL ORTHOTISTS AND PROSTHETISTS 22 MEDICAL ORTHOTISTS AND PROSTHETISTS 637 OCCUPATIONAL THERAPISTS 6,993 OCCUPATIONAL THERAPY ASSISTANTS 987 OCCUPATIONAL THERAPY TECHNICIANS 193 ORTHOPAEDIC FOOTWEAR TECHNICIANS 105 ORTHOPAEDIC TECHNICAL ASSISTANTS 101 SINGLE-MEDIUM THERAPISTS (OCCUPATIONAL 64 THERAPY) SUPPLEMENTARY MEDICAL ORTHOTISTS AND 7 PROSTHETISTS SUPPLEMENTARY OCCUPATIONAL THERAPISTS 1 OCCUPATIONAL THERAPY MEDICAL ORTHOTICS & PROSTHETICS & ARTS THERAPY Total 9,188 OPTOMETRY AND DISPENSING OPTICIANS DISPENSING OPTICIANS 420 OPTOMETRISTS 4,179 ORTHOPTISTS 34 SUPPLEMENTARY OPTICAL DISPENSERS 25 SUPPLEMENTARY OPTOMETRISTS 39 OPTOMETRY AND DISPENSING OPTICIANS Total 4,697 PHYSIOTHERAPY PODIATRY AND BIOKINETICISTS 1,514 BIOKINETICS MASSEURS 42 PHYSIOTHERAPISTS 10,547 PHYSIOTHERAPY ASSISTANTS 558 PHYSIOTHERAPY TECHNICIANS 9 PODIATRISTS 380 REMEDIAL GYMNASTS 4 SUPPLEMENTARY PHYSIOTHERAPISTS 11 SUPPLEMENTARY PODIATRISTS 19 PHYSIOTHERAPY PODIATRY AND BIOKINETICS Total 13,084 PSYCHOLOGY INTERN PSYCHOLOGISTS 6,226 PSYCHOLOGISTS 10,567 PSYCHOMETRISTS 7,945 PSYCHO-TECHNICIANS 833 REGISTERED COUNSELLORS 954 PSYCHOLOGY Total 26,525 11

14 RADIOGRAPHY AND CLINICAL CLINICAL TECHNOLOGISTS 1,575 TECHNOLOGY ELECTRO-ENCEPHALOGRAPHIC TECHNICIANS 127 GRADUATE CLINICAL TECHNOLOGISTS 1 RADIATION TECHNOLOGISTS 30 RADIOGRAPHERS 11,628 RESTRICTED SUPP DIAG RADIOGRAPHERS 33 SUPPL ELECTRO-ENCEPH TECHNICIANS 1 SUPPLEMENTARY CLINICAL TECHNOLOGISTS 28 SUPPLEMENTARY DIAGNOSTIC RADIOGRAPHERS 879 SUPPLEMENTARY RADIATION TECHNOLOGISTS 1 RADIOGRAPHY AND CLINICAL TECHNOLOGY Total 14,303 SPEECH LANGUAGE AND HEARING AUDIOLOGISTS 388 PROFESSIONS AUDIOMETRICIANS 32 COMMUNITY SPEECH AND HEARING WORKERS 81 HEARING AID ACOUSTICIANS 217 SPEECH AND HEARING CORRECTIONISTS 38 SPEECH THERAPISTS 790 SPEECH THERAPISTS AND AUDIOLOGISTS 3,230 SPEECH THERAPY ASSISTANTS 7 SUPPLEMENTARY AUDIOLOGISTS 1 SUPPLEMENTARY HEARING AID ACOUSTICIANS 6 SUPPLEMENTARY SPEECH THERAPISTS AND AUDI- OLOGISTS 1 SPEECH LANGUAGE AND HEARING PROFESSIONS Total 4,791 Grand Total 319,345 12

15 Total No of Students Registered per Professional Board (As at 31 March 2010) Board Name Registrar Name Total DENTAL THERAPY AND ORAL HYGIENE STUDENT DENTAL ASSISTANT 1,321 STUDENT DENTAL THERAPISTS 571 STUDENT ORAL HYGIENISTS 858 DENTAL THERAPY AND ORAL HYGIENE Total 2,750 DIETETICS STUDENT DIETITIANS 2,812 STUDENT NUTRITIONIST 124 DIETETICS Total 2,936 EMERGENCY CARE PRACTITIONERS STUDENT EMERGENCY CARE PRACTIONERS 130 STUDENT EMERGENCY CARE TECHNICIANS 533 STUDENT PARAMEDICS 1,094 EMERGENCY CARE PRACTITIONERS Total 1,757 ENVIRONMENTAL HEALTH OFFICERS STUDENT ENVIRONMENTAL HEALTH OFFICERS 5,256 ENVIRONMENTAL HEALTH OFFICERS Total 5,256 MEDICAL AND DENTAL PROFESSIONS MEDICAL STUDENTS 23,487 BOARD STUDENT BIOMEDICAL ENGINEERS 1 STUDENT CLINICAL ASSOCIATES 96 STUDENT CLINICAL BIOCHEMISTS 1 STUDENT DENTISTS 4,190 STUDENT GENETIC COUNSELLORS 23 STUDENT INTERNS 13,579 STUDENT MEDICAL PHYSICIST 94 STUDENT MEDICAL SCIENTIST 69 STUDENT MEDICAL SCIENTISTS 528 MEDICAL AND DENTAL PROFESSIONS BOARD Total 42,068 MEDICAL TECHNOLOGY STUDENT LABORATORY ASSISTANT 505 STUDENT MEDICAL TECHNICIANS 4,026 STUDENT MEDICAL TECHNOLOGISTS 7,287 MEDICAL TECHNOLOGY Total 11,818 OCCUPATIONAL THERAPY MEDICAL ART THERAPY STUDENTS 34 ORTHOTICS & PROSTHETICS & ARTS DELETED ART THERAPY STUDENT 2 THERAPY STUDENT ASST MED ORTH PROST & 16 LEATHERWORKERS STUDENT MEDICAL ORTHOTISTS AND PROSTHETISTS 345 STUDENT OCCUPATIONAL THERAPISTS 4,261 STUDENT OCCUPATIONAL THERAPY ASSISTANT 131 OCCUPATIONAL THERAPY MEDICAL ORTHOTICS & PROSTHETICS & ARTS THERAPY Total 4,789 13

16 OPTOMETRY AND DISPENSING OPTICIANS STUDENT DISPENSING OPTICIANS 487 STUDENT OPTOMETRISTS 2,640 OPTOMETRY AND DISPENSING OPTICIANS Total 3,127 PHYSIOTHERAPY PODIATRY AND STUDENT BIOKINETICISTS 1,514 BIOKINETICS STUDENT PHYSIOTHERAPISTS 5,056 STUDENT PHYSIOTHERAPY ASSISTANTS 6 STUDENT PODIATRISTS 378 PHYSIOTHERAPY PODIATRY AND BIOKINETICS Total 6,954 PSYCHOLOGY STUDENT PSYCHOLOGISTS 5,277 PSYCHOLOGY Total 5,277 RADIOGRAPHY AND CLINICAL STUDENT CLINICAL TECHNOLOGISTS 1,175 TECHNOLOGY STUDENT ELECTRO-ENCEPHALOGRAPHIC 38 TECHNICIANS STUDENT RADIATION TECHNOLOGISTS 18 STUDENT RADIOGRAPHERS 4,710 STUDENT SUPPLEMENTARY DIAGNOSTIC RADIOGRAPHERS 163 RADIOGRAPHY AND CLINICAL TECHNOLOGY Total 6,104 SPEECH LANGUAGE AND HEARING STUDENT AUDIOLOGISTS 253 PROFESSIONS STUDENT COMMUNITY SPEECH AND HEARING 17 WORKERS STUDENT HEARING AID ACOUSTICIANS 28 STUDENT SPEECH THERAPISTS AND AUDIOLOGISTS 2,319 SPEECH LANGUAGE AND HEARING PROFESSIONS Total 2,617 Grand Total 95,453 14

17 FINANCE Motlatjo Rampedi, Chief Financial Officer Strategic objectives The Financial Services Department ensures Council maintains satisfactory accounting records and is responsible for preparing financial statements and related information, as well as ensuring the professional management of internal financial controls which will provide reasonable assurance regarding the achievements of Council objectives. Overview Beginning of November 2009 all the financial modules were migrated to the Oracle system resulting in the audit been done in two different financial systems. The migration of the data was the cause of numerous challenges, which resulted in the external audit only commencing in October 2010, which is six months after the financial year end. At that time it was assumed that all system related challenges were resolved. It was later discovered while the audit was underway that the migrated data as well as additional systemic issues required more attention. These additional issues were attended to by the Finance Team whilst the other challenges were referred to the Oracle Consultants for resolution. Despite the additional challenges faced, the audit was finally completed in March Notwithstanding the challenges experienced, the revenue target set was achieved, whilst effective and sustainable budget control measures were successfully implemented. The Council is currently faced with the challenge of a high number of unallocated payments, received due to the incorrect use of reference numbers on payments. has affected the department s service delivery levels as much productive time was spent reconciling unallocated payments of accounts. This negatively impacted on the department s turnaround time for the issuing of practising cards. Debit Orders During the 2009/2010 period, practitioners accounts were loaded with debit order payment instructions. 129 transactions failed the first bank test due to either accounts been inactive or invalid, while 538 transactions were rejected by the bank mainly due to non sufficient funds and stop payments which could be as a result of the late submission of the file. The delay in the submission of the file was due to the technical challenges experienced as it was the first time that we did the run in the Oracle system which had additional mandatory fields. Controls We are pleased to report that expenses during the year were in line with budget projections due to the implementation of effective control measure. These measures ensured all expenses incurred were accurately budgeted for whilst unbudgeted expenses were taken to the relevant structures for approval, if deemed necessary. However, the high cost of professional conduct inquiries, some of which were heard in court, were not controllable and consequently these expenses were not in line with budget provision. The audited financial statements bear testament to the effectiveness of our system of internal controls. The Finance Team worked tirelessly on the suspense account with the aim of reducing the balance in the account. This lack and incorrect use of reference number 15

18 Increase in Annual Fees As a statutory body, the HPCSA is not subsidised by government and to meet its mandate of protecting the public and guiding the professions, it is reliant on fees and fines paid by practitioners. For the year 2009/2010 Council s annual fee increases were different for each Board. The annual fees are based on the strategic objectives and their administration percentage allocation. Percentage allocation is based on a formula which takes into account the number of practitioners registered per Board and the combined income strength. Annual fees are used to cover the costs of administering the professions under the ambit of Council in terms of registration, maintaining standards of education and training, as well as ensuring fair standards of professional practice. Factors which attributed to the increase include rising costs in executing disciplinary cases which Council is legally obligated to investigate and where necessary prosecute, as well as the various committees that look into different Board issues. CORPORATE GOVERNANCE The effective adherence to good corporate governance principles and the maintenance of an adequate system of internal controls resulted in HPCSA obtaining an unqualified audit opinion from our external auditors for this financial year. We proudly refer you to page 82 to 104 for the Audited Financial Statements reflecting our implementation of these sound corporate governance principles. 16

19 HUMAN RESOURCES Vusi Mncwango, Senior Manager The Council regards its employees as its most important asset, and to this end has established and implemented best practice human resource systems, policies and procedures. This vision has been further supported through the creation of a learning environment aimed at attracting and retaining competent employees who, through their productivity ensure efficient and effective service delivery to both internal and external clients. Overview The review period was characterised by the implementation of a totally new operating system which required focussed efforts in ensuring buy-in and acceptance of the new system by staff. This was successfully achieved with the implementation of a change management project for the duration of implementation and positive engagement with staff through a change agent network. Training and skills development received the highest priority to ensure employees are well equipped and knowledgeable to effectively work in the new system. Happy and healthy employees remained paramount through the implementation of the Employee Assistance Programme (EAP), HIV/AIDS management, programme for people living with disabilities, sports and recreation. Change Management The implementation of Council s new ERS operating system required employee acceptance of and commitment to the fundamental change in the way we work. The process of engendering a fundamental change necessitated effective change management. This successful network contributed towards employee commitment and ensuring ongoing organisational effectiveness during the transition from the old to the new system. Climate Survey A climate survey was conducted amongst staff in stages to measure perceptions regarding the implementation of Oracle system. Recommendations from the survey were effectively utilised to minimise teething problems experienced at various roll-out stages. Employee Relations Employee relations seek to advocate consistent and fair labour practices and promote a harmonious relationship between management, employees and the recognised trade union. The HPCSA managed to construct healthy communication channels with the trade union and other stakeholders, resulting in a positive contribution towards the Council s transformation agenda. Furthermore, a transformation committee was established to create a platform for management and the trade union to regularly interact on transformational issues that may impact on employees conditions of employment. Whilst it is acknowledged that disagreements are inherent to the labour relations sphere, our engagements with our stakeholders were characterised by ongoing efforts to build a mutually beneficial relationship. Consequently a change agent network was established to engage those staff members most impacted by the changes taking place within the HPCSA and to create a platform for the exchange of information. 17

20 Performance Management A Performance Management and Development System (PMDS) was implemented during the 2009/10 financial year to ensure the realisation of strategic goals. The PMDS created an environment in which employees were encouraged to perform to the best of their abilities with meaningful guidance and support from managers. During the period under review the PMDS resulted in the following outcomes: Performance Assessment Outcomes as at 31 March 2010 combined senior management and general employees): PERFORMANCE ASSESSMENT OUTCOMES FOR 2009/2010 FINANCIAL YEAR No of employees Male Female African Coloured Indian White African Coloured Indian White With A rating With B rating With C rating With D rating With A on probation With B on probation With C on probation TOTAL Employee Wellness In order to pro-actively and holistically address the health and well-being of employees, the employee wellness programme, under the professional expertise of the Health Services Specialist implemented the following initiatives during the period: Employee Assistance Programme In partnership with renowned and accredited health service providers, the Employee Assistance Programme offers an excellent eight hours daily consultative service available to all employees and their immediate family members. HIV/AIDS Management Programme The effect of HIV/AIDS remains a high-risk for the organisation. We are pleased to announce that 61 employees attended a voluntary counselling and testing session on World AIDS Day, 1 December, where prominent speakers addressed employees on the topic. While the number of employees diagnosed with HIV/AIDS is minimal, in light of the high prevalence of people living with HIV and AIDS in South Africa and considering the high risk average age of the HPCSA s workforce, we are cognisant that the results are not a true reflection of the number of employees living with this pandemic. As such, concerted efforts are being made to encourage employees to attend to these voluntary counselling and testing sessions. Programme for People Living with Disabilities The Council continues to support its strategy to employ people living with disabilities. Initially, this initiative formed part of the HPCSA s programme 18

21 for increasing the productivity of employees, as the Council had implemented the Performance Management Development System at the beginning of the financial year under review. A comprehensive programme based on supervisorsupervisee, one-on-one coaching and counselling was developed and implemented to stimulate confidence and enhance the competencies of employees living with disabilities in the HPCSA workplace. Sports and Recreation Sports and recreation have been taken to another level in the HPCSA. Sport has been identified as a mechanism that unites and bridges cultural gaps in a diversified society, and therefore we offer staff the opportunity to participate in different sporting and recreation games like soccer, table tennis, netball and volleyball. C o m p e t i n g in sport tournaments against other organisations is also fully encouraged, and we have found the spinoffs to be excellent cooperation and networking opportunities. Employment Equity In terms of the Employment Equity Act, as a designated employer the HPCSA annually submits equity and progress reports. We are pleased to report that employment equity targets, as set out in the provincial and national guidelines, were well achieved during the reporting period. Staff Composition and promotions HPCSA s gender and age analysis for the period is reflected in the table below. Council employed 177 permanent and 13 temporary employees at the end of the 2009/2010 financial year. Of these, 64% fell within the core business unit, i.e. Registrations and Professional Boards. Profile of the total workforce as at 31 March 2010 (combined with race and gender breakdown): Foreign Male Female nationals Occupational category Salary levels African Coloured Indian White African Coloured Indian White Male Female Total Legislators, Senior officials and managers FU- DU Professionals DL-CU Technicians and associate professionals CL - BU Clerks BL Service and sales workers BL Elementary occupations BL - AU People with disabilities Total permanent employees Non-permanent employees Total During the period under review, 12 employees were promoted, while 51 employees progressed up a notch within their salary level. 19

22 Notch Progression by department as at 31 March 2010 Department Promotions to another level Progressions to another notch within salary level % of employees promoted to another level Office of the Registrar % CPD, Registrations and % records Legal services % Financial services % Information technology 1 0 0% Professional Boards % Public Relations % Support services % Human resources % Total % Training and Skills Development The Council regards the development of its staff as a pre-requisite to the successful implementation of its turnaround strategy. The Human Resources and Remuneration Committee (HR & REMCO) identified training as a key component to empower and enhance the capability of staff. Consequently 1% of the total salary bill has been allocated towards training. Building of skills capacity in critical areas within the organisation remained a key focus during the year under review. Due to the implementation of the new operating system, staff received training in the areas of financial management, management accounting, human capital management, materials management and document management. The aim of the training was to equip employees with the requisite knowledge and skills to operate the Oracle system. Study Bursaries Out of 39 applications received by the Human Resources department for bursaries, 34 bursaries were approved and issued to empower staff to further their studies at academic institutions. A total of five applications were declined due to the failure of applicant in meeting the necessary requirements. Staff Turnover The current staff turnover percentage for the organisation is 6.4%. As a counter-measure, Management took a decision to offer contract employees permanent positions. This resolution brought about stability in the retention of critical skills. The Human Resources Development Strategy was developed and aligned to current transformation initiatives and programmes, forecasting on organisational needs. To this end, various training and development programmes have been rolled out as reflected hereto: 20

23 Training and skills development provided for the period 1 April 2009 to 31 March 2010 Occupational category Salary levels African Coloured Male Indian White African Female Coloured Indian White Other forms of training Male Female Learnerships Total Legislators, Senior officials and managers FU- DU Professionals DL-CU Technicians and associate professionals CL - BU Clerks BL Service and sales workers BL Elementary occupations BL - AU People with disabilities Total permanent employees Leave Utilisation The HPCSA s leave policy emphasises the need to carefully monitor the utilisation of sick leave. The following tables provide an indication of the use and cost of annual leave and sick leave. Annual leave utilisation for the period 1 April 2009 to 31 March 2010 Department Total days taken % of total Leave cost Senior Management (F1 - D3) % 212, Highly skilled supervision (D2 C4) % 210, Highly skilled production (C3 C1) % 223, Skilled (B4 B2) % 266, Lower skilled (B1 A) % Total % 932,

24 Sick Leave utilisation for the period 1 April 2009 to 31 March 2010 Department Total days taken % of total Sick Leave Cost Senior Management (F1 - D3) % 175, Highly skilled supervision (D2 C4) % 286, Highly skilled production (C3 C1) % 352, Skilled (B4 B2) % 1,119, Lower skilled (B1 A) % 31, Total % 1,964, Labour relations The following table summarises the outcome of disciplinary hearings conducted within the HPCSA for the year under review. Misconduct and disciplinary hearings finalised, 1 April 2009 to 31 March 2010 Outcome Number % of total Correctional counselling 1 7 Verbal warning 0 0 Written warning 7 50 Final written warning 1 7 Suspended without pay 0 0 Fine 1 7 Demotion 0 0 Dismissal 3 22 Not guilty 1 7 Total Misconduct addressed at disciplinary hearings for the period 1 April 2009 to 31 March 2010 Type of misconduct Number % of total Bribery and defeating the ends of justice Dereliction of duty and incapacity 2 25 Fraud and unauthorized use of pin code Poor work performance 2 25 Total