The society of general and family practitioners (SGFP)--(special interest group of s a m a)
presentation to portfolio committee
17 September 2002
subject : medicines and related substances amendment act of 2002

Thanks to committee for opportunity to present some comments, concerns
and suggestions regarding the pending legislation, particularly focusing
on access to, and dispensing of, medication ;our very presence here reflects
our country's post-1994 democratization, with ordinary citizens having
access to, and being part of, the decision- and policy-making processes at the
very highest level;

we know that the committee will view our comments as part of a process of constructive engagement between value-adding and affected stakeholders.

Comments
the SGFP represents some 6000 general and family practitioners
nationally, most of whom are also sama members;

these members are drawn from and serve the full demographic spectrum of
South Africa's people, and are jealously proud South Africans, who believe that
our country needs and deserves to rave home-grown and proudly-South
African" solutions to issues which this bill attempts to address

the society fully subscribes to the broad aims of the bill in seeking to solve
i.a. the issues of access, quality and safety, cost, dispensing standards and
unethical/perverse elements in the medicine manufacture, distribution a;
supply-chain;

the society is willing and able to partner government and other relevant stakeholders in achieving these objective equitably and effectively in a win-win scenario without the side -effect of unintended negative sequellae which we believe will accompany the application of the bill in its current format

specific proposals dealing with the bill on a line-by-line basis have already
reached this committee via the NCD of which the society is a member, so i will
refrain from repeating

somewhat boring though important bits of " legalese" i would rather focus on the spirit and :"heart" pulsing this legislation.

Comments and concerns:

many doctors deliver a medicine dispensing service to bona fide patients:
no" open-shop" or "off-the street" dispensing, as per
H.P.C.S.A. rule this has the full support of the society which seed dispensing as an integral part of the trust-relationship between doctor
patient, with the latter having a choice as to where he or she wishes to
obtain required medication- given the paucity of qualified pharmacist in our country and their distribution which may well be even more skewed than that of the primary family practitioner terms in of rural and previously - disadvantaged area cover, any onerous addition dispensing available and regulated sources of quality , affordable medicine -we do not believe govt . Wishes to even unintentionally further disadvantage any South African in this way , esp the poorest of the poor whom " package deals" are available range in price from 30 to 120 South African rands
i should further emphasize the society's strong commitment to encourage the
use of quality generic medicines through peer and other forms of persuasion in
the market place our goal is excellent, appropriate, value adding medication
at best price, given the reality of resource-constraints;

in the same vein we support govt's exploration of alternative sourcing
mechanisms for crucial, nation-life supporting medication and medical devices
(not losing sight of quality-concerns), while engaging the acknowledged
important multinational pharmaceutical companies positively

being proudly South African , we should buy South African proudly.

Democracy is about freedom of choice and responsibility
medical practice is about making a living through patient care
and advocacy, in a non-paternalistic way: our advocacy role
increasingly requires of us to help the care-seeker balance
and exercise that freedom in the medial sphere within
a framework of cost-constraints.

Constructive suggestions:

"physician, heal thyself" recommend change to:
'physician, heal, educate,(jointly) regulate thyself"-this is an expanded acknowledgement of the need for introspection within the profess ion, with a clearly-defined strategy and plan to address any deficiencies proactively: the s0ciety therefore strongly supports the implementation of well-structured ' compulsory dispensing education and training modules in our case under the auspices of the hpcsa, as well as for the dispensing person to submit and commit to a legal and ethically-binding code of good dispensing conduct/practice, again under the primary jurisdiction of the relevant statutory professional body

promotion of positive partnership".
Between govt. ,relevant professional associations/bodies
civil society/labour and consumer groups. As well as medicine manufacture and supply chain role-players, so that all push together to achieve a shared common
vision of affordable and accessible excellent medicines as part of the pursuit of
health for all South Africans;
in conclusion the society sees itself not as a spectator , but a participant in giving flesh to that vision
however , the society believe there should be significant change in some areas for the bill's content to achieve its intent.

Once again, many thanks to the committee for their time and attention
presented by:
Dr Trevor R Terblanche
(exec. Member-sgfp)