Department of Health

Durban - A battle is brewing between the SA Medical Association (Sama) and health minister Manto Tshabalala-Msimang over the proposed Health Professions Amendment Bill, which would give the minister authority to select the members of the Health Professions Council of SA and other professional boards.

At least 10 of the 12 chapters of the National Health Act (Act No 61 of2003) will come into effect on 2 May 2005 after the Act was proclaimed by President Thabo Mbeki in the Government Gazette published yesterday. (18 April)

15 DECEMBER 2000

An enormous gap in health staffing exists between the United Kingdom and India. India has fewer than 3000 psychiatrists for its one billion population compared with one psychiatrist for every 9000 people in the United Kingdom, a 27-fold difference.1 Despite this inequality, the NHS has launched a scheme to recruit senior psychiatrists and other specialists from India and other developing countries. This scheme will worsen the brain drain and inequities in global health unless it is explicitly linked with measures to enable the flow of doctors back to developing countries. Opportunities or opportunism? Overseas recruitment schemes are marketed primarily as an opportunity for doctors to experience one of the world's best healthcare systems. Yet it is obvious that the NHS is trying to fill jobs in specialties where there is a shortage of staff. Although shortages are acknowledged in the promotional material for the new NHS international fellowship scheme, the difficulties that doctors will face when they attempt to return home are ignored. Experience with previous schemes, such as the overseas doctors' training scheme, suggests that few doctors returned to their home countries. Indeed, when I finished my training in psychiatry in the United Kingdom in 1992, I found that few routes were available to facilitate my return to India.2 My work in developing countries over the past decade has been entirely funded by research grants, mainly from the Wellcome Trust. Recruitment is being promoted using the obvious advantages the NHS has over employers in developing countries. The code of practice for international recruitment explicitly states that there should be no NHS advertising in developing countries unless that country has specifically invited the UK to undertake a recruitment programme and that recruitment should only be undertaken as part of an inter-governmental cooperation agreement... encouraging the exchange of healthcare personnel, healthcare information, and guidelines.5 The promotional material for the scheme does not indicate that either condition has been met.4 Summary points * The developing world has fewer doctors per population than developed countries * Schemes to recruit doctors from developing countries risk damaging their fragile health systems * Working and training in another country provides valuable experience * Partnerships between institutions in developed and developing countries are needed to encourage doctors to return * Institutions in developed countries need to reform to provide more rewarding professional environments Ultimately, all concerned parties need to define the obligations and responsibilities of institutions in rich and developing countries. Unless these steps are taken urgently, the brain drain will continue to fuel the huge inequities in global health. (Source: Vikram Patel, senior lecturer, London School of Hygiene and Tropical Medicine, London WC1E 7HT BMJ 2003;327:926-928,18 October) //\//Links letters in response to this article yielded some very valid points on both sides of the argument: http://bmj.bmjjournals.com/current.shtml#LETTERS Various discussions and opinions have followed to this article from all over the world on the email discussion list Afro-Nets, See 'Recruiting doctors from poor countries' Information and archives: http://www.afronets.org Brain drain and health professionals. Tikki Pang, Mary Ann Lansang, Andy Haines. BMJ vol 324, 2 March 2002. Medical migration: who are the real losers? Peter Bundred, Cheryl Levitt. The Lancet, vol 356, July 15, 2000 Trade in health services. Rupa Chanda. Bulletin of the WHO, 2002, 80 (2).

The Department of Health is to use its volunteer programme during April this year to improve the quality of care it provides, the department announced on Wednesday (16 January). At the African National Congress' 90th birthday celebrations in Durban earlier this month President Thabo Mbeki said 2002 would be the year of the volunteer for reconstruction and development. He said that during April, volunteers should assist the government in the delivery of health services. Mngadi said the department was still drafting a nation-wide programme outlining various activities for the month. The document would be made public before the end of February. Tshabalala-Msimang would also be involved in the programme. Mngadi said HIV/AIDS, tuberculosis and other infectious diseases were among the challenges the department would address in April. (Source: SAPA, 16 January 2002)

At the end of August the first phase of PharMIS (Pharmaceutical Management Information System) was launched by the Department of Health - Pharmaceutical Policy and Planning Cluster, supported by the EQUITY project. Expenditure on pharmaceuticals in provincial health departments is exceeded only by personnel expenditure, and up till now data about pharmaceuticals has been fragmented, incompatible and inaccessible for analysis and management. The system currently provides a datawarehouse of drug supply management information from most of the provincial depots, and a web interface to reports from this data. More information from pharmis.pwv.gov.za

The National Assembly's Portfolio Committee on Health was briefed this week by the Department of Health on the National Health Laboratory Services Bill.

This document is intended primarily for the incoming DH&WMT in the Halegratz district, the Lowveld regional office and the provincial health department. This report presents the health and welfare situation analysis that was conducted by health and welfare workers of the Halegratz district between February and April 1998, with support from the Initiative for Sub-district Support (ISDS), a project of the Health Systems Trust (HST). This document discusses the health and welfare problems prevailing in the district.