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Annual Report. Presentation by Adv. Boyce Mkhize Registrar and CEO to Parliamentary Portfolio Committee: Health 19 October 2004. Structure of Presentation. HPCSA and its Mandate Structure and Current Leadership Staff Structure and Equity Profile Key Strategic Focus Areas:

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Annual Report

Presentation by

Adv. Boyce Mkhize

Registrar and CEO


Parliamentary Portfolio Committee: Health

19 October 2004

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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

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Founded for Public Protection


Quality healthcare standards for all


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

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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

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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

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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

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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

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HPCSA Structure


52 Members

Executive Committee

10 Members

Management Committee

4 Members

Finance & Investment




Human Rights and

Ethics Committee





Professional Conduct

Review Committee

Committee on Undesirable

Business Practices

12 Professional Boards

Occupational Therapy &

Medical Orthotics


Dental Therapy

& Oral Hygiene

Environmental Health


Speech, Language &

Hearing Professions

Optometry & Dispensing


Physiotherapy, Podiatry

& Biokinetics

Radiography & Clinical


Medical Technology

Medical & Dental



Emergency Care Personnel

HPCSA Administration

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Composition of HPCSA

  • 25 Persons designated by Professional Boards

    (At least one per Professional Board, the rest proportional to the number of registered practitioners within each Professional Board)

  • 1 Person 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

  • 52 Total

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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

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Transformation : HPCSA

Old New

MDB 27%/62% 60%/40%

DTB 33%/67% 60%/40%

EMC 35%/65% 55%/45%

Psy 43%/56% 63%/27%

Optom 28%/61% 46%/63%

MedTech 38%/61% 70%/30%

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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

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Current Leadership

Prof. Nicky Padayachee


Prof. Letticia Moja

Vice President

Adv. Boyce Mkhize


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Administration Structure


Adv. Boyce Mkhize



Senior Manager:

Legal Services

Adv. Tshepo Boikanyo

Senior Manager:

Professional Boards

Johann Coetzer

Senior Manager: CPD,

Registration & Records

Barbara van Stade

Senior Manager:


Nathaniel Seleka

Manager: Information


Walter Maphosa

Manager: PR and

Service Delivery

Anina Steele

Manger: Support


Anton Swanepoel

Manager: Human


Nthabiseng Mphuthi

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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

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Registration - Statistics

As at 31 March 2004: 105 441 practitioners

  • Dental Therapy & Oral Hygiene 1311

  • Dietetics 1511

  • Environmental Health Practitioners 2536

  • Emergency Care Practitioners 26726

  • 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

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Registration - Challenges


  • 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

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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

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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)

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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

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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

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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

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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

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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

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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

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HPCSA Contact Details

  • Physical Address:

    553 Vermeulen Street, Arcadia, (Cnr Vermeulen & Hamilton Streets)

  • Postal Address:

    P O Box 205, Pretoria, 0001

  • Telephone : (012) 338 9300/01 Fax: (012) 328 5120

  • Website:

  • E-mail: [email protected]