Johannesburg — Medical botch-ups won't be swept under the carpet, says new boss

THE Health Professions Council of South Africa has passed "inappropriately light" sentences on guilty practitioners, declared council president Professor Nicky Padayachee this week.

The newly inaugurated president promised a radical overhaul of the council so that it could do its job as a watchdog for the public.

Of 1 137 complaints it received during the 15-month period ending March this year, 122 cases were referred to the police for further action.

Padayachee said: "Our first responsibility is to protect people. Instead there has been a tendency to focus on the interests of professional members."

From now on the council intends to:

Take complaints very seriously by fast-tracking them, according to specific deadlines, and passing appropriate penalties;

Involve lay people in disciplinary steps and decisions, including chairing the committees of preliminary and professional conduct inquiries;

Have an ombudsman to listen to complaints and conduct conciliation;

Stamp out perverse incentives and unacceptable business practices;

Operate as a performance-based institution with standards, deadlines and good governance - to be ensured by an audit with an independent chairman; and

Operate consultatively and transparently, by releasing information on disciplinary hearings and details, including naming guilty practitioners.

This week the council reported that it received an average of 79 complaints each month from January 2003 to March 2004 - slightly down from 88 each month in 2002.

Nearly half of the 1 263 matters finalised by the preliminary inquiry committee were referred to professional conduct inquiries.

But the council has a major backlog. Only 183 of the 596 matters sent to professional conduct inquiries were finalised.

Practitioners were suspended in 19 cases and acquitted in 12 cases.

In 73 cases they paid fines before their inquiries and in 10 cases they were cautioned or reprimanded.

Earlier this month, the Sunday Times reported that in 2002:

A surgeon was only cautioned and reprimanded for operating on the wrong knee of his patient;

A doctor was cautioned and reprimanded for removing a patient's kidney without his consent; and

A doctor found guilty of incompetently performing a vasectomy was only cautioned.

Padayachee said the council would conduct a study of complaints it had received during the past 20 years.

He warned that it was not uncommon for doctors to practise outside of their level of competence. "This is dangerous and we will come down on it seriously," said Padayachee.

Revisions to regulations will provide for harsher sanctions by, for instance, making offenders pay the total costs for errors and increasing fines.

Penalties may include suspension from practice or the enforcement of practice under supervision in state hospitals.

Council chief executive and registrar Boyce Mkhize said outside law firms were being employed to tackle the list of cases but another year would be needed to clear the backlog.

Padayachee said the old system was open to abuse of power.

"In the past, one person could be there for 20 years. Now our policy is that nobody serves more than two terms. This way nobody will become an institution," he said.

Meanwhile, the British Medical Journal recently published a review on peer assessment of physicians and methods used for this. The authors suggested that patients were better equipped than the physicians' peers to evaluate certain aspects, such as their humanistic qualities.