Dental Technicians Amendment Bill and Traditional Health Practitioners Bill: briefings

Meeting report

SOCIAL SERVICES SELECT COMMITTEE
7 October 2004
DENTAL TECHNICIANS AMENDMENT BILL AND TRADITIONAL HEALTH PRACTITIONERS BILL: BRIEFINGS

Chairperson: Ms J Masilo (ANC)

Documents handed out
Dental Technicians Amendment Bill [B63 - 2003]
Traditional Health Practitioners Bill [B66 - 2003]
Department PowerPoint presentation on Traditional Health Practitioners Bill
Department briefing on Dental Technicians Amendment Bill

SUMMARY
Members heard briefings by the Department of Health on the Dental Technicians Amendment Bill and the Traditional Health Practitioners Bill. Background information on the objectives of the amendments and the purpose behind the traditional practitioners legislation was provided. Concerns were raised about the consultation process in both cases and the efficacy of implementation including financial implications. Members would debate both Bills in the near future.

MINUTES

Department briefing on Dental Technicians Amendment Bill
Dr J Smit (Director: Department of Health) said Clause 1 of the Bill sought to include the definition of an "informally trained person" as the current Act did not recognise such persons. The South African Dental Technician Council had requested that training procedures be improved to nullify the problem of inadequate training. Technicians also wanted increased control over payments made by patients. Clause 32(3) was designed to include the notion of juristic persons into the Act to protect small dental laboratories operating within rural areas. Clause 50(1) sought to govern how informally trained persons could be registered by the Council.

Discussion
Mr T Setona (ANC) required clarity on the reasons for the amendments and details of problems faced by individuals within the industry and the nature of the informally trained. Concern was raised over the level of consultation with stakeholders and the role of the Qualification Authority. How would the Department ensure compliance with the regulations and what penalties and sanctions were proposed for offenders, he asked. The amendments were welcomed in general as part of the overall transformation agenda.

Mr M Sulliman (ANC) inquired about Clause 50(1) detailing the role of the Minister in making regulations and sought clarity on the role of provincial MECs in this regard.

Dr Smit responded that the SA Dental Technician Council had informed the Department of illegally trained persons working within laboratories that had not registered with the Council. The Council wanted to address this and conduct accredited training of technicians by means of formal training institutions presenting a bridging course. The intention was to protect the public from unethical practitioners.

Mr M Motsapi (Department Legal Advisor) confirmed that the amendments followed recommendations of the Council and the Council was to regulate the profession in accordance with National Health policy. The Minister made regulations but was to comply with the Council's recommendations.

Dr Smit added that the envisaged training institutions would comply with the Council's recommendations. The purpose of amendments to the fee structure was to assist small operations in accessing payment from dentists and to remove inconsistencies associated with medical schemes or patients.

The Chairperson acknowledged that the amendment detailing juristic persons was intended to protect small operations from aggressive competition from larger organisations.

Mr Setona inquired about the budgetary consequences for provinces and the anticipated impact of the amendments on current services provided.

Mr Sulliman asked about the dangers of inflated claims being submitted and whether a standard price structure was in place.

Dr Smit responded that the registration process was the sole preserve of the Council and the Department was not involved. Inspectors were in place to visit laboratories and ensure compliance of legislation. Action would follow identification of offenders. The Council on an annual basis reviewed the fee structure and fees were published in the Government Gazette. Contravention of the stipulated fee could result in disciplinary procedures.

Mr Motsapi indicated that the Department would be conducting educational workshops on the details of the amendments within all provinces.

Dr Smit confirmed that inspection was the responsibility of the Council as most laboratories were in the private sector. The public sector possessed a few.

Mr M Thetjeng (DA) expressed lack of clarity on the role of the provinces and questioned the relevance of the amendments to the provincial authorities. The provincial MECs appeared to be excluded from the process.

Mr Motsapi responded that the Bill was intended to assist the people of the provinces to receive improved dental service delivery and was directed at health service providers. For this reason, a general awareness of the amendments was required within the provinces.

Department briefing on Traditional Health Practitioners Bill
Ms T Mdlalose (Director: Human Resource Development) provided a brief history of the origins of the Bill, emphasising the workshop where the Interim Council had been constituted. Submissions had been received from numerous stakeholders, including medical bodies and NGOs. The Council also allowed for community representation from nominated persons. Clause 2 of the Bill explained the objectives of the Interim Council and Chapter 2 detailed the legal framework governing the Council.

Discussion
The Chairperson asked whether the present briefing was the first for the NCOP and whether a report of the workshop could be made available to Members.

Mr Setona concurred that the Committee required background information on the consultation process. He asked whether proposals from committees and interested parties had been taken into account in the writing of the Bill.

Mr J Thlagale (UCDP) referred Members to page 24 of the Bill that outlined the role of the NCOP in the process.

Mr B Tolo (ANC) agreed that further background information was needed particularly on financial considerations and implications for the Department. The period of membership of the Council needed to be clarified.

Members also questioned whether business and labour had been involved in the consultation process and, in particular, medical schemes.

Ms Mdlalose replied that the financial implications were for Departmental costs which had budgeted accordingly. The Council would be supported by the Department for three years after which membership fees would suffice. Members of the Council who were disqualified for an offence could undergo a process of rehabilitation and could be readmitted. The Chairperson and vice-Chairperson could serve only two terms of three years each. Research was a component of the Council and extensive research into traditional medicines was occurring at certain tertiary institutions. The Department was in consultation with the Department of Science and Technology to discuss the protection of intellectual property and further scientific study to improve efficacy of treatments.

Approximately 200 000 traditional health practitioners were currently operating in South Africa and all provinces were represented within the Council. No consultation with business and labour had occurred although some discussion with medical schemes had taken place. The Council would negotiate with medical schemes on the claims regime to be imposed. Spiritual healing was not considered within the current Bill as the particular nature of this activity was difficult to determine although Council would consider other aspects of traditional practice in due course. The Bill dealt with local practice.

Mr Setona questioned the practice of excluding certain activities from the Bill as this served to divide the traditional field rather than unite and strengthen. This appeared contrary to the spirit and purpose of the Bill. Public hearings within provinces should serve as a practical platform to discuss this issue. The composition of the Council should include representation from business and labour.

Mr Thlagale raised the issue of immigrants entering South Africa with traditional knowledge and establishing practices with different approaches and knowledge bases. The protection of local practices and local products and knowledge required clarification.

Mr Motsapi referred to Clause 47 that indicated minimum standards to be applied in the registration of practitioners. The Bill created the framework within which the Council would operate and provided powers to assist in this task. The Council would deal with the issue of protecting local knowledge and products and formulate appropriate responses. Clause 21(2)(b) provides requirements for registration and only South African citizens would be accommodated at this stage as the quality of external training was difficult to ascertain.

Mr Setona stated whether the Bill was not promoting xenophobia in rejecting healers from other countries particularly within the Southern African region. The reality on the ground was that many foreign practitioners were already operating. The intention to protect local healers seemed to be compromised. The Department should consider improving the system of vetting foreign qualifications and allow for the movement of people.

Ms Mdlalose indicated that the Departments of Health and Home Affairs together with the Council would discuss the question of international qualifications to determine an appropriate framework that maintained local standards. The overall objective was to protect the users of traditional services.

The Chairperson indicated that public hearings would occur in provinces and the Committee would debate the merits and demerits of the Bills next week. Members would receive copies of the amendments to the Traditional Health Practitioners Bill as determined by the Portfolio Committee.

The meeting was adjourned.