1. Annual Report Presentation by Adv. Boyce Mkhize Registrar and CEO to Parliamentary Portfolio Committee: Health 19 October 2004

2. Structure of Presentation HPCSA and its Mandate Structure and Current Leadership Staff Structure and Equity Profile Key Strategic Focus Areas: –Registration –Professional Conduct –Continuing Professional Development –Finances Broader Challenges

3. Founded for Public Protection Vision Quality healthcare standards for all Mission To enhance the quality of health by developing strategic policy frameworks for effective co-ordination and guidance of the professional boards in: Setting health care standards for training and discipline in the professions registered with Council Ensuring on-going professional competence; and Fostering compliance with those standards

4. Founded for Public Protection Statutory body established in terms of the Health Professions Act (Act No.56 of 1974) HPCSA has 12 Professional Boards operating under its auspices The Professional Boards control the professions within their ambit under the overarching coordination and guidance of the HPCSA

5. Founded for Public Protection To ensure quality of life for all South Africans by: Promoting the health of South African population Determining and upholding standards of education & training Determining and maintaining standards of professional practice and conduct Advising Minister of Health on matters pertaining to Act

6. Functions of Professional Boards Operate as Standards Generating Body (SGB), developing education and training outcomes Develop professional practice framework Develop national strategy and action plans re. training, supervision and career path development (including Internship) Evaluate registration applications Exercise Education, Training and Quality Assurance (ETQA) functions on behalf of HPCSA

7. Functions of Professional Boards Evaluate education and training courses and academic facilities Recognise courses for registration and additional qualifications purposes Develop policy documents and issue rulings to guide professions Conduct prelim & professional conduct inquiries Formulate regulations and rules of conduct and professional practice Assess non-compliant applications for registration, including foreign applications

8. HPCSA 52 Members Management Committee 4 Members Finance & Investment Committee Audit Committee HPCSA Structure Dental Therapy & Oral Hygiene Dietetics Emergency Care Personnel Environmental Health Practitioners Medical & Dental Medical Technology Occupational Therapy & Medical Orthotics /Prosthetics Optometry & Dispensing Opticians Physiotherapy, Podiatry & Biokinetics Psychology Radiography & Clinical Technology Speech, Language & Hearing Professions HPCSA Administration Executive Committee 10 Members Human Rights and Ethics Committee CPD Committee Health Committee 12 Professional Boards Professional Conduct Review Committee Committee on Undesirable Business Practices

9. Composition of HPCSA 25Persons designated by Professional Boards (At least one per Professional Board, the rest proportional to the number ofregistered practitioners within each Professional Board) 1Person employed by Dept of Health, appointed by Minister 1 Person employed by Dept of Education, appointed by Minister 9 Registered persons appointed by Minister of Health 1 Person employed by SA Military Health Services, appointed by Minister of Defense 3 Persons appointed by the Committee of University Principals (SAUVCA) 2 Persons appointed by the Committee of Technikon Principals 9 Public representatives who are not registered with Council (one for each province), appointed by the MEC’s responsible for Health in each province 1 Person versed in Law, appointed by Minister of Health 52Total

10. Transformation : HPCSA Demographic Profile First elections according to new requirements took place end 2003 Council now reflects 63% of individuals from historically disadvantaged communities and a much significant representation of women Comparator previous term: 54% Black vs 46% White

11. Transformation : HPCSA OldNew MDB27%/62% 60%/40% DTB33%/67%60%/40% EMC35%/65%55%/45% Psy43%/56%63%/27% Optom28%/61%46%/63% MedTech38%/61%70%/30%

12. Transformation HPCSA Governance Issues Charter for Councillors---covenanting to good professional and ethical behaviour of Councillors Financial Policies and new procurement procedures Audit & Risk Management Committee; Finance and Investment Committee, HR and Remuneration Committee---Governance Structures Annual report & independent auditors

13. Current Leadership Prof. Nicky Padayachee President Prof. Letticia Moja Vice President Adv. Boyce Mkhize Registrar/CEO

14. Administration Structure Registrar/CEO Adv. Boyce Mkhize COO (Vacant) Senior Manager: Legal Services Adv. Tshepo Boikanyo Senior Manager: Professional Boards Johann Coetzer Senior Manager: CPD, Registration & Records Barbara van Stade Senior Manager: Finance Nathaniel Seleka Manager: PR and Service Delivery Anina Steele Manager: Information Technology Walter Maphosa Manager: Human Resources Nthabiseng Mphuthi Manger: Support Services Anton Swanepoel

15. Administration Equity Profile Occupational Category MaleFemaleTotal AfricanColouredAsianWhiteAfricanColouredAsianWhite Senior Officials & Managers 4228 7 % Professionals623213 10 % Technicians & Associated Professions 71152622 18 % Clerks16330911877 62 % Maintenance Workers 224 3 % Total35 28 % 3 2 % 1 1 % 5 4 % 40 32 % 11 9 % 1 1 % 28 23 % 124 44 (35 %)80 (65 %)

16. Administration Equity Profile Occupational Category BlackWhiteTotal AfricanColouredAsian Senior Officials & Managers 40048 Professionals900413 Technicians & Associated Professions 1221722 Clerks461211877 Maintenance Workers40004 Total5732233124 73 %27 %

17. Registration with HPCSA Registration with HPCSA is a legislative requirement and precondition for the practice of any profession registrable in terms of the Act Performance of professional acts for reward without such registration attracts criminal sanctions

18. Registration - Statistics As at 31 March 2004: 105 441 practitioners Dental Therapy & Oral Hygiene 1311 Dietetics 1511 Environmental Health Practitioners 2536 Emergency Care Practitioners26726 Medical & Dental 36995 Medical Technology 5921 Occupational Therapy & Medical Orthotics/Prosthetics 3604 Optometry & Dispensing Opticians 2509 Physiotherapy, Podiatry & Biokinetics 5630 Psychology 7724 Radiography & Clinical Technology 5974 Speech, Language & Hearing Professions 1709

19. Registration - Challenges Erasures More than 8000 erased due to non-payment of annual fees Tracking of practitioners-- challenge Foreign Qualified Practitioners Policy framework being revised to streamline and harmonize with National Health Department policy eg. No private practice registration except for RSA citizens

20. Professional Conduct - Statistics Received 1341 complaints previous year – increase of 27 % Unable to finalise new cases and backlog of old cases: –Increased Legal Services’ in-house capacity –Outsourced 108 old cases to external legal firms – 23 cases have been finalised in 3 months; 33 hearing dates

21. Professional Conduct - Statistics As at 31 March 2004 finalised 203 professional conduct cases (14 per month) Conviction rate: 86 % 54 % of guilty verdicts in Dishonesty/Criminality category 22 % of guilty verdicts in Practice Issues 19 % of guilty verdicts in Treatment 5 % of guilty verdicts in Personal Behaviour As at 30 September 2004 finalised 132 cases (22 per month)

22. Professional Conduct - Challenges System of Peer Review creates perception of professional and not public protection Perceptions about light/inconsistent sentences Professional Conduct Review Committee to Council level to monitor processes and issue guidelines This Committee is developing guidelines to improve consistency and tightening of sentences Creating ombudsperson to facilate processing of minor complaints & drafting charge sheets

23. Professional Conduct - Challenges Introducing categorisation of complaints Empowering Committees of Preliminary Inquiry to finalise “lesser” complaints Council proposing inclusion of community representatives on Professional Conduct Committees Initiatives can only be realised through revision of the Act

24. Continuing Professional Development Council Committee appointed to re- configure current CPD system Current system is time based, practitioners earn points for related (or non-related) CPD activities Proposed system is outcome based, practitioners earn units only for related, measurable outcomes

25. Sustaining the HPCSA Favourable Audit Opinion Generated about R63 million Gross Revenue compared to R45million previous year Net surplus from Operations – R402 980 Provisions for post-retirement medical benefits, leave and legal services costs Revised HR benefits and conditions

26. Broader Challenges Over-exerting power of private health care establishments over practitioners Disintegrated regulatory processes between HPCSA and other structures like Council for Medical Schemes Interference by Medical Aid Schemes on practitioners’ autonomy/ independence

27. Broader Challenges Barriers to quality health-care access manifested through inadequate infrastructure, equipment and capacity [ Council sometimes forced to withdraw internship status for certain internship sites] Barriers to education and training opportunities in health-care---stringent admission criteria which are sometimes indirectly discriminatory— notion of independence of institutions needs review in this regard

28. HPCSA Contact Details Physical Address: 553 Vermeulen Street, Arcadia, (Cnr Vermeulen & Hamilton Streets) Postal Address: P O Box 205, Pretoria, 0001 Telephone : (012) 338 9300/01Fax: (012) 328 5120 Website: www.hpcsa.co.za E-mail: hpcsa@hpcsa.co.za

29. Thank you for your attention