Doctors left in the lurch

Rapule Tabane: The Mail & Guardian, 23 July 2004 (South Africa)

In an about-face, the South Africa Medical Association (Sama) has written to the Department of Health and dissociated itself from further court action by doctors aimed at forcing the government to drop new medicine dispensing regulations. This comes after Sama has spent months urging doctors not to comply with the new dispensing regulations. Many of the doctors, who are now technically not able to dispense medicines, feel left in the lurch by the medical association.

Earlier this month the Pretoria High Court dismissed an application by doctors organised under the National Convention on Dispensing (NCD) and supported by Sama that the dispensing regulations be declared unconstitutional. The implication of the judgement is that no doctor may dispense medication to a patient without being in possession of a dispensing licence.

The judgement immediately criminalised the work of thousands of doctors who have not applied for the necessary documentation. Some doctors have accused Sama of treachery, saying it conducted roadshows urging doctors not to comply, but has now left them in the lurch. But Sama says it has already advised its members to comply. Sama president Kgosi Letlape maintained that the organisation wrote to the government to point out that the ruling would have negative implications for patients.

The letter to acting health director-general Dr K Chetty, said that Sama wished to state unequivocally that it accepted the court decision on the matter would continue to encourage doctors to fully comply with the law. In this regard the board of the Medical Association had resolved to withdraw from the National Council on Dispensing [NCD] and would no longer be a part of any further litigation process in respect of this matter. The letter added that Sama believed that it was the right time to work together with the Health Department to expedite the licensing process, saying that there were a number of challenges still to be tackled in the short-term so that patient care and access to drugs were not compromised.

Health Minister Dr Manto Tshabalala-Msimang said in a statement that it was unfortunate that it had taken so long for Sama to adopt a rational approach to the transformation process in the health sector. She said that thousands of doctors were influenced by Sama not to comply with the requirements of the Act, adding that the main objective of the dispensing regulations was to ensure that South Africans received safe and quality medicines from health professionals with appropriate dispensing competencies.

The department was committed to support doctors and other health professionals to comply with the laws and issue licences where they are due, she said. Letlape said Sama had 17 000 members; he was not aware how many had applied or completed the dispensing course.  Tshabalala-Msimang's spokesperson, Sibani Mngadi said so far more than 1500 licences to dispense had been issued. The situation was improving because the department was receiving 40 proofs of completion of the course a day.