Human resources in Medical Faculties of South African Universities: briefing

Meeting report

PORTFOLIO COMMITTEE ON HEALTH
16 MARCH 1999
HUMAN RESOURCES IN MEDICAL FACULTIES OF SOUTH AFRICAN UNIVERSITIES: BRIEFING

Chairperson: Dr. S.A.Nkomo(ANC)

Documents handed out
Medunsa
University of Cape Town
University of Natal
University of Orange Free State
University of Pretoria
University of Stellenbosch
University of Transkei

SUMMARY
In this meeting, the deans of the Faculty of Medicine of Medunsa, Pretoria, Stellenbosch, and Orange Free State Universities responded to twelve questions that had been put to them by the committee during their inquiry into medical faculties. Issues being addressed range from race and gender admission criteria, academic progress, the make up of the workforce, the budget, the evaluation process of policies and programs, as well as the future plans around these issues. A common concern to all universities was their inability to fill vacant management posts due to budget constraints. Further, there seem to be a similarity of challenges, methods, and achievements reported by deans of these universities, with a slight difference from Medunsa. The remaining universities will make their presentation on Wednesday 17 March.

MINUTES
The chairperson opened the meeting by welcoming everyone and explaining the purpose of the meeting: to analyze the human resource aspect of medical faculties of SA Universities. He introduced Dr. Steven Hendricks from the National Department of health, Professor Bomela of Medunsa and Professor Du Plessis of the University of Pretoria and asked Professor Bomela to proceed with his briefing.

Medunsa
Professor Bomela indicated that the Deans were given short notice and could not prepare extensive documents. He asked if he could just answer the 12 questions that were asked. He indicated that the budget for 1999/2000 is still in the process of completion and is not available in the report. Prof. Bomela highlighted resource difficulties which are directly linked to racial policies of the past as the distinguishing factors between Medunsa and other universities.

The chairperson then asked him for recommendations for addressing the issue. He stated that, together with other universities, they have been asking Vice chancellors to pay special attention to medical faculties' problems. He feels that the present moratorium on appointments should be lifted and the national department should assist in bridging the imbalances caused by previous systems in resource allocation between black and white universities.

The chairperson then asked Dr. Rajoo from the National Department of Education to respond to the problem expressed by Professor Bomela.

Dr. Rajoo: We feel that the deans should have a right to air their needs and expectations for the faculties that they head. I will certainly put this matter to the attention of the chairperson of the Education Portfolio Committee. I must say however, that it would have helped if Professor Bomela had given us his budget information so that we could see we can better evaluate his problems. I find it alarming that, as a dean of the faculty, you do not know your budget at this stage. Secondly, you could not address us on the curriculum question.

The chair then asked Dr. Hendricks of the National Health Department to comment on the question of the inability of Medunsa and other universities to fill vacant management posts.

Dr. Hendricks: Universities have certain requirements for candidates in terms of appointments. The perceived moratorium is not necessarily the cause of post not being filled. Where appropriate candidates are identified the institutions do make appointments. The drawback is that universities require too many qualifications for one senior management position while most candidates do not meet these requirements. From the National department we feel that there should be the separation of posts so that requirements can be reduced to what most candidates can meet. The department will have to continue its interactions with the deans to push the transformation forward. We all have a collective agreement that the deans should go ahead and fill the vacant posts when posts are separated.

The Chairperson opened questions for Dr. Hendricks:
Beatrice Marschoff (ANC): Prof. Bomela has indicated that there are posts that they cannot fill. We all know that there are cuts on provincial health budgets. It is not clear how the National department is trying to address this problem, what is the position?

Dr. Hendricks: Two weeks ago Medunsa advertised two senior managerial posts and they could only do so if there are funds to meet these posts. The filling of posts has always been possible. It has been the meeting of requirements by candidates that has been difficult. We understand that decisions on requirements fall under the University Acts and the National department would not like to contravene these nor clash with the deans.

Professor Bomela: The problem is not about finding suitable candidates asit is now being portrayed. It is simply the problem of the budget. We need the removal of a moratorium on the human resource supply.

The chairperson opened the floor for further questions to Prof. Bomela’s full address (summary of which is not all included here):
Ms. Baloyi: As you indicated that your courses also include a community service element, are you able to filter into the rural areas? Are you also taking into account the national plans of getting doctors into public service ?

Ms. Njobe (ANC): You mentioned that you have fewer females enrolled as student doctors. What is your faculty doing to attract females to medical study?

Ms. Vilakazi: On the free choice of courses. If a student comes with the aim of doing a certain degree and finds that your requirements do not allow them to do so, they end up in a different field of study. Can they move freely back to their preferred choice of study when they later meet the requirements?

Ms. Baloyi: Can Professor Bomela clarify the problem that occurred at Medunsa last year where the final year students were refused financial aid?

Dr. Jassat: Regarding South African students who went over to the Dominican Republic, Medunsa was the only university willing to accept them on their return. This was a big issue and I request some clarification.

Answers by Professor Bomela:
About the community projects, we have a medical research institute which is funded by external donors. Part of its function is to engage in community-based research. We also have satellite community activities in the Northern Province, Mpumalanga and the North West Province. Our Nutrition Unit which works with the community is another example.

On the question of attracting females to medicine, we do not have enough applications from females. We have an officer whose task it is to look at the gender issue. I am not sure whether the health and education departments are playing a satisfactory role in this aspect.

Regarding free movement between degrees, we allow students to move, for example from medicine to dentistry, depending on their eligibility.

On funding, this problem is not only confined to final year students . Limitations that come from the National Department of Education require that student at all stages make a contribution towards their study fees. We are willing to help the really needy and deserving students but experience has taught us that some students do not pass on the funds that parents give them to pay their fees to the university. Instead of paying their fee accounts some monies end up paying for music systems and BMWs.

About students from the Caribbean, the Medical and Dental Council felt that their qualifications were below standard. We were prepared to evaluate them and provide bridging courses so that we could accept some of them. On assessing them we found that according to our acceptance standards we could only accept three out of the total of 63. The senate felt that we had to accept 60 instead. For this reason we could not leave any of them out. In assessing their progress we found their pass rate was very low.

University of Pretoria
Professor du Plessis gave his presentation.

Questions and comments by committee members
Mrs. M. Njobe(ANC): You referred to programs in the schools and communities where you reach out to attract interest in the medical profession. Have you evaluated the progress of these projects, bearing in mind that you still have a low percentage of people of color in your faculty?

Professor du Plessis: We do these projects because they are required by schools themselves. But I cannot answer on monitoring yet. We still have to work on that.

Ms B Marschoff(ANC): The Medunsa professor indicated that most blacks end up at Medunsa because they do not feel socially and culturally accepted in historically white universities, have you done any research on this problem?

Ms N Maphazi: The medium of presentation is Afrikaans at both Pretoria and Stellenbosch. It feels as if both universities are not friendly and accommodating to Blacks and other non-Afrikaans speaking people. Is this not one of the reasons for a lower percentage of these people in your faculties?

Professor du Plessis: Regarding language as a threat to admission, we do not think this analysis is true. We have many English-speaking students who do not find it difficult to study at our University. Their number is increasing all the time. We have a continuous intake of Blacks, Coloureds and Indians who are studying happily and successfully at our university. Students do not have a problem amongst each other and they accept each other as fellow students.

University Of Orange Free State
Professor Le Roux made his presentation.

Mr. Mpehle: You indicated your concern at the poor attendance at lectures. It is a serious problem and I would like to know if you are doing anything to address it.

Professor Le Roux: It is not just Blacks who do not attend lectures, all students are given too many rights. It is these rights that universities are giving to students and it is worrying, but this is their choice and there is not much one can do about it.

Mrs. Vilakazi: Since universities realize that the principal problem for most students is financial, how do you accommodate the parents. Do you not think that it would be better if universities stop demanding lump sum payments and accommodate installments from parents?

Professor Le Roux: About installments, the department does not make the rules. We can pass this suggestion on to the decision-making body.

Miss Khonou:
Are you making any effort to uplift the Blacks in your university?

Professor Le Roux:
About employing Blacks in management positions, like anyone else, they do not want to work in academic offices. Everybody can tell you that they want to go out to where the money is. This is an old phenomenon of history that people have always wanted to go where the money is. We should note that If there are no blacks applying, it is impossible to appoint them to posts.

University of Stellenbosch
Professor Lochner made his presentation.

Ms. Baloyi: Looking at your mission statement that you cater for the Afrikaans community first and then others to fill the gaps, also among your criteria is being Afrikaans speaking which is a second language for most blacks, how can you be taken seriously when you mention that you are trying to increase your intake of black students.

Professor Lochner : Afrikaans is not an admission criterion and is not mentioned anywhere as a pre-requisite for admission at Stellenbosch. Secondly, Afrikaans cannot be said to cause drop-outs. You should recall that our drop-out rate of 5% is the lowest nationally indicating that the language is not a problem. It should be noted that in our academic hospitals we work in an environment where the majority of our patients are Afrikaans speaking. It is advisable that if a student is to succeed in working with these patients they should be able to speak the language.

Mrs. M. Njobe: Can you clarify the reason that the rate of white students enrolling in your faculty is dropping while that of people of color is increasing. Secondly, I would like you to clarify what you mean by the crisis in black schools.

Professor Lochner: Regarding the drop in the intake of white students, I would say that our requirements for racial intakes lead us to what I would call discrimination against whites. Even if they have high marks there is still a limit on the numbers we can take if we are to increase the representation of people of color.

The chairperson thanked the deans for attending this process of shaping national policy. It is very useful that a formula is established as to how our medical profession should work. I can say that in doing so we will be even ahead of most countries, including the UK and the USA, who did not have clear formulas the last time we worked with them on similar issues.
This meeting will continue tomorrow with UCT, UNITRA, and Natal university making presentations.