Where is the care?

In respect of your itinerant practice:

You are registered to be in practice and in attendance at the public hospitals and clinics, and are therefore supposed to be in attendance at these places for the purpose of consulting with and attending to the needs of the government’s patients (who present themselves for treatment in their states of vulnerability). So when the government’s patients arrive at these places and you are not in attendance, and are not on some form of condoned or accepted leave of absence, then you are guilty of itinerant practice.

In respect of your touting:

You are openly, publicly and for the object of increased personal gain, creating and supplying content to news agencies, radio and television stations, newspapers, websites and the rumour mill for their own reuse and resale, in aid of their own personal gain — where this content discloses the location of where your practice of healthcare is conducted; where this content makes widely known the working hours of availability of these services; where this content propagates en masse the opinion (which feeds the perception) that your skills are qualitative in nature and that your employer is currently underpaying you for the superior skills and abilities which you possess, such that this perception works in aid of embellishing the “value for money” proposition of obtaining your services, at the places in which you offer them, rather than the services offered by your competitors, in another location who may be paid more, and by doing all of these things you are guilty of seeking to grow your propensity to benefit from your practice of your health profession through the unethical means of touting and solicitation.

In respect of your solicitation of a perverse incentive:

You have publicly admitted that in your own opinion the government has contracted you to provide 100% of the services required by the government’s patients who present themselves at the public hospitals for treatment. You contend that the state is only paying you for 66.66% of these services and as such you have demanded an increase of 50% in your wage rate to reach, in your minds, a situation where the 100% of work is compensated by 100% of wages. However, for the duration of the strike you have withheld from the government’s patients an amount of healthcare equal to 66.66% of the entire workload for each day, or equal to 66.66% of the entire healthcare required by each of the government’s patients. And as you have admitted that the government has contracted and is paying you for the 66.66%, then you are guilty in the first instance of fraud — by deliberately withholding delivery of contracted services. Now you have also admitted that you are withholding this 66.66% on the basis of the solicitation of the 50% increase, and so you are guilty in the second instance of extortion and racketeering (by withholding for further gain that which the patients are already entitled to receive). Finally, by soliciting a financial incentive to provide the government’s vulnerable patients with their healthcare in part or in toto, you are guilty of the solicitation of a perverse incentive, being the 50% increase in your personal gain, because the patients are ordinarily (according to you) each to receive the 66.66% of their healthcare — and this additional 33.34% of services which you claim are not be paid for by the government — can only be provided (as per your claims) if you are to receive an increased benefit to your person. Whereas we have no evidence that the patient needs or requires this “additional 33.34% in healthcare services” which you are trying to force the patients to buy and the government to pay you to provide; that is that we have no evidence that says there is any real difference between the 66.66% which you admit you are being paid to provide and the 66.66% + 33.34% scenario that you are demanding. Indeed there is further no evidence which supports this notion that the patients even need this “additional” treatment. The government maintains that you are being paid for the services which you are required to provide, in toto, and thus your demands to supply unnecessary additional services to these patients, in aid of your own increased gain, must be seen as the solicitation of a perverse incentive, of which you are guilty.

The medics on strike now claim that they are fighting for our healthcare system, not seeking increases in their own gain, so why are they complaining about the latest wage increase offer? And where is the evidence that any of the other healthcare workers support the medics on this strike?

What would we find if we conducted a forensic investigation into the activities of every academic medic at UKZN’s NRM Medical School? Apart from the issue of private practices, what sort of gift giving would we find? What sort of juggling would I expect when looking through the invoices and explanations for expenses on research projects? And surely before joining this strike, UKZN’s NRM Medical School must take responsibility for having trained the medics, who created the bad policy and the abysmal conditions in the public hospitals in the first place because we politicos take advice, in these regards, from, and entrust the running of the government’s hospitals to your graduates. But then again UKZN’s NRM Medical School helped the police to murder Steve Biko — so it’s not like you lot actually care about us ordinary citizens, is it?

From what is presented, there are a number of reasons to dismiss every person who has the task of saving lives but is instead on strike, but I think that we should also strip them of their HPCSA registration because they evidently are not fit to be healthcare workers, they were evidently lying during their interviews when they said they wanted to help people and because their disgraceful conduct during this strike is at variance with the requirements for the conduct of the health professions.

We have already seen that obtaining a MBChB entails obtaining fewer credit points than a combined BA, BA (Hons) and MA programme, and that there are less than 50 additional credit points which can be derived from each of the internship and community service years as the “post graduate students” only present 1 or 2 cases each, once or twice a week for review by their registrars and consultants and in total this does not amount to more than 500 notional hours of study per year.

So as far as we are all concerned the current wage rate for people who possess MBChBs and 3 years of supervised work experience is in way excess of the actual academic qualifications of these people.

I think we should normalise through wage reduction, the basis of compensation so that everyone with a master’s degree in any healthcare discipline and one year of healthcare work experience is paid the same as someone with a MBChB and 3 years of intern/comserv work experience such that everyone with a honours degree in any healthcare discipline and one year of healthcare work experience is paid the same as someone with just a MBChB and no intern/comserv work experience.

Then you can make statements in the media about how much you care about the health system and the other healthcare workers, instead of your own gain.

However, if you are really serious about improving the health system in South Africa, then it is clear that the healthcare practitioners need new leaders, for their professional associations, who are actually able to advocate for better working conditions and for better terms of service in both the public and private domains. We are ready and willing to assist these professional associations to improve their advocacy abilities and representative capacities. And because we evidently have a different dictionary, we will provide this service to the public, as a public and community service at no cost because that’s what community and public service is about – the sacrifice of personal gain for the public good. Such that labelling an instance of overly remunerated employment as “a year of community service” is a bit misleading.

One last thing, as you are aware every one of the medics in the public sector is engaged in some form of training, learning or research activities and as such, perhaps we will accede to your demands for 50% salary increases if you accede to the need for the 200% increase in MBChB tuition and supervision fees, in intern/comserv supervision fees, in MMed tuition and supervision fees, and in all other postgraduate medical tuition, supervision and research fees as levied by the public hospitals to the medical schools and then in turn to the students and researchers. This will assist the public hospitals to buy more equipment and pay their non-medical staff better wages because you care about the health system and the rights of everyone — not just your selves.