ANNUAL REPORT. Protecting the public and guiding the professions

Transcription

1 ANNUAL REPORT Protecting the public and guiding the professions

2 VVISION Quality and Equitable Healthcare for All MMOTTO Protecting the Public and Guiding the Professions M ISSION To enhance the quality of healthcare for all by developing strategic policy frameworks for effective and efficient coordination and guidance of the professions through: Setting contextually relevant healthcare training and practice standards for registered professions Ensuring compliance with standards Fostering on-going professional development and competence Protecting the public in matters involving the rendering of health services Public and stakeholder engagement Upholding and maintaining ethical and professional standards within the health professions VVALUES In fulfilling its roles of regulator, guide & advocate and administrator, the HPCSA holds the following values central to its functioning

3 CONTENTS PART A PART B PART C GENERAL INFORMATION PERFORMANCE INFORMATION PROFESSIONAL BOARDS 1. THE HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA (HPCSA) GENERAL INFORMATION 6 2. ABBREVIATIONS/ ACRONYMS 8 3. FOREWORD BY THE PRESIDENT 9 4. REGISTRAR/ CHIEF EXECUTIVE OFFICER S OVERVIEW STATEMENT OF RESPONSIBILITY AND CONFIRMATION OF ACCURACY FOR THE ANNUAL REPORT STRATEGIC OVERVIEW LEGISLATIVE AND OTHER MANDATES ORGANISATIONAL STRUCTURE SITUATIONAL ANALYSIS Service Delivery and Organisational Environment Key Policy development and legislative changes Strategic Outcome Oriented Goals PERFORMANCE INFORMATION BY PROGRAMME/ ACTIVITY/ OBJECTIVE Programme Programme Programme Programme REVENUE COLLECTION Capital Investment 60 DENTAL THERAPY AND ORAL HYGIENE 68 DIETETICS AND NUTRITION 71 EMERGENCY CARE 73 ENVIRONMENTAL HEALTH PRACTITIONERS 76 MEDICAL AND DENTAL PROFESSIONS 80 MEDICAL TECHNOLOGY 82 OCCUPATIONAL THERAPY, AND MEDICAL ORTHOTICS AND PROSTHETICS AND ARTS THERAPY 86 OPTOMETRY AND DISPENSING OPTICIANS 90 PHYSIOTHERAPY, PODIATRY, AND BIOKINETICS 94 PSYCHOLOGY 98 RADIOGRAPHY AND CLINICAL TECHNOLOGY 104 SPEECH, LANGUAGE AND HEARING PROFESSIONS 109

4 PART D PART E PART F GOVERNANCE HUMAN RESOURCE MANAGEMENT FINANCIAL INFORMATION INTRODUCTION 114 THE EXECUTIVE AUTHORITY 114 THE ACCOUNTING AUTHORITY/ COUNCIL 114 RISK MANAGEMENT 121 INTERNAL AUDIT AND AUDIT COMMITTEES 121 COMPLIANCE WITH LAWS AND REGULATIONS 124 FRAUD AND CORRUPTION 124 MINIMISING CONFLICT OF INTEREST 125 CODE OF CONDUCT 125 HEALTH AND SAFETY AND ENVIRONMENTAL ISSUES 125 COUNCIL SECRETARIAT 126 SOCIAL RESPONSIBILITY 126 AUDIT COMMITTEE REPORT 1. INTRODUCTION HUMAN RESOURCE OVERSIGHT STATISTICS 130 AUDIT AND RISK COMMITTEE REPORT 139 COUNCILOR S RESPONSIBILITIES AND APPROVAL 142 AUDITORS REPORT 143 COUNCILORS REPORT 145 ANNUAL FINANCIAL STATEMENTS 147

5 4 HPCSA ANNUAL REPORT 2016/17

6 Part GENERAL INFORMATION

7 PART A: GENERAL INFORMATION 1. GENERAL INFORMATION Country of incorporation and domicile Nature of business and principal activities South Africa Health Professions Regulator Dental Therapy & Oral Hygeine Dietetics & Nutrition Emergency Care Environmental Health Practitioners Medical and Dental Medical Technology Optometry and Dispensing Opticians Occupational Therapy, Medical Orthotics, Prosthetics and Arts Therapy Psychology Physiotherapy, Podiatry and Biokinetics Radiography and Clinical Technology Speech-Language and Hearing Community Representative not registered in Terms of Act Dr. Tufayl Ahmed Muslim Prof. Sussana Hanekom Mr. Lesiba Arnold Malotana (Vice President) Mrs Dagmar Muhlbauer Mr. Simphiwe Sobuwa Ms. Duduzile Julia Sebidi Dr. Tebogo Kgosietsile Solomon Letlape (President) Prof. Yusuf Ismail Osman Dr. Reno Lance Morar Mr. Molefe Aubrey William Louw Mr. Maemo Kobe Ms. Martha S van Niekerk Prof. Basil Joseph Pillay Ms. Nokuzola Doris Dantile Mr. Aladdin Speelman Dr. Sadna Balton Ms. Xoliswa Bacela Mr. Ketso Obed Tsekeli Ms. Ruth Maphosa Gontsana Ms. Julia Mmaphuti Nare Adv Tebogo Mafafo Prof. Nobelungu Julia Mekwa Ms. Marie Mercia Isaacs Department of Higher Education and Training Dr Engela Van Staden *Appointed April 2016 Department of Health Dr. Terence Carter *Resigned October 2016 Person versed in Law Person appointed by the Universities South Africa (Higher Education South Africa ) now Universities South Africa (USAF) Mr Sello Ramasala Prof. Khaya Mfenyana Prof. Nomthandazo Gwele Prof. GJ van Zyl South African Military Health Services Major-General Z Dabula * Appointed June 2016 Appointed by the Minister Dr AM Thulare * Appointed February HPCSA ANNUAL REPORT 2016/17

8 Registered office 553 Madiba Street Cnr Hamilton and Madiba Street Arcadia 0001 Postal address P O Box 205 Pretoria 0001 Bankers ABSA Bank Limited Auditors Morar Incorporated Chartered Accountants (SA) Registered Auditor Website Preparer of AFS The annual financial statements in Part F were internally prepared by Ms M de Graaff, the Chief Financial Officer HPCSA ANNUAL REPORT 2016/17 7

9 2. ABBREVIATIONS/ ACRONYMS AIDS Acquired Immune Deficiency Syndrome MTT Ministerial Task Team AMCOA Annual Association Medical Councils of Africa NCEMS National Committee of Emergency Medical Care APP Annual Performance Plan NECET National Emergency Care Education and ARCOM Audit and Risk Committee (of Council) Training AVE Advertising Value Equivalent NDoH National Department of Health BHF Board of Healthcare Funders NDP National Development Plan BHSc Bachelor of Health Science NHI National Health Insurance BKIN CEU CHE CMS CPD CUT, FS DENTASA DHET DHMO Biokinetics Internship Committee Continuing Educational Units Council on Higher Education Council for Medical Schemes Continuous Professional Development Central University of Technology, Free State Dental Technologists Association of South Africa Department of Higher Education and Training District Health Management Office OCB OHASA OHSC OHSCC PBODO PFMA Occupational Therapy, Orthotics & Prosthetics and Art Therapy Professions Board Occupational Health Association of South Africa Office of Health Standards Compliance Oral Health Stakeholder Consultative Committee Professional Board for Optometry and Dispensing Opticians Public Finance Management Act (Act No 1 of 1999) DUT Durban University of Technology PPB Professional Board of Physiotherapy, Podiatry ECG Electro Cardiographic and Biokinetics EEG Electro Encelographic PTA Physiotherapy Assistant ECFMG Education Commission for Foreign Medical Graduates ReLPAG Recognition of Prior Learning in Psychology Action Group EPASSA Ethnomedicine Practitioners Association of South PsySSA Psychology Society South Africa Africa RICA Regulation of Interception of Communications and EPIC HASA HEI HEQSF HIV HoD HPCNA HPCSA HRH ID IT IVR JASA M&E MCC Electronic Portfolio of International Credentials Hospital Association of South Africa Higher Education Institution Higher Education Qualifications Subframework Human Immunodeficiency Syndrome Head of Department Health Professions Council of Namibia Health Professions Council of South Africa Human Resources for Health Identity Document Information Technology Interactive Voice Response Justice Alliance of South Africa Monitoring & Evaluation Medicines Control Council RPL SADA SADTA SALGA SANC SAPS SAQA SGB SMLTSA UCT UNISA Wits Provision of Communication-Related Information Act (Act No 70 of 2002) Recognition of Prior Learning South African Dental Association South African Dental Therapists Association South African Local Government Association South African Nursing Council South African Police Service South African Qualifications Authority Standards Generating Body Society of Medical Laboratory Technologists of South Africa University of Cape Town University of South Africa University of the Witwatersrand MoU Memorandum of Understanding MTSF Medium Term Strategic Framework 8 HPCSA ANNUAL REPORT 2016/17

10 3. FOREWORD BY THE PRESIDENT - DR TKS LETLAPE In line with our obligations to Parliament and the people of the Republic of South Africa, we are pleased to report back on how the Health Professions Council of South Africa (HPCSA) performed in the delivery of its mandate during the period under review. The year 2016/17 has been a year characterised by both achievements and challenges. The achievements were the compilation of the 2016/17 unqualified Annual Report and the launch of the Turnaround programme. The main challenges centred around the implementation of the Ministerial Task Team (MTT) Report recommendations. The key role and responsibility of the HPCSA is to coordinate the activities of the Professional Boards in accordance with the Health Professions Act No.56 of 1974 and fulfil the mandate of the said Act. The HPCSA is legislatively enjoined to promote and regulate inter-professional liaison between the health professions in the interest of the public and to fulfil an advisory role to the Minister of Health on matters falling within the scope of the Health Professions Act to support the universal norms and values of health professions and the national health policy. Ministerial Task Team Report The HPCSA has been continuously updating the Minister on progress made with regard to Council s actions in relation to the Ministerial Task Team Report findings. During the latter part of the financial year, the HPCSA implemented four of the five key Ministerial Task Team recommendations to ensure an effective and efficient Council. The HPCSA s Strategic Plan highlights four key strategic goals, namely: An improved business model to enhance the functioning of the HPCSA; Adequate, effective and efficient support by and to Council, Professional Boards and Secretariat; An advocacy and advisory role to enhance engagements with all key stakeholders; and Legislative and regulatory consistency across the HPCSA and its Professional Boards. In implementing the first strategic goal, in January 2017, a service provider, Fever Tree Consultants (FTC) was appointed to assist the HPCSA in its endeavours to better service key stakeholders the practitioners. The Secretariat, together with consultants from FTC, has been working tirelessly to help build a new organisation characterised by innovation, professionalism and excellence in service delivery. As Council and members of the Professional Boards, our task is to continuously provide strategic direction and support, an area that we have focused on during the past year. Our collective commitment to excellence in leadership and innovation must remain our focus in the coming financial year. Different work streams have been established comprising of specialists from different fields within Council. Governance The HPCSA continued to adhere to the principles of good governance as embodied in the King Reports, the Health Professions Act and any relevant legislation and governance prescripts. Adherence to these principles ensures that the HPCSA maintains the integrity of its operations, thus gaining credibility from and confidence of its important HPCSA ANNUAL REPORT 2016/17 9

11 stakeholders. To this end, all HPCSA Councillors were trained by the Institute of Directors in Southern Africa (IoDSA) on good corporate governance as contained in King III Report. Good corporate governance and stakeholder confidence are fundamental elements in determining the nature of the relationship between the HPCSA, its shareholder represented by the Minister of Health, the healthcare industry and the South African public. Council s Audit Committee is chaired by an independent external person to ensure that our relationships with our stakeholders are honest and transparent. The Committee was satisfied at the acceptable way risks have been managed. Our external auditors have expressed an unqualified opinion on the annual financial statements for the period under review. Acknowledgements A special word of thanks to the Minister of Health Dr Aaron Motsoaledi for his continued guidance and support and for continuously guiding the HPCSA in carrying out its complex mandate. I also express sincere gratitude to all Members of Council and the Professional Boards for their hard work and commitment in their contribution to making the HPCSA accomplish its goals. I would be remiss in if I do not appreciate the HPCSA officials for their dedication, availability and willingness at all times to assist in operational matters. Thank you. International Relations The HPCSA continues to maintain and build relationships with other African countries to foster improved collaboration and synergy. The HPCSA aims to continuously expand its footprint within the African continent as means of exchanging knowledge and skills. This will assist in improving the HPCSA in its delivery of services. Currently, the HPCSA is deemed to be an organisation that can be used in benchmarking to obtain and identify good practice. DR TKS LETLAPE PRESIDENT: HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA The HPCSA also played a vital role as Secretariat for Association Medical Councils of Africa (AMCOA). This, the HPCSA did by organising the 20 th Annual AMCOA Conference, which took place at the Malawi Medical Practitioners and Dentists Board in Mangochi, Malawi. The focus of the Conference was on the profession and the enhancement of regulation, licensure for Medical and Dental Practice and continuing professional development to promote high standards of care. In line with the AMCOA mission, the Conference facilitated ongoing exchange of information among regulatory authorities within the region as well as develop protocols for licensure of medical and dental practice. 10 HPCSA ANNUAL REPORT 2016/17

12 4. REGISTRAR/ CHIEF EXECUTIVE OFFICER S OVERVIEW It gives me great pleasure to present the 2016/17 Annual Report. This report gives an account of the HPCSA s operational and financial performance, but also reflects progress made on one of our flagship projects that Council embarked on during the period under review, the Turnaround Project. In setting the appropriate and relevant standards for healthcare training and education, registration, practice and continuing development of professionals, the HPCSA committed to fairness, transparency, consistency and accountability, while executing its mandate professionally, efficiently and effectively. Furthermore, the HPCSA executed its advocacy and advisory role for healthcare within South Africa with respect, honesty, dignity and integrity. In implementing recommendations from the Ministerial Task Team and in keeping with the HPCSA s vision and mission, the HPCSA embarked on a Turnaround Programme, to improve efficiency and ensure that it is fit for purpose. The Turnaround Programme is well underway and has made significant progress. We are confident that the strategic direction we have chosen is sound. Registrations The HPCSA continued to bring its services closer to the practitioners. To this end, the HPCSA, during the year of review, launched the Online Renewal and Payment Portal. Over practitioners utilised the portal by renewing their registrations and paying their annual fees. While the primary focus of the portal was to provide an easier renewal platform for practitioners, it has the added functionality of cleaning up the overall practitioner database allowing them an opportunity to update their contact details, and, in some cases, update their identification numbers. In the same period, the HPCSA registered practitioners who qualified for registration in accordance with the Act. Amongst these, were practitioners joining internship training programmes, as well as students studying towards a health profession registrable in terms of the Act. With the launch of the Online Renewal and Payment Portal, offsite renewal was only embarked on for students. Practitioners could henceforth renew and make annual payments online in the comfort of their homes or practices. In 2015/16, Council supported and approved that further research be conducted with regard to best practice in implementing Maintenance of Licensure. A task team of the CPD Committee was appointed to engage Professional Boards, practitioners and other stakeholders with a view to piloting Maintenance of Licensure from January From an operations point of view, Council implemented an IT module that can efficiently handle the increased load from the expanded CPD portfolio requirements. The module is expected to be in place for the maintenance of licensure piloting phase in January Stakeholder engagement and advocacy is key to the operations of Council. As a means of engaging and interacting with practitioners and the public through direct dialogue, the HPCSA continued to conduct practitioner and public roadshows in all the provinces throughout the country. The practitioner roadshows and symposia enable the HPCSA to highlight pertinent issues that affect practitioners at their respective work environments. In the period under review, the engagement sessions were HPCSA ANNUAL REPORT 2016/17 11

13 doubled to ensure that Council increases its footprint to allow for more robust interactions with stakeholders. Risk Management The HPCSA matured in terms of risk management. In the year under review, the HPCSA approved an Enterprise Risk Management Policy Framework, which provided a basis for a comprehensive risk management strategy to meet both legislative and best business practice requirements. The HPCSA also developed and approved a Compliance Management Policy Framework aimed at ensuring that the HPCSA s compliance risks are identified and effectively managed on an ongoing basis. Risk Awareness Workshops were held for all HPCSA employees to enhance control measures. I look forward to your continued assistance and pledge my support to you in the year to come which I have no doubt will be a fruitful one. As the administration, we remain committed to delivering the highest quality of service to you. Thank you. ADV. FP KHUMALO ACTING REGISTRAR/ CEO Compliance and Enforcement The HPCSA, through its Inspectorate Office, continued to work closely with law enforcement authorities to ensure compliance with the Health Professions Act. The period under review also saw the HPCSA Inspectorate Office working with other law enforcement agencies investigating and finalising 289 of the 371 cases reported. Clean Audit The HPCSA once again received an unqualified clean audit for the third consecutive year. We acknowledge the hard work and commitment of Council, its committees, Executive Management, the Finance Team and other departments in ensuring that this achievement was realised. Acknowledgements My sincere appreciation goes to the HPCSA President Dr Kgosi Letlape, the Vice- President Mr Arnold Malotana, for their continued leadership and the Council for its guidance. I express my deepest gratitude to the Executive Management of the HPCSA for your endless support, the employees of HPCSA, for your challenging work and determination to ensure that we deliver on our mandate. 12 HPCSA ANNUAL REPORT 2016/17

14 5. STATEMENT OF RESPONSIBILITY AND CONFIRMATION OF ACCURACY FOR THE ANNUAL REPORT The Registrar is required in terms of the Health Professions Act no 56 of 1974 to maintain adequate accounting records and is responsible for the content and integrity of the annual financial statements and related financial information included in this report. It is his responsibility to ensure that the annual financial statements fairly present the state of affairs of the HPCSA as at the end of the financial year and the results of its operations and cash flows for the period then ended, in conformity with Entity specific basis of preparation. The external auditors are engaged to express an independent opinion on the annual financial statements. The annual financial statements are prepared in accordance with Entity specific basis of preparation and are based upon appropriate accounting policies consistently applied and supported by reasonable and prudent judgements and estimates. The Registrar acknowledges that he is ultimately responsible for the system of internal financial control established by the HPCSA and place considerable importance on maintaining a strong control environment. These controls enable the Registrar to meet his obligations and set standards for internal control with the view to reducing the risk of error or loss in a cost-effective manner. The standards include the proper delegation of responsibilities within a clearly defined framework, effective accounting procedures and adequate segregation of duties to ensure an acceptable level of risk. These controls are monitored throughout the HPCSA and all employees are required to maintain the highest ethical standards in ensuring that the HPCSA s business is conducted in a manner that in all reasonable circumstances is above reproach. applied and managed within predetermined procedures and constraints. The Registrar is of the opinion, based on the information and explanations given by Management, that the system of internal control provides reasonable assurance that the financial records may be relied on for the preparation of the annual financial statements. However, any system of internal financial control can provide only reasonable, and not absolute, assurance against material misstatement or loss. The Registrar has reviewed the HPCSA s cash flow forecast for the year to 31 March 2018 and, in light of this review and the current financial position, he is satisfied that the HPCSA has or had access to adequate resources to continue in operational existence for the foreseeable future. The external auditors are responsible for independently auditing and reporting on the company s annual financial statements. The annual financial statements have been examined by the company s external auditors and their report is presented on page 142 and 143. The annual financial statements set out on pages 146 to 175, which have been prepared on the going concern basis, were approved by the Council on 29 September 2017 and were signed on their behalf by: Approval of financial statements DR TKS LETLAPE PRESIDENT: HPCSA The focus of risk management is on identifying, assessing, managing and monitoring all known forms of risk across the HPCSA. While risks cannot be fully eliminated, the HPCSA endeavours to minimise them by ensuring that appropriate infrastructure, controls, systems and ethical behaviour are HPCSA ANNUAL REPORT 2016/17 13

15 6. STRATEGIC OVERVIEW Vision Quality and Equitable Healthcare for All Mission To enhance the quality of healthcare for all by developing strategic policy frameworks for effective and efficient coordination and guidance of the professions through: Setting contextually relevant healthcare training and practice standards for registered professions Ensuring compliance with standards Fostering on-going professional development and competence Protecting the public in matters involving the rendering of health services Public and stakeholder engagement Upholding and maintaining ethical and professional standards within the health professions Motto and Values Motto: Protecting the Public and Guiding the Professions Values: In fulfilling its roles of regulator, guide & advocate and administrator, the HPCSA holds the following values central to its functioning 7. LEGISLATIVE AND OTHER MANDATES The Health Professions Council of South Africa (HPCSA) referred to as Council, is a statutory body established by the Health Professions Act, 56 of 1974 (as amended). Its mandate is to regulate the health professions in the country in aspects pertaining to education, training and registration, professional conduct and ethical behaviour, ensuring Continuing Professional Development (CPD), and fostering compliance with healthcare standards. LEGISLATIVE MANDATE Constitution of the Republic of South Africa, 1996 The HPCSA derives its constitutional mandate from Section 27 of the Constitution of South Africa, 1996 which provides that everyone has the right to have access to health care services, including reproductive health care. National Health Act No. 61 of 2003 The National Health Act No.61 of 2003 provides a framework for a structured, uniform health system for South Africa. The HPCSA plays a pivotal role in promoting the provisions in the act through: a) Advocating for the rights and duties of users and Health Care Personnel as set out in Chapter 2 of the National Health Act b) Assisting the Minister of Health in setting Regulations Relating to Human Resources as per Chapter 7, Section 52 of the National Health Act c) Representation at the Forum of Statutory Health Professional Councils and ensuring that it meets the responsibilities as set out in Chapter 7, section 50 of the National Health Act d) Collaborating with other Health Councils and statutory bodies provided for in the National Health Act 14 HPCSA ANNUAL REPORT 2016/17

16 The Health Professions Act No. 56 of 1974 (as amended) The Health Professions Council of South Africa derives its mandate from the Health Professions Act, 56 of 1974 (as amended). The Act seeks to provide for control over the education, training and registration for and practising of health professions registered under the Act; and to provide for matters incidental thereto. The objects and functions as per the Health Professions Act, 56 of 1974 (as amended) for constituents of the HPCSA, namely Council and its Professional Boards are as follows: OBJECTIVES AND FUNCTIONS OF COUNCIL Objects and functions of Council are: a) To co-ordinate the activities of the Professional Boards established in terms of this Act and to act as an advisory and communicatory body for such Professional Boards; b) To promote and to regulate inter-professional liaison between health professions in the interest of the public; c) To determine strategic policy in accordance with national health policy as determined by the Minister, and to make decisions in terms thereof, with regard to the Professional Boards and the health professions, for matters such as finance, education, training, registration, ethics and professional conduct, disciplinary procedure, scope of the professions, inter-professional matters and maintenance of professional competence; d) To consult and liaise with relevant authorities on matters affecting the Professional Boards in general; e) To assist in the promotion of the health of the population of the Republic; f ) Subject to legislation regulating healthcare providers and consistency with national policy determined by the Minister, to control and to exercise authority in respect of all matters affecting the education and training of persons in, and the manner of the exercise of the practices pursued in connection with, the diagnosis, treatment or prevention of physical or mental defects, illnesses or deficiencies in human kind; g) To promote liaison in the field of education and training referred to in paragraph (f ), both in the Republic and elsewhere, and to promote the standards of such education and training in the Republic; h) To advise the Minister on any matter falling within the scope of this Act in order to support the universal norms and values of health professions, with greater emphasis on professional practice, democracy, transparency, equity, accessibility and community involvement; i) To communicate to the Minister information of public importance acquired by the Council in the course of the performance of its functions under this Act; j) To serve and protect the public in matters involving the rendering of health services by persons practising a health profession; k) To exercise its powers and discharge its responsibilities in the best interest of the public and in accordance with national health policy determined by the Minister; l) To be transparent and accountable to the public in achieving its objectives and when performing its functions and exercising its powers; m) To uphold and maintain professional and ethical standards within the health professions; n) To ensure the investigation of complaints concerning persons registered in terms of this Act and to ensure that appropriate disciplinary action is taken against such persons in accordance with this Act in order to protect the interest of the public; o) To ensure that persons registered in terms of this Act behave towards users of health services in a manner that respects their constitutional rights to human dignity, bodily and psychological integrity and equality, and that disciplinary action is taken against persons who fail to act accordingly; HPCSA ANNUAL REPORT 2016/17 15

17 p) To submit to the Minister- I. A five-year strategic plan within six months of the Council coming into office, which includes details as to how the Council plans to fulfil its objectives under this Act; II. Every six months, a report on the status of health professions and on matters of public importance that have come to the attention of the Council in the course of the performance of its functions under this Act; III. An annual report within six months of the end of the financial year; q) To ensure that an annual budget for the Council and the Professional Boards is drawn up and that the Council and the Professional Boards operate within the parameters of such budget. Objects of Professional Boards. The objects of a Professional Board are: a) To consult and liaise with other Professional Boards and relevant authorities on matters affecting the Professional Board. b) To assist in the promotion of the health of the population of the Republic on a national basis. c) Subject to legislation regulating health care providers and consistency with national policy determined by the Minister, to control and to exercise authority in respect of all matters affecting the education and training of persons in, and the manner of the exercise of the practices pursued in connection with, any health profession falling within the ambit of the Professional Board. d) To promote liaison in the field of the education and training contemplated in paragraph (c), both in the Republic and elsewhere, and to promote the standards of such education and training in the Republic. e) To make recommendations to the Council to advise the Minister on any matter falling within the scope of this Act as it relates to any health profession falling within the ambit of the Professional Board in order to support the universal norms and values of such profession or professions, with greater emphasis on professional practice, democracy, transparency, equity, accessibility and community involvement. f ) To make recommendations to the Council and the Minister on matters of public importance acquired by the Professional Board in the course of the performance of its functions under this Act. g) To maintain and enhance the dignity of the relevant health profession and the integrity of the persons practising the profession. h) To guide the relevant health profession or professions and to protect the public. 16 HPCSA ANNUAL REPORT 2016/17

18 Table 1: Roles and responsibilities of the relevant bodies within the HPCSA Council Professional Boards Registrar ROLE AND RESPONSIBILITY Co-ordinate the activities and communication amongst the Professional Boards Stakeholder engagement Strategic planning and budgeting Uphold and maintain professional and ethical standards Ensure the investigation of complaints Ensure transparency and accountability to the public Control and exercise authority in respect of all matters affecting the education, training and practice of persons in any health profession falling within the ambit of the Professional Boards Maintain and enhance the dignity of the relevant health profession and the integrity of the persons practising such profession Make recommendations to the Council to advise the Minister on issues pertaining to Professionals under the ambit of the Board Carry out the duties assigned to or imposed upon him or her in terms of the Act Records management Adequate financial management Ensures that Council has the required systems Transparent use of resources POLICY MANDATE The HPCSA is influenced by national policies and plans, including, but not limited to, the National Development Plan (NDP), NDOH strategic plan and the medium term strategic framework (MTSF). National Development Plan 2030 (NDP) The National Development Plan (NDP) is the focal policy framework as highlighted in the 2016 Budget Speech. It is the overarching South African plan to which the National Department of Health (NDOH) as well as other departments and entities would need to align in order to achieve the stated outcomes. The NDP s Vision for 2030 in relation to health includes: Raising the life expectancy to at least 70 years; Ensuring that the generation of under-20s is largely free of HIV; Significantly reducing the burden of disease; and Achieving an infant mortality rate of less than 20 deaths per 1000 live births, and an under-5 mortality rate of less than 30 per The NDP further sets Goals for 2030 in relation, but not limited to: Universal Health Coverage, and Posts filled with skilled, committed and competent individuals The HPCSA will be contributing to this by actively advocating to practitioners and the public to ensure adequately qualified professionals are developed and available. National Health Insurance (NHI) The National Health Insurance (NHI) is a health financing system that is designed to pool funds to provide access to quality, affordable personal health services for all South Africans based on their health needs, irrespective of their socioeconomic status 1. 1 HPCSA ANNUAL REPORT 2016/17 17

19 The HPCSA and its Professional Boards are actively engaged with NHI and the strategy for Human Resources for Health to promote awareness, debate and ultimately actively participate and support these critical initiatives which are aimed at enhancing access to and provision of healthcare to the South African population. The HPCSA sees itself playing a pivotal role in aspects of the NHI relating, but not limited to, the following: The contracting of private health care providers through providing input on the general practitioner contracting model, and Enhancing human resources for health by ensuring that there are adequately qualified professionals trained and registered that meet the needs of the country by effectively carrying out its mandate of providing for control over the education, training and registration for and practising of health professions registered under the Act. Regulators such as the HPCSA and other statutory bodies support the implementation of Phase 1 of the NHI. This implementation includes the establishment of six (6) work streams that will support the required activities. These work streams include the following: Work Stream 1: Prepare for establishing the NHI Fund, including reviewing other relevant legislations and inter-governmental functions and fiscal framework that will be impacted by the implementation of NHI. Work Stream 2: Clarification of the NHI benefits and services including the PHC Lab 52. Work Stream 3: Preparation for the purchaserprovider split. Work Stream 4: Review of medical schemes to define their future role. Work Stream 5: Completion of NHI Policy paper and NHI Bill. Work Stream 6: Strengthening of the District Health System in preparation for a functional District Health Management Office (DHMO). Council and its Professional Boards are committed into making sure that professions at the HPCSA contribute to the effectiveness and success of the NHI; and will be forwarding inputs that will contribute to the successful establishment and implementation of the NHI. NATIONAL DEPARTMENT OF HEALTH STRATEGIC PLAN AND MEDIUM TERM STRATEGIC FRAMEWORK The alignment between the NDP 2030 Vision and the NDOH Strategic Plan is shown in the following table: 18 HPCSA ANNUAL REPORT 2016/17

20 LINK BETWEEN NATIONAL DEVELOPMENT PLAN AND THE NATIONAL DEPARTMENT OF HEALTH STRATEGIC GOALS NDP GOALS 2030 Average male and NDP PRIORITIES 2030 NDOH STRATEGIC GOALS HPCSA PROGRAMMES HPCSA STRATEGIC OBJECTIVES Develop an female life expectancy overarching at birth increased to Council plan to 70 years enable effective Stakeholder engagement Proactive twoway engagement between Council and NDoH allowing for inclusive in policy Address the social determinants that affect health and diseases Prevent and reduce the disease burden and promote health Prevent disease and reduce its burden, and promote health Improving the role of the HPCSA as an advocate & advisor and enhanced engagement with all key stakeholders formulation Engage with Joint Health Sciences Coordinating Committee to address cross cutting issues between Department of Higher Education & Training (DHET) & NDoH Bridge gaps between NDoH and Professional Boards through the use of policy forum (e.g. Forum of Statutory Councils) HPCSA ANNUAL REPORT 2016/17 19

21 NDP GOALS 2030 Tuberculosis (TB) prevention and cure progressively improved Maternal, infant and child mortality reduced Prevalence of Non- Communicable diseases reduced Injury, accidents and violence reduced by 50% from 2010 levels Health systems reforms completed NDP PRIORITIES 2030 Strengthen the health system Improve health information systems Improve quality by using evidence NDOH STRATEGIC GOALS Improve health facility planning by implementing norms and standards Improve financial management by improving capacity, contract management, revenue collection and supply chain management reforms Develop an efficient health management information system for improved decision making Improve the quality of care by setting and monitoring national norms and standards, improving system for user feedback, increasing safety in health care, and by improving clinical governance HPCSA PROGRAMMES Improving the role of the HPCSA as an advocate & advisor and enhanced engagement with all key stakeholders HPCSA STRATEGIC OBJECTIVES Simplification and clarification for distribution to the public on different entities roles and responsibilities (e.g. National Council vs HPCSA) Providing a platform and mechanisms for Boards to engage with NDoH effectively 20 HPCSA ANNUAL REPORT 2016/17

22 NDP GOALS 2030 Primary healthcare teams deployed to provide care to families and communities Universal health coverage achieved Posts filled with skilled, committed and competent individuals NDP PRIORITIES 2030 Financing universal healthcare coverage Improve human resources in the health sector NDOH STRATEGIC GOALS Re-engineer primary healthcare by: increasing the number of ward based outreach teams, contracting general practitioners, and district specialist teams, and expanding school health services Make progress towards universal health coverage through the development of the National Health Insurance scheme, and improve the readiness of health facilities for its implementation HPCSA PROGRAMMES Improving the role of the HPCSA as an advocate & advisor and enhanced engagement with all key stakeholders Improving the role of the HPCSA as an advocate & advisor and enhanced engagement with all key stakeholders Co-ordination to ensure legislative and regulatory consistency across the HPCSA and its Professional Boards HPCSA STRATEGIC OBJECTIVES HPCSA ANNUAL REPORT 2016/17 21

23 8. HPCSA ORGANISATIONAL STRUCTURE The mandate of the HPCSA as legislated in the Health Professions Act of 1974 (as amended) is realised through the functions of three separate structural components, namely: Council, the twelve Professional Boards and the Secretariat. 8.1 HPCSA REPORTING STRUCTURE TO THE MINISTRY OF HEALTH Parliament Minister of Health Department of Health Health Professions Council of South Africa Professional Conduct Review Committe Human Rights and Ethics CPD Committee Business Practice Committee HPCSA 32 Members Executive Committee Finance and Investment Committee Audit and Risk Committee Tender Committee Human Resources and Renumeration Committee Pension and Provident Trustee Committee Education, Training and Quality Assurance Committee Health Committee Professional Boards HPCSA Administration 22 HPCSA ANNUAL REPORT 2016/17

24 8.2 THE PROFESSIONAL BOARDS The Professional Boards of the HPCSA include: 12 Professional Boards Dental Therapy and Oral Hygiene Dietetics and Nutrition Emergency Care Environmental Health Practitioners Medical and Dental Medical Technology Occupational Therapy, Medical Orthotics, Prosthetics and Arts Therapy Optometry and Dispensing Opticians Physiotherapy, Podiatry and Biokinetics Psychology Radiography and Clinical Technology Speech, Language and Hearing Professions The primary role of the Department Professional Boards is to provide administrative support to the twelve (12) Professional Boards under the auspices of the Health Professions Council. The underlying consideration for ensuring quality assurance at the HPCSA is the protection of the public through the establishment of a policy framework to ensure the provision of health care professionals who are competent to practise their professions ethically. The Health Professions Act 56 of 1974 sets a fundamental basis for the quality assurance function of the HPCSA. At a strategic Ievel, Professional Boards have a responsibility to assist in the promotion of the health of the population of the Republic and to make recommendations to Council to advise the Minister on any matter falling within the scope of the Act to support the universal norms and values of such profession(s). Professional Boards are statutory structures whose overall objective is to ensure the establishment and maintenance of acceptable levels of health care services in the professions under their purview. In terms of the Health Professions Act, Act 56 of 1974, Professional Boards assume control and exercise authority in respect of all matters affecting the training of persons in, and the manner of the exercise of the practices pursued in connection with, any profession failing within the ambit of the Professional Board, and to maintain and enhance the dignity of the profession and the integrity of the persons practising the profession. In terms of these delegations, Professional Boards have a responsibility to: determine standards for education and training based on the needs of the country and aligned to best practice; 2. ensure compliance to those standards in terms of the process of evaluation and accreditation of education and training facilities; 3. determine and ensure maintenance of standards for professional practice and professional conduct; 4. ensure compliance to Continuing Professional Development (CPD) and to enhance a culture of life- long learning within the scope of the profession directives; 5. grant certification to students and to compliant practitioners to practise their professions once all the registrations requirements had been complied with; 6. register, where applicable, graduates for internship where applicable and graduates for compulsory Community Service; HPCSA ANNUAL REPORT 2016/17 23

25 7. develop policy and formulate regulations and rules of conduct for professional practice. Any decision of a Professional Board relating to a matter falling entirely within its ambit shall not be subject to ratification by the Council, and the Council shall, for this purpose, determine whether a matter falls entirely within the ambit of a Professional /Board. 8.3 EXECUTIVE MANAGEMENT STRUCTURE The operational structure of Administration / Secretariat is as follows: HPCSA Registrar/CEO Council Secretariat Chief Operations Officer Ombudsman Chief Information Officer CPD, Registrations and Records Risk Management Officer Human Resources Support Services PR and Service Delivery Legal Services Chief Financial Officer Professional Boards Administration 24 HPCSA ANNUAL REPORT 2016/17

26 Part PERFORMANCE INFORMATION

27 PART B: PERFORMANCE INFORMATION 1 SITUATIONAL ANALYSIS 1.1 Service Delivery and Organizational Environment The performance environment of the HPCSA is impacted on the supply and demand of health professionals practicing in the country. As the HPCSA has a responsibility to guide the professions and to protect the public, there is a requirement that healthcare professionals practising within South Africa maintain the relevant ethical conduct and professional standards in line with international standards and local norms. In order to ensure the realisation of quality healthcare for the population, there is a requirement that the HPCSA keeps abreast of global, regional and local trends in terms of healthcare practices as well as the shifting healthcare needs of the population. Defining the scope of practice and scope of a profession in light of the shifting environment then becomes a key responsibility of the HPCSA. Furthermore, the management of issues such as scope creep between the professions become some of the challenges to which the HPCSA has to respond. The performance delivery environment of HPCSA had been characterized by serious reputational risk as Council processes were seen as slow and ineffective. To this end Council has endeavored to improve its business model in order to improve the situation and enhance its functioning. As a result, Council in its strategic planning has shifted towards a turn-around strategy. Although the strategic objectives have remained the same, the targets for some indicators have been updated due to the shift towards a turn-around strategy in order to improve on service delivery to our practitioners and the public. Income for the HPCSA is generated, inter alia, from fees payable by practitioners. All individuals who practise any of the health care professions incorporated in the scope of the HPCSA are obliged by the Health Professions Act No. 56 of 1974 to register with the Council. Failure to do so constitutes a criminal offence. During the period under review, practitioners, or 85% of practitioners were expected to pay annual renewal fees and renew their registration. Ninety - six percent (96%) paid their dues and the balance 4% run the risk of being suspended from practising their profession as stipulated in the Act. Annexure 1 depicts the growth of the total register from April 2014 to March 2016, including those health practitioners who do not necessarily pay annual fees, such as intern students, interns, and practitioners exempted due to old age. BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 DOH DA DENTAL ASSISTANT 2,974 3,003 3,049 3,131 DA S STUDENT DENTAL ASSISTANT 1,673 1,748 1,820 1,991 OH ORAL HYGIENIST 1,110 1,143 1,195 1,220 OH S STUDENT ORAL HYGIENIST TT DENTAL THERAPIST TT S STUDENT DENTAL THERAPIST DOH Total 6,892 7,086 7,361 7, HPCSA ANNUAL REPORT 2016/17

28 BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 DTB DT DIETITIAN 2,778 2,949 3,145 3,311 DT S STUDENT DIETITIAN 1,381 1,510 1,650 1,676 NT NUTRITIONIST NT S STUDENT NUTRITIONIST DTB Total 4,597 4,947 5,308 5,500 EHP FI FOOD INSPECTOR HI HI S HIA ENVIRONMENTAL HEALTH PRACTITIONER STUDENT ENVIRONMENTAL HEALTH OFFICER ENVIRONMENTAL HEALTH ASSISTANT 3,363 3,447 3,567 3,658 2,304 2,469 2,471 2, EHP Total 5,738 5,990 6,113 6,254 EMB ANA AMBULANCE EMERGENCY ASSISTANT 8,507 8,882 9,225 9,636 ANT PARAMEDIC 1,598 1,605 1,591 1,552 ANTS STUDENT PARAMEDIC BAA BASIC AMBULANCE ASSISTANT 55,631 56,786 55,400 53,022 ECP EMERGENCY CARE PRACTITIONER ECPS STUDENT EMERGENCY CARE PRACTITIONER ECPV ECP VISITING STUDENT ECT EMERGENCY CARE TECHNICIAN ,063 1,113 ECTS OECO STUDENT EMERGENCY CARE TECHNICIAN OPERATIONAL EMERGENCY CARE ORDERLY EMB Total 69,111 70,905 70,051 68,209 MDB AN ANAESTHETIST S ASSISTANT BE BIOMEDICAL ENGINEER CA CLINICAL ASSOCIATE CA S STUDENT CLINICAL ASSOCIATE DP DENTIST 5,817 6,006 6,158 6,314 DP S STUDENT DENTIST 1,292 1,324 1,439 1,447 HPCSA ANNUAL REPORT 2016/17 27

29 BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 GC GENETIC COUNSELLOR GC S STUDENT GENETIC COUNSELLOR GCIN INTERN GENETIC COUNSELLOR GR GENETIC COUNSELLOR GR S STUDENT GENETIC COUNSELLOR GRIN INTERN GENETIC COUNSELLOR HA HEALTH ASSISTANT IN INTERN 3,251 3,106 3,132 3,272 IN S STUDENT INTERN 1,011 1,077 1,427 1,350 KB CLINICAL BIOCHEMIST MP MEDICAL PRACTITIONER 40,716 41,886 43,141 44,653 MP S MEDICAL STUDENT 10,686 11,594 12,372 12,656 MS & MW MEDICAL SCIENTIST MS S & MW S STUDENT MEDICAL SCIENTIST MSIN & MWIN INTERN MEDICAL SCIENTIST PH MEDICAL PHYSICIST PH S STUDENT MEDICAL PHYSICIST PHIN INTERN MEDICAL PHYSICIST SMW SUPPLEMENTARY MEDICAL SCIENTIST VS VISITING STUDENT MDB Total 65,133 68,406 70,627 72,823 MTB CT CYTO-TECHNICIAN GT MEDICAL TECHNICIAN 2,943 3,121 3,375 3,538 GT S STUDENT MEDICAL TECHNICIAN 2,370 2,405 2,495 2,560 LA LABORATORY ASSISTANT LA S STUDENT LABORATORY ASSISTANT MLS MEDICAL LABORATORY SCIENTIST MT MEDICAL TECHNOLOGIST 5,075 5,257 5,362 5,480 MT S STUDENT MEDICAL TECHNOLOGIST 3,882 4,213 4,335 4,265 MTIN MEDICAL TECHNOLOGY INTERN HPCSA ANNUAL REPORT 2016/17

30 BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 SGT SLA SUPPLEMENTARY MEDICAL TECHNICIAN SUPPLEMENTARY LABORATORY ASSISTANT MTB Total 16,279 17,115 17,889 18,518 OCP AOS ASST MED ORTH PROST & LEATHERWORKER AT ARTS THERAPIST AT S ARTS THERAPY STUDENT OB OS OS S OSA OSIN ORTHOPAEDIC FOOTWEAR TECHNICIAN MEDICAL ORTHOTIST AND PROSTHETIST STUDENT MEDICAL ORTHOTIST AND PROSTHETIST ORTHOPAEDIC TECHNICAL ASSISTANT INTERN MEDICAL ORTHOTIST AND PROSTHETIST OT OCCUPATIONAL THERAPIST 4,299 4,534 4,812 5,021 OT S OTB OTBS OTES OTT SOS STUDENT OCCUPATIONAL THERAPIST OCCUPATIONAL THERAPY ASSISTANT STUDENT OCCUPATIONAL THERAPY ASSISTANT DELETED - ART THERAPY STUDENT OCCUPATIONAL THERAPY TECHNICIAN SUPPLEMENTARY MEDICAL ORTHOTIST AND PROSTHETIST 1,951 2,048 2,270 2, OCP Total 7,899 8,332 8,908 9,133 ODO OD DISPENSING OPTICIAN OD S STUDENT DISPENSING OPTICIAN OP OPTOMETRIST 3,533 3,600 3,702 3,767 OP S STUDENT OPTOMETRIST HPCSA ANNUAL REPORT 2016/17 29

31 BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 OR ORTHOPTIST SOD SUPPLEMENTARY OPTICAL DISPENSER SOP SUPPLEMENTARY OPTOMETRIST ODO Total 4,902 5,032 5,158 5,252 PPB BK BIOKINETICIST 1,305 1,384 1,505 1,618 BK S STUDENT BIOKINETICIST BKIN INTERN BIOKINETICIST CH PODIATRIST CH S STUDENT PODIATRIST MA MASSEUR PT PHYSIOTHERAPIST 6,670 6,902 7,196 7,473 PT S STUDENT PHYSIOTHERAPIST 2,097 2,155 2,474 2,271 PTA PHYSIOTHERAPY ASSISTANT PTAS STUDENT PHYSIOTHERAPY ASSISTANT PTT PHYSIOTHERAPY TECHNICIAN RM REMEDIAL GYMNAST SCH SUPPLEMENTARY PODIATRIST SPT SUPPLEMENTARY PHYSIOTHERAPIST PPB Total 11,686 12,280 13,284 13,688 PSB PM PSYCHO-TECHNICIAN PMT PSYCHOMETRIST 1,981 1,981 2,028 2,066 PMTS STUDENT PSYCHOMETRIST PRC REGISTERED COUNSELLOR 1,724 1,812 1,977 2,176 PS PSYCHOLOGIST 7,622 7,891 8,190 8,453 PS S STUDENT PSYCHOLOGIST 1,195 1,300 1,429 1,493 PS V PSYCHOLOGY VISITING STUDENT PSIN INTERN PSYCHOLOGIST SRC STUDENT REGISTERED COUNSELLOR 192 1,361 2,045 2,494 PSB Total 13,814 15,523 17,016 18, HPCSA ANNUAL REPORT 2016/17

32 BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 RCT DR RADIOGRAPHER 6,739 6,997 7,321 7,559 DR S STUDENT RADIOGRAPHER 1,890 1,987 1,937 2,067 DR V EE EE S VISITING STUDENT RADIOGRAPHER ELECTRO-ENCEPHALOGRAPHIC TECHNICIAN STUDENT ELECTRO- ENCEPHALOGRAPHIC TECHNICIAN KT CLINICAL TECHNOLOGIST KT S KTG STUDENT CLINICAL TECHNOLOGIST GRADUATE CLINICAL TECHNOLOGIST RLT RADIATION TECHNOLOGIST RLTS RSDR SDR SDRS SKT STUDENT RADIATION TECHNOLOGIST RESTRICTED SUPP DIAG RADIOGRAPHER SUPPLEMENTARY DIAGNOSTIC RADIOGRAPHER STUDENT SUPPLEMENTARY DIAGNOSTIC RADIOGRAPHER SUPPLEMENTARY CLINICAL TECHNOLOGIST RCT Total 10,771 11,176 11,565 11,978 SLH AM AUDIOMETRICIAN AU AUDIOLOGIST AU S STUDENT AUDIOLOGIST GAK HEARING AID ACOUSTICIAN GAKS SAA STUDENT HEARING AID ACOUSTICIAN SPEECH AND AUDIOLOGY ASSISTANT SAU SUPPLEMENTARY AUDIOLOGIST SGAK SUPPLEMENTARY HEARING AID ACOUSTICIAN HPCSA ANNUAL REPORT 2016/17 31

33 BRD CODE REG CODE REG NAME APR 2014 APR 2015 APR 2016 APR 2017 SGG SGK COMMUNITY SPEECH AND HEARING WORKER SPEECH AND HEARING CORRECTIONIST SHA SPEECH AND HEARING ASSISTANT SSTA SUPPLEMENTARY SPEECH THERAPIST AND AUDIOLOGIST ST SPEECH THERAPIST ,024 ST S STUDENT SPEECH THERAPIST STA STAS SPEECH THERAPIST AND AUDIOLOGIST STUDENT SPEECH THERAPIST AND AUDIOLOGIST 1,453 1,475 1,516 1, STB SPEECH THERAPY ASSISTANT SLH Total 4,148 4,428 4,832 5,106 Grand Total 220, , , ,365 During the year under review, Council adopted and approved a five-year strategic plan. The strategic planning process of Council sought to ensure that a comprehensive, integrated and consolidated strategy was developed for the HPCSA and that, through this process, alignment in outcome and expectation is achieved for all relevant internal and external stakeholders. The development of the strategic plan was informed by the outcomes of both internal and external evaluations which highlighted the need for the HPCSA to review its business model in order to ensure effectiveness and efficiency in the execution of its legislative mandate. The new business model will inform the required legislative review that will enable the model. To achieve this strategic objective, the HPCSA has gone out on tender and appointed a service provider in the name of Fever Tree Consulting to undertake business re-engineering process for the HPCSA for a period of 18 months, which commenced in February 2017 and will be completed in July This project is designed and focused on the following key areas: a. Business Process Re-Engineering; b. Business Operating Model and Organizational design; c. ICT Roadmap, ICT Governance and IT Strategic Plan with clearly proposed technology tools that will support the new business model; and d. Clearly defined implementation plan. 32 HPCSA ANNUAL REPORT 2016/17

34 Furthermore, the role of the HPCSA is impacted directly by the National Development Agenda, the Legislative and Regulatory Environment, Practitioners and the Public (see Figure 2 below). External Opportunities and Threats The following areas have been identified that pose both opportunities and threats to the Professions: Technology Advances in technology have and will change the environment for the professions and is having a dramatic effect on the way the health industry operates. These shifts have resulted in the following opportunities: Migrating towards an online platform provides an opportunity in enhancing the efficiency of registrations. Greater cross-sharing of information between regulators and governmental departments e.g. potential use of databases, such as those under the Regulation of Interception of Communications and Provision of Communication-Related Information Act (RICA) to verify practitioner details) has the potential to improve the effectiveness of the HPCSA. Increased access to smart-phones and health apps allows detailed monitoring of the health needs of society providing valuable insights enabling proactive and efficient communication and training. The harnessing of social media to transform the way the HPCSA engages with stakeholders. Assisted reality and virtual reality has the potential to reform the way education and training is delivered as well as its accessibility. These shifts can assist taking health services to areas and individuals who previously may not have had access to it, as well as providing support to those practitioners placed in rural areas. The HPCSA needs to position itself and embrace technology in order to effectively regulate in the future or it runs the risk of becoming ineffective and redundant. Other threats that technology entails are as follows: Greater public access to information together with advances in technology and equipment may require Council reviewing the scopes of professions / practice. Due to the greater access of information, challenges exist in protecting the public from unsound practices, confidentiality and unsafe medical devices. Healthy Lifestyle In support of promoting a long and healthy life for all South Africans, the HPCSA notes that an opportunity exists to HPCSA ANNUAL REPORT 2016/17 33

35 intensify training and support in priority diseases and health programmes. These priority diseases as noted by the NDOH include but are not limited to Tuberculosis (TB); Human Immunodeficiency Virus(HIV)/Acquired immune deficiency syndrome (AIDS); maternal and child morbidity and mortality; and non-communicable diseases driven by risk factors related to life-style; and violence, injuries and trauma. Threat: Tertiary Environment ( Student Protests ) The extremely volatile environment at tertiary institutions has had far-reaching implications for all health professions and training countrywide. Strikes and the intermittent shutdown of several universities decreased time afforded for the training, and thus posed a serious threat in the provision of quality health professionals. The protests also posed a threat to the HPCSA s income, because the HPCSA had an expectation to register new health practitioners to increase its revenue generation. As a result of the disruptions at universities, there was an eminent challenge of healthcare practitioners not completing their academic qualifications and thus not registering with the HPCSA. 1.2 Stakeholder Analysis The HPCSA s legislative mandate includes performing an advocacy and advisory role with its key strategic stakeholders. In this regard, the HPCSA has a complex internal and external stakeholder base. Stakeholder engagement can be seen as one of the key strategic enablers and part of the legislative mandate of the Boards and Council. It therefore, forms an integral part of the strategy development process: 1.3 Summary of Key Issues The key issues, which have to be addressed in the Strategy and resolved during the term of Council and are cross-cutting across the Professional Boards include: 34 HPCSA ANNUAL REPORT 2016/17

36 Other Operational Performance of the HPCSA is as follows: 1. Registration of Health Practitioners In the year under review, Council registered more than healthcare practitioners in line with its legislative mandate. Registrations were conducted mainly at the Head Office in Pretoria, and, to a limited extent, at offsite registration venues. The offsite registrations were targeted mainly to capture newly qualified health practitioners graduating from student status to other categories, including internship and community service before they could leave training institutions for deployment. The achievements are outlined below: 2 In house Registration During the period under review, Council registered practitioners who qualified for registration in accordance with the Act. Among these, were practitioners joining internship training programmes as well as students studying towards a health profession registrable in terms of the Act. The following tables depict movements that resulted in changes to the registers kept by Council, as well as other services provided to practitioners in the period, 1 April 2016 to 31 March 2017, with comparative numbers for the period 1 April 2015 to 31 March 2016: Table 1: Registrations CATEGORY NUMBER REGISTERED IN 2015/2016 NUMBER REGISTERED IN 2016/2017 Prescribed Registrations Specialists Foreign Qualified Additional Category Additional Qualification Category Change Table 2: Removals NUMBER NUMBER CATEGORY RECORDED RECORDED IN IN 2015/ /2017 Voluntary Erasures Suspensions for not paying annual fees Instruction to Erase Deaths HPCSA ANNUAL REPORT 2016/17 35

37 Table 3: Other Services up the overall practitioner database in terms of providing updated contact details, and in some cases updated CATEGORY NUMBER ISSUED IN 2015/2016 NUMBER ISSUED IN 2016/2017 identification numbers. 4. Continuing Professional Development (CPD) Certificates of Status Certified Extracts Intern Duty Certificates Verification of Credentials In addition, Registrations attended to various walk-in applications and enquiries from practitioners who visited Council s Client Contact Centre. There were more walkin practitioners recorded over the renewal period, for an extended period, as Council replaced off-site renewals with the Online Renewal Portal. Practitioners who had not made use of the Online Renewal and Payment Portal renewed their registration physically by queuing at the Head Office in Pretoria. During November and December 2016, Council attended to off-site registration of undergraduate students who had completed their studies at various institutions around the country, and were due to commence with internship training and community service. A total of students were registered. In the absence of an automated registration system for practitioners, offsite registrations remain a valuable initiative benefitting healthcare practitioners, particularly those proceeding to do internship and community service commencing early in the new year. The service reduces non-compliant applications received as applicants are present to promptly attend to outstanding requirements leading to registration. 3. Online Renewal and Payment Portal The Online Renewal and Payment Portal was launched on 1 March Over practitioners engaged with the portal and paid their annual fees through the portal in the comfort of their homes or practices. While the primary focus of the portal is to provide an easier renewal platform for practitioners, it has the added functionality of cleaning Council is working on an urgent plan to revamp and redefine the CPD programme, taking into account the expanded requirements of Maintenance of Licensure. In 2015/16, Council supported and approved that further research be conducted with regard to best practice in implementing the Maintenance of Licensure requirement. A Task Team of the CPD Committee was appointed to engage Professional Boards, practitioners and other stakeholders with a view to piloting Maintenance of Licensure from January From an operations point of view, Council implemented an IT module that can efficiently handle the increased load from the expanded CPD portfolio requirements. The module is expected to be in place for the Maintenance of Licensure piloting phase in January Document Management The HPCSA is required to ensure efficient, accurate and secure record-keeping of health practitioners information on its database. In line with this objective, the HPCSA commenced with the digitisation project, to convert paper records to the electronic format. The HPCSA identified close to five million paper records across various document types or categories from all departments in the HPCSA, that would be scanned and ultimately indexed to practitioner records on the main database. Once the project is complete, retrieval of documents will be electronic, improving accessibility of records, thereby reducing processing time. During its peak renewal period in March 2017, the HPCSA had an extremely busy time as more than identification numbers of practitioners who previously could not use the portal either because Council did not have the identity number on file or had an old identity number different from the one currently in use. Practitioners could not change this information as it required confirmation from the HPCSA. The practitioners could, however, change their contact details through the portal. 36 HPCSA ANNUAL REPORT 2016/17

38 The HPCSA continued utilising the Electronic Portfolio of International Credentials (EPIC) portal to verify credentials of applicants with foreign qualifications who are applying to be medical practitioners in terms of section 25 of the Act. The challenge that still remains with verifications is that the Education Commission for Foreign Medical Graduates (ECFMG) does not have links with all medical schools from which Council receives applicants. Applicants from such medical schools are, however, not excluded, as their applications are considered by the relevant committee of the Medical and Dental Board. 2. ADVOCACY AND STAKEHOLDER ENGAGEMENT One of the strategic objectives for the HPCSA is advocacy and stakeholder engagement. For the HPCSA to remain relevant and survive within the healthcare environment, it requires regular interaction with important stakeholder groups. Advocacy and stakeholder engagement play an important role in how stakeholders and the general public perceive the HPCSA. Council ensured that it achieved its objective of being an advisor and advocate in the healthcare regulatory environment. In the period under review, the HPCSA developed a stakeholder engagement strategy to guide its engagement with both internal and external stakeholders. This was to ensure that the relevant information is conveyed, especially when major decisions have to be implemented. The Strategy has since been forwarded to the Business Process Re-engineering for further alignment. 2.1 Stakeholder Engagement Initiatives Practitioner Roadshows and Symposia The HPCSA continued to conduct the practitioner roadshows as a means of engaging with practitioners, through direct dialogue, on pertinent issues that affect them in their respective work environments. These issues arrange from clarifying the role of the HPCSA, improving the HPCSA s service and accessibility, legal processes and how to avoid litigation, ethical guidelines and rules, latest rulings and continuing professional development (CPD) and education on the Health Committee. The roadshows are in line with upholding the HPCSA s mandate of guiding the professions. Two (2) practitioner roadshows were held in the year under review. Over and above the Practitioner Roadshows, Council hosted eleven (11) symposia around the country which were attended by approximately practitioners. The symposia were an increase from the six (6) that were held during the previous financial period. The symposia are an engagement platform initiated by Council as a mechanism to interact and engage practitioners and receive feedback from them on pertinent issues that affect them. The symposia also afford practitioners an opportunity to keep abreast with new developments within their respective professions at the same allowing them to ensure that their knowledge stays relevant and up to date. The HPCSA Ombudsman presents accredited ethics lectures at these Symposia and Roadshows, to different groups of professionals registered under the Act as part of the Continuing Professional Development (CPD). Practitioners obtain Continuing Educational Units (CEUs) at these engagement sessions. 2.2 Public Awareness Campaigns In the year under review, the HPCSA in collaboration with the Department of Health and other healthcare regulatory bodies, rolled out three (3) Public Awareness Campaigns in Phoenix, (KwaZulu-Natal), Port Elizabeth (Eastern Cape) and in Seshego, Limpopo province. This was in contrast to one (1) public awareness campaign/ roadshow that was held in the 2015/16 financial year. Members of the public who were in attendance were educated on the following topics: The different mandates of the various healthcare regulators the HPCSA, the Department of Health, the South African Nursing Council (SANC), the Office of the Health Standards Compliance. The role of the HPCSA Inspectorate Office and how to identify a bogus healthcare practitioner and what to do. HPCSA ANNUAL REPORT 2016/17 37

39 The rights of patients the Do s and Don ts for patients when consulting a practitioner. The dangers of using skin lightening creams and medicines and many other topics. These roadshows were characterised by robust interaction between Council and the said communities. The community members came out in numbers to learn more about their rights and the channels to use when lodging a complaint with each of the healthcare regulatory bodies in attendance. 2.3 Community Radio Campaign To bolster the community awareness campaign, the HPCSA embarked on a nationwide community radio campaign in over 41 community radio stations. Topics that were addresses ranged from the mandate of the HPCSA, online registration, bogus practitioners and processes on how to lodge a complaint with the HPCSA. The 41 community radio stations had a total listenership of four million. 2.4 Publications Professional Boards newsletters Professional Boards continued to communicate through electronic and printed newsletters. The Department assisted in developing eleven (11) Professional Boards Newsletters. Practitioners are continuously encouraged to update their addresses and contacts with Council so as to facilitate electronic communication via and special SMS notifications, which allows for real-time communication. Over and above the Professional Boards newsletters, practitioners received e-bulletin which provided practitioners with the much needed information from Council. The Bulletin Magazine is an annual magazine that is distributed to all HPCSA stakeholders. The Magazine communicates critical information to the HPCSA s registered practitioners guiding their professional conduct and best practices in healthcare delivery, thus contributing to quality standards that promote the health of all South Africans. Internal stakeholder engagement was vital to ensure that staff is continuously kept abreast of all activities that take place within Council. To this end, the Department: Public Relations and Service Delivery published six (6) internal newsletters PULSE and four (4) Pulse express, which was an employee publication specifically on the Turnaround progress updates. The HPCSA also published articles on key strategic magazines, such as the Pan African Magazines, Leadership Magazine and Sunday Times Healthy Times. 2.5 Media liaison and publicity Council continued to nurture relations with the media in a bid to create a lasting relationship of mutual respect. To this end, 44 radio interviews were conducted, 16 media releases issued and 42 media enquiries responded to within a 24- hour turnaround time. The HPCSA website continued to be the first point of call for both the public and practitioners for information. 2.6 Reputation Management Media monitoring is a vital tool to keep track of news that relate to the HPCSA, stakeholders and the health environment in general. Media monitoring enables the organisation to determine the Advertising Value Equivalent (AVE) and monitor the organisation s brand and executives in the news. It furthermore monitors corporate reputation and tracks the effectiveness of media releases. AVE is a value that is used in the public relations industry to measure the benefit to a client from media coverage of a public relations campaign. In the year under review, the total AVE for the HPCSA was R Resource Centre The Resource Centre is housed within the Department and plays a role in continuous learning of staff members for research purposes in order to perform their duties. The goal was to change the traditional resource centre into a learning common. This meant an increase in collaborations and increase for digital resources. The Resource Centre provides for an environment that inspires learning and allows for the reconstruction of understanding from a 38 HPCSA ANNUAL REPORT 2016/17

40 variety of foundations. Part of it involves having access to information in the Resource Centre and designing a space for what staff need now and what Council could envision for the future. 2.8 Focus on Customer Service One of the most critical service challenges businesses face today is driving cost-efficiency in call centres while maintaining the quality of customer interactions. The Call Centre is responsible for maintaining a positive image with the public and practitioners by providing an effective interface and professional first line telephonic assistance and problem-solving ability. The primary purpose is to ensure a high standard of service delivery to external clients through effective management, tracking and resolution of front office queries escalated throughout Council. To do this, Council s Call Centre: handled over incoming calls of which related to Registration enquiries, to Finance, to Professional Boards and were Legal/ General enquiries, with approximately info enquiries which were answered within our turn-around time of 24 hours. printed practicing cards and updated of practitioners addresses and approximately unresolved Registration queries were escalated to the registration department for resolution. In the period under review, the Call Centre s Interactive Voice Response (IVR) message was updated, allowing change of addresses, card request card and HPCSA banking details to be loaded to the incoming calls queue options. The new Call Centre CIC CISCO Telephone software system was also implemented as was a new wireless headsets for agents. Council is embarking on a project to develop the Call Centre Self-Service Capability, Interactive Voice Response (IVR) and the entire Council s CIC Telephone System to enhance service delivery to practitioners and the public. The advantages that the Self-Service Capability system offered is that only the really complicated enquiries will have to go to the agents, which leads to reduced holding time for callers. The system can be accessed even after normal working hours and during weekends and public holidays. Through the HPCSA s dedicated complaints address, servicedelivery@hpcsa.co.za, Council received a total of s during the year and 90% of those complaints were resolved within a 48 hour turnaround time. Practitioners are encouraged to use the complaints line to provide negative or positive feedback on the service they have received from HPCSA staff. Council also attends key stakeholder events, such as those of the South African Dental Association (SADA), Board of Healthcare Funders (BHF), Hospital Association of South Africa (HASA) and many other conferences to provide onsite assistance with HPCSA customer-related enquiries and allow practitioners an opportunity to get information and provide feedback on HPCSA services. An online feedback form is loaded on the HPCSA website, to allow for both practitioners and the public alike to send complaints and compliments on the service offered by the HPCSA. The HPCSA conducted its first Customer Satisfaction Survey in the period under review and the results will be published in the next financial year. 3. INFRASTRUCTURE The HPCSA owns two (2) buildings as part of its immovable assets in Arcadia. Due to the HPCSA s ever-growing staff complement, additional office space of about 850 square meters was rented to accommodate about 80 staff members at the Nedbank Plaza Building. This space expansion will ensure that the organisation will be able to accommodate the space demands for the next two to three years based on the current growth trend. The HPCSA rented other offices in three (3) provinces, namely: Durban, KwaZulu Natal, East London in the Eastern Cape and Cape Town in the Western Cape. These satellite offices house staff from the Inspectorate Office. In the period under review, the Department completed several maintenance projects in the two buildings, including: Renovation of the Council Chambers basement ablution facilities, Council Chambers basement kitchen and lobby area, HPCSA ANNUAL REPORT 2016/17 39

41 Renovation of the Registrar s office and kitchen, Renovation of the canteen area, Renovation of the Maintenance Officers workshop, and The creation of office space for 20 staff members within the main building. Provision was made in the budget for the Department to develop a property roadmap to conduct a feasibility study on the construction of a new building in the current parking lot adjoining the HPCSA (Metrodenpark) building. When constructed, this building will ensure that there is adequate office space and facilities for all staff members for the next 20 to 30 years. Parking has also been a challenge in the two existing buildings due to limited space. This has also been resolved by renting 40 parking bays at the Nedbank Plaza building, a move that will ensure that all staff members are provided with a safe and adequate parking space for their vehicles. As part of the HPCSA infrastructure, the HPCSA deployed state of the art information technology to ensure that it stabilises and optimises the information and communication technology environment and supports efficiency and effectiveness of the services provided to its stakeholders. 4. COMPLAINTS MANAGEMENT, COMPLIANCE AND ENFORCEMENT The The HPCSA has a responsibility to receive, investigate, and in appropriate instances prosecute cases of unprofessional conduct. In terms of Section 3 of the Health Professions Act,1974 one of the objects and functions of the HPCSA is to ensure the investigation of complaints concerning persons registered in terms of this Act and to ensure that appropriate disciplinary action is taken against such persons in order to protect the interest of the public and to ensure that persons registered in terms of this Act behave towards users of healthcare services in a manner that respects their constitutional rights to human dignity, bodily and psychological integrity and equality. During the reporting period, the HPCSA received new complaints of which 595 were referred to the Ombudsman, 312 were police files and were complaints to be investigated. From 1 April 2016 to 31 March 2017, the HPCSA finalised a total of 216 matters at Professional Conduct Inquiry level, at Preliminary Inquiry level, at Road Accident Appeal Tribunal level and 553 matters were investigated and finalised at the Inspectorate level. The table below depicts the breakdown of cases handled in the three previous financial years: NUMBER OF COMPLAINTS RECEIVED DESCRIPTION 2014/ / / MATTERS FINALISED BY COMMITTEES OF PRELIMINARY INQUIRY DESCRIPTION 2014/ / / HPCSA ANNUAL REPORT 2016/17

42 5. PROFESSIONAL CONDUCT INQUIRY 01 APRIL 2016 TO 31 MARCH 2017 Following is a breakdown of matters that were referred for direct Inquiry before Committees of Professional Conduct Inquiry and the penalties imposed. SUMMARY OF FINALISED MATTERS ACCORDING TO PENALTIES 01 APRIL MARCH 2017 DESCRIPTION 2014/ / /2017 Suspensions Acquittals Fines Imposed at inquiry Caution & Reprimand Admission of Guilt Fines4(9) Finalised at Health Committee Finalised at Prelim Erasures TOTAL BREAKDOWN PER BOARD BREAKDOWN OF FINALIZED MATTERS PER PROFESSIONAL BOARD 01 APRIL MARCH 2017 BOARD 2014 / / / Medical and Dental Dental Therapy and Oral Hygiene Dietetics Medical Technology Occupational Therapy, Medical Orthotics & Prosthetics Optometry & Dispensing Opticians Physiotherapy, Podiatry and Biokinetics Psychology Speech, Language and Hearing Emergency Care Personnel Radiography and Clinical Technology Environmental Health TOTALS HPCSA ANNUAL REPORT 2016/17 41

43 FINALISED MATTERS PER OFFENCE BREAKDOWN OF FINALIZED MATTERS PER OFFENCE 01 APRIL MARCH 2017 TYPE OF OFFENCE 2014 / / /2017 Unethical Advertising Incompetence Over servicing Breach of confidentiality Damaging Professional Reputation of Colleague Insufficient Care/Treatment & Mismanagement of Patients Negligence Unacceptable/Inappropriate Relationship with Patients Refusing to treat patients Misdiagnosis Practicing Outside Scope of competence Fraudulent Certificates/Incorrect Information on Death Certificates Refusing to complete forms / producing inaccurate reports Overcharging / charging for services not rendered Issues relating to Consent Fraud and Theft Bringing the Professions into disrepute Employing unregistered practitioners Unethical dispensing, using of unregistered medicine and prescribing of drugs Contempt of Council Supersession / Contravening the Hazardous Substances Act, Practicing without registration TOTAL HPCSA ANNUAL REPORT 2016/17

44 6. MEDIATION The Ombudsman plays an active role in Council Committees, Professional Boards and Boards Committees. The Office of the Ombudsman also prepares and presents reports to the Professional Conduct Review Committee of Council and the Medical and Dental Professions Board on cases mediated upon. The Office of the HPCSA Ombudsman has established communication channels between Council, government and other stakeholders through constructive dialogue. This has resulted in the marked improvement on the referral processes for complaints not falling under the jurisdiction of the HPCSA. A Memorandum of Understanding (MOU) was signed with the Office of Health Standards Compliance (OHSC). Other relations established are with Council for Medical Schemes (CMS) and the Consumer Commissioner. The average turnaround time for the Office of the Ombudsman is 118 days. During this reporting period, contact mediations formed less than 1% of all the (306) matters finalised. Below is a Table that depicts complains received in the period of 2016/2017 financial year. This indicated a 6% decrease from the previous year when 676 complains were received. Of the 306 complaints finalised, three were finalised through contact mediation. 67 complaints were referred for preliminary investigations whilst 262 cases were carried over to the following year. Also of note is the increased turnaround time from 97 to 118 days this was due to the absence of an Ombudsman for a period in excess of six (6) months. INDICATOR 2015/ /17 Number Percentage Number Percentage Number of complaints received for mediation Number of complaints finalised % % Number of matters referred for preliminary investigation 83 12% % Number of matters finalised through contact mediation Cases Pending Mediation 41 6% % Turn - around time for finalising matters 97 days 118 days 6.1 BOARD DISTRIBUTION OF COMPLAINTS HPCSA ANNUAL REPORT 2016/17 43

45 The analysis of the 638 complaints received as shown in Figure 3.2 indicated that the Medical and Dental Professions Board accounted for 91.53%(584) of the complaints. This was followed by the Optometry and Dispensing Opticians Board at 2.5%(16); Psychology Board at 2.03%(13), Podiatry and Biokinetics Board at 1.56%(10), Speech, Language and Hearing Professions at 0.78% (5), Occupational Therapy, Medical Orthotics and Prosthetics and Arts Therapy, Radiography and Clinical Technology and OCT at 0.47%(3). There were no complaints mediated for practitioners registered under the following Professional Boards: Environmental Health Medical and Technology Board Dietetics and Nutrition Board 6.2 Provincial Distribution of Complaints 44 HPCSA ANNUAL REPORT 2016/17

46 The provincial distribution of complaints is a reflection of the register of practitioners with Gauteng having most of the practitioners registered under the Act. Registered practitioners in Gauteng account for 58.77%(373) of complaints, followed by KwaZulu-Natal at 15%(90); Western Cape at 13.94%(89); Eastern Cape at 6.4%(19); Free State at 2.97% (20); Mpumalanga at 2.35%(18); Limpopo at 2%(14); North-West at 14% (9) and Northern Cape at 0.94%(6). 6.3 Nature of Complaints 7. COMPLIANCE AND ENFORCEMENT : INSPECTORATE OFFICE One of the responsibilities of the HPCSA is to enforce compliance by practitioners in line with the provisions of the Health Professions Act, Council is embarking on a campaign to ensure that all health practitioners comply with all the regulations, ethical rules and in line with the provisions of the Health Professions Act. In order to execute the HPCSA established the Inspectorate Office whose main focus and primary role is to ensure that registered practitioners comply with the provisions of the Act, as well as all rules and regulations governing the practitioners. Over and above the overarching responsibility of ensuring compliance, the Inspectorate Office is also responsible for the following duties: Conducting proactive inspections of premises to ensure compliance Assisting Professional Boards with the inspections on clinical and professional compliance matters Ensuring compliance with penalties imposed by the Professional Conduct Committee Collect outstanding fines and attend to criminal matters in respect of unregistered practitioners. To this end, the HPCSA working with other law enforcement and other regulatory institutions in the health sector and members of public to expose and arrest these illegal practitioners. Currently, the HPCSA is involved in a number of cases where people who are neither trained (qualified) nor registered with the Council are practicing as health care professionals. People use forged documents such as fake qualifications, fake registration papers and fake registration numbers. Members of the public are urged to be vigilant of such illegal and bogus doctors and are advised to report suspicious activities of such to the HPCSA. The table below depicts the comparative analysis of the number of activities undertaken and performance under law enforcement and compliance in the 2015/16 and 2016/17 financial years: HPCSA ANNUAL REPORT 2016/17 45

47 2015/ / Compliance inspections. Conducted 367 that is 22% compliance rate achieved. 449 Backlog criminal cases reported of unregistered persons. Investigated and finalised 227 i.e. 51% conviction rate. Complaints received before the establishment of the Inspectorate Office. 186 new files criminal cases reported of unregistered persons. Investigated and finalised 143 i.e. 76% clearance rate. 53 matters referred for collection of outstanding fines, 50 outstanding fines were collected i.e. 94% success rate. 675 Compliance inspections. Conducted that is 234% compliance rate achieved. 371 Backlog criminal cases reported of unregistered persons. Investigated and finalised 289 i.e. 78% conviction rate. Complaints received before the establishment of the Inspectorate Office. 287 new files criminal cases reported of unregistered persons. Investigated and finalised 264 i.e. 92% clearance rate. 56 matters referred for collection of outstanding fines, 37 outstanding fines were collected i.e. 66% success rate. DESCRIPTION ANNUAL TARGET 2015/ 2016/ ACTUAL PERFORMANCE 2015/ 2016/ CLEARANCE RATE 2015/ 2016/ Compliance inspection % 234% DESCRIPTION MATTERS RECEIVED 2015/ 2016/ 2015/ FINALISED 2016/ CLEARANCE RATE 2015/ 2016/ Unregistered persons (criminal cases) % 79% Matters referred for collection % 66% DESCRIPTION MATTERS RECEIVED 2015/ 2016/ FINALISED 2015/ 2016/ CLEARANCE RATE 2015/ 2016/ Unregistered persons (criminal cases) % 79% Matters referred for collection % 66% 46 HPCSA ANNUAL REPORT 2016/17

48 8. KEY POLICY DEVELOPMENT AND LEGISLATIVE CHANGES Council to have jurisdiction over practitioners following disciplinary processes i.e. the professional will remain registered but shall not be licensed to practise. In the current financial year, there were no legislative The HPCSA s CPD Committee began the process of this changes. However, under the current legislative framework, initiative with there being the development of a draft any person who wishes to practice any profession registrable policy in consultation with a wider range of stakeholders, in terms of the Health Professions Act must be registered. including, but not limited to, practitioners, professional The mischief with the current legislative framework is that associations, universities, public and government. the Council loses jurisdiction over practitioners in an event that they are removed from the register for whatever reason, The Council s Business reengineering process is intended thus it cannot enforce discipline and ensure continuing to review the HPCSA s business processes which is likely professional development. to have an impact on the HPCSA s legislative framework, To address this, Council has embarked on the development which is highly likely to require legislative changes. of a policy that will separate the registration regime from On 6 March 2017, the HPCSA through its legal the license to practice. This separation will ensure that all representatives met with the Department of Health also persons who meet the minimum criteria for registration through its legal representatives where the Department of are registered. Any person so registered wishing to practice Health was advised that the HPCSA had decided to put the will have to apply and be issued with a license to practice. Health Professions Amendment Bill on hold in view of the The primary purpose of this initiative is to ensure that all HPCSA s embarking on the business process reengineering registered and licensed practitioners, under the jurisdiction following the MTT s recommendations and the Law Reform of the HPCSA, maintain their competence. Commission s recommendation to consider consolidating Under this dispensation, it will be required for practitioners the Health Professions Act and promulgating it afresh. to maintain their licenses. Under the maintenance of 9. STRATEGIC OUTCOME licensure, the Council will have to satisfy itself that the ORIENTED GOALS practitioner is still competent, both clinically and ethically to be able to practice. In 2011, the HPCSA decided that practitioners will require a license to practise their profession. The primary purpose of this initiative is to ensure that all registered and licensed practitioners, under the jurisdiction of the HPCSA, maintain their competence and performance for the well-being and The strategic outcome oriented goals of the HPCSA, as agreed upon by Council, attest to the HPCSA s role in facilitating the achievement of the national socio-economic and socio-political development agenda. Following are Council s Strategic Programmes/ Goals: best interest of patients. This will also assure the public that Improved Business Model to enhance the healthcare practitioners are up-to-date with knowledge functioning of the HPCSA and current trends, there is an improved quality of care, Adequate, effective and efficient support provided there is early detection of non-performance and there is to the Professional Boards and Secretariat professional accountability. Improving the role of the HPCSA as an advocate and The separation of registration and licensure to practise will allow individuals who have met requirements via advisor through enhanced engagement with all key stakeholders an accredited programme/examination to practise Legislative and regulatory consistency across the the profession whereas licensure will require proof of HPCSA and its Professional Boards compliance with the HPCSA requirements in order to continue to practise (entitlement to practise) thus allowing The HPCSA s Goals and SMART Goal Statements with 5 - year targets are: HPCSA ANNUAL REPORT 2016/17 47

49 SECTION 3: PERFORMANCE INFORMATION BY PROGRAMME 48 HPCSA ANNUAL REPORT 2016/17

50 SECTION 3: PERFORMANCE INFORMATION BY PROGRAMME HPCSA ANNUAL REPORT 2016/17 49

51 Strategic Objectives, Performance Indicators, Planned targets and actual achievements PROGRAMME 1: IMPROVED BUSINESS MODEL TO ENHANCE THE FUNCTIONING OF THE HPCSA STRATEGIC INDICATORS OBJECTIVES PLANNED TARGET 2016/17 ACTUAL ACHIEVEMENT 2016/17 DEVIATION FROM PLANNED TARGET TO ACTUAL ACHIEVEMENT FOR 2016/17 COMMENT ON DEVIATION Improved Performance and functionality through a review of the current business model Business Model Review Completion (%) 100% 10% 90% The Consultant was appointed in December 2016 and only resumed work in January 2017 Client Satisfaction (%) Establish Baseline 65% Not Applicable Not Applicable Improved functioning of the Secretariat, Board & Council through Role Clarification and Delegation of Authority Performance Establish Baseline Not Applicable Not Applicable Evaluation (%) Approved Yes Yes Not Applicable Not Applicable Delegation of Authority (Yes/No) Strategy to overcome areas of under performance The Service provider has been appointed and the Business Model Review will be completed in July In the process of Business Model Review there will be implementation of Quick Wins Changes to planned targets Business Review Model will be completed in July HPCSA ANNUAL REPORT 2016/17

52 Linking performance with budgets PROGRAMME 1: IMPROVED BUSINESS MODEL TO ENHANCE THE FUNCTIONING OF THE HPCSA Yearly Description Roll-over Virements Budget 2015/16 Surplus Adjusted Yearly Budget Yearto-date actuals Positive/ (Negative) variances % Variance Capital projects % Strategic projects (Strategic sessions) % Strategic projects (Special Projects) % Strategic projects (Business Process % Re-engineering Project) Strategic projects-offsite (annual fee renewals & % new registrations) ERS projects % Reason for variances Business Process Re- engineering project, IT projects including Collaboration platform, converged network upgrades, Online claim projects scheduled to be finalised in 2017/18. Funding for these projects were rolled-over to 2017/18 financial year. HPCSA ANNUAL REPORT 2016/17 51

53 PROGRAMME 2: ADEQUATE, EFFECTIVE AND EFFICIENT SUPPORT PROVIDED TO AND BY COUNCIL, PROFESSIONAL BOARDS AND SECRETARIAT PLANNED TARGET STRATEGIC OBJECTIVES INDICATORS 2016/17 ACTUAL ACHIEVEMENT 2016/17 DEVIATION FROM PLANNED TARGET TO ACTUAL COMMENT ON DEVIATION ACHIEVEMENT FOR 2016/17 Improved Communication and Knowledge Management Framework Developed (%) 100% (Office 365, Skype for Business, Online meetings & Intranet 75% (Office 365, Skype for Business & Online meetings) 25% Intranet development delayed due to analysis of data on the fileshare Implementation (%) 25% (Council) 75% Not Applicable Not Applicable Enhanced Competence of Council members, Board Members & Secretariat Number of training 1 Training Sessions 2 Training Sessions Not applicable Not Applicable sessions held Attendance at training 80% 70% 10% (%) Improved effectiveness and efficiency of meetings Enhancement and Standardization of Templates, Processes & Systems (%) 100% 95% 5% Only agendas and minutes for committees of Preliminary Inquiry and Professional Conduct Committees not standardized Compliance to Establish Baseline 100% Not applicable Not applicable Processes and Regulations Conduct research on all 100% 100% Not applicable Not applicable agenda items requiring research (%) 52 HPCSA ANNUAL REPORT 2016/17

54 PROGRAMME 2: ADEQUATE, EFFECTIVE AND EFFICIENT SUPPORT PROVIDED TO AND BY COUNCIL, PROFESSIONAL BOARDS AND SECRETARIAT PLANNED TARGET STRATEGIC OBJECTIVES INDICATORS 2016/17 ACTUAL ACHIEVEMENT 2016/17 DEVIATION FROM PLANNED TARGET TO ACTUAL COMMENT ON DEVIATION ACHIEVEMENT FOR 2016/17 Reduction of litigation Establish Baseline due to ultra vires decisions (%) Digital Transformation within the HPCSA Develop IR Roadmap 100% developed 100% Developed Not applicable Not applicable (%) IT Road Map Implementation 33% 50% (Online renewals, Not applicable Not applicable Collaboration Platform &Upgraded Oracle, Document scanning) Rationalization of Committees Rationalization of Committees (Yes/No) Yes Yes Not applicable Not applicable Strategy to overcome areas of under - performance Council Secretariat to provide reasons for non attendance Not applicable HPCSA ANNUAL REPORT 2016/17 53

55 Linking performance with budgets PROGRAMME 2: ADEQUATE, EFFECTIVE AND EFFICIENT SUPPORT PROVIDED TO AND BY COUNCIL, PROFESSIONAL BOARDS AND SECRETARIAT Description INCOME Yearly Roll-over Virements Budget 2015/16 Surplus Adjusted Yearly Budget Year-todate actuals Positive/ (Negative) % Variance variances Annual Fees % Registration fees % Examination fees % Accreditation training institution % Evaluation Fees % Penalties % Sundry fee (Including Restoration fees) % Other Income (Including Interest received) % EXPENDITURE Council and Council committees % Professional Boards and committees % Professional Board Evaluations % Administration expenditure % Employee expenditure % 54 HPCSA ANNUAL REPORT 2016/17

56 Reason for variances Income Less Emergency Care practitioners choosing to stay registered with HPCSA leading to a reduction in annual fee and registration fee revenue received. For all Professional Boards of Council less practitioners choose to be restored, write examination. Reason for variances Expenditure Positive variances for Council, Professional Board and committee expenditure was due to less meetings required than was budgeted for. Administration expenditure positive variances were due to savings in costs and expenditure planned for 2016/17 roll-over to 2017/18. Employee expenditure negative variance due to move of employees to cost-to-company, additional labour relation expenditure and savings in employee vacancies not realised. HPCSA ANNUAL REPORT 2016/17 55

57 PROGRAMME 3: IMPROVING THE ROLE OF THE HPCSA AS AN ADVOCATE AND ADVISOR THROUGH ENHANCED ENGAGEMENT WITH ALL KEY STAKEHOLDERS STRATEGIC INDICATORS OBJECTIVES PLANNED TARGET 2016/17 ACTUAL ACHIEVEMENT 2016/17 DEVIATION FROM PLANNED TARGET TO COMMENT ON DEVIATION ACTUAL ACHIEVEMENT FOR 2016/17 Effective Stakeholder Engagement Development of Stakeholder Engagement Plan (%) 100% developed 0% 100% deviation Deferred as it will be addressed through the Turnaround strategy Implementation (%) Ongoing See above See above See above Cohesive Internal environment between Boards, Secretariat and Council (e.g. inter-board Forum) Number of inter-board forum meetings 2 0 Development of Terms of reference Was awaiting development of Terms and Reference for the Inter-Board Forum Define Terms of 100% defined 100% defined Not applicable Not applicable Reference for interboard forum (%) Strategy to overcome areas of under - performance The Stakeholder Engagement Strategy is deferred; as it will be addressed through the Turnaround Strategy Changes to planned targets The Stakeholder Engagement Strategy is being looked at as part of the Turnaround Strategy 56 HPCSA ANNUAL REPORT 2016/17

58 Linking performance with budgets PROGRAMME 3: IMPROVING THE ROLE OF THE HPCSA AS AN ADVOCATE AND ADVISOR THROUGH ENHANCED ENGAGEMENT WITH ALL KEY STAKEHOLDERS Yearly Description Roll-over Virements Budget 2015/16 Surplus Adjusted Yearly Budget Yearto-date actuals Positive/ (Negative) variances % Variance Public relations / publications % International conferences / overseas travel % Local conferences and meetings % AMCOA conference % Ombudsman costs % Inspectorate Expenses % Reason for variances Expenditure Negative variance for Public relations were due to additional public relations roadshows and seminars held during 2016/17 financial year. Savings for International and local conferences were roll-over to 2017/18 financial year to fund AMCOA conference hosted by HPCSA in 2017/18 financial year. HPCSA ANNUAL REPORT 2016/17 57

59 PROGRAMME 4: LEGISLATIVE AND REGULATORY CONSISTENCY ACROSS THE HPCSA AND ITS PROFESSIONAL BOARDS PLANNED TARGET STRATEGIC OBJECTIVES INDICATORS 2016/17 ACTUAL ACHIEVEMENT 2016/17 DEVIATION FROM PLANNED TARGET TO ACTUAL ACHIEVEMENT FOR 2016/17 COMMENT ON DEVIATION Legislative Review to ensure legislation meets the requirements of changing healthcare landscape. Report on Legislation (Yes/No) Yes No Not applicable Legislative review awaiting the revised business model Sections Yes No Not applicable As above Promulgated ((Yes/ No) Finalise processes pertaining to Concept Document Yes Yes Not applicable Not applicable registrations and licensure to practice to ensure that jurisdiction is maintained at all times and ensure effective enforcement of the legislation (Phase 2). Regulatory Consistency Oversight Matrix 90% 100% Not applicable Not applicable Monitor the regulatory review Compliance to ensure consistency within legislation, regulations, rules, policies and procedures; and ensure decisions made are updated and communicated. Strategy to overcome areas of under performance Legislative review awaiting the revised business model. Changes to planned targets Legislative review awaiting the revised business model. 58 HPCSA ANNUAL REPORT 2016/17

60 Linking performance with budgets PROGRAMME 4: LEGISLATIVE AND REGULATORY CONSISTENCY ACROSS THE HPCSA AND ITS PROFESSIONAL BOARDS Yearly Description Roll-over Virements 2015/16 Surplus Budget Adjusted Yearly Budget Yearto-date actuals Positive/ (Negative) variances % Variance Professional conduct Enquiries % Prelim committees % Appeal committees % Professional conduct inspections % Litigation (External Legal Firms) % Reason for variances Expenditure Positive variance was due to savings in Litigation costs and less Appeal committee meetings required than budgeted for. HPCSA ANNUAL REPORT 2016/17 59

61 10. REVENUE COLLECTION 10.1 Capital Investment The role of the Department: Financial Services is to ensure that Council maintains satisfactory accounting records, prepares for the audit of Annual Financial Statements, provides any other related information on an annual basis, as well as maintain a proper system of internal controls, which will provide reasonable assurance regarding the achievements of Council s objectives. REVENUE The operations of Council are funded by revenue from healthcare practitioners. Revenue is primarily comprised of annual fees, registration fees and penalty fees. During the year under review, the revenue increased by 11% from R191,53 million to R212,69 million and investment revenue increased by 9% from R20,7 million to R22,5 million during the same period. The annual fees increased by 12% from R168,2 million to R188,3 million mainly due to the increase in membership fees. Registration fees increased from R17,3 million to R18,8 million. Fees from penalties imposed on practitioners decreased from R2,9 million to R2,8 million. EXPENSES Operating expenses increased to R228,1 million from R279,6 million representing an increase of 23%. The main reasons for the increase are as follows: Council, Professional Boards and committee meetings expenditure decreased by 2% from R46,5 million to R45,5 million due to an decrease in the number of meeting and venue costs. Employment costs increased by 22% due to annual salary increment, benchmarking and additional employees appointed in terms of the new organisational structure. Information Technology costs increased from R5,4 million to R7,3 million due to increase in Oracle license costs and appointment of ERS Oracle specialists to upgrade the Oracle environment. Legal costs increased by 11% from R12,6 million to R13,9 million. Costs incurred and recovered for Road Accident Fund (RAF) cases increased by 76% from R6,9 million to R12,1 million due to increase in RAF activities. Reversal of revenue due to suspension of membership as a result of non-payment by healthcare practitioners increased from R7,4 million to R8,2 million. DEFICIT GENERATED The net deficit generated by Council was R24,2 million for the year under review compared to a deficit of R2,4 million in the previous financial year. The net deficit increased was mainly due to: less annual fees revenue received below budget including R8 million for the Emergency Care Board and R1 million for the Medical and Dental Board; less registration fees revenue received below budget of R6 million from the Emergency Care Board care; less restoration fee revenue received below budget of R5,8 million due to less practitioners choosing to get restored after suspension; additional interest revenue received above budget of R2 million; additional cost above budget of the R6,1 million settlements paid to the previous CEO and COO. additional labour costs above budget of R1 million; additional costs above budget of R1 million to finalise HPCSA Strategic plan; savings in professional conduct, preliminary, appeal committee expenditure and litigation expenditure of R8 million; additional costs above budget of R4,4 million spend on improving IT capital infrastructure; additional costs above budget of R1 million spend on additional roadshows; and 60 HPCSA ANNUAL REPORT 2016/17

62 additional costs of R6 million spend on employee cost which included cost to move employee to costto-company. PROCUREMENT ACTIVITIES The annual procurement spent totalled R76,8 million of which R46,4 million was spent on the 20 top suppliers, which constitutes 60 percent BBBEE spend, a remarkable improvement compared to previous years. The other significant development which in procurement was the development of the legal services Tariff Structure for the HPCSA, which is aimed at controlling the legal costs. HPCSA ANNUAL REPORT 2016/17 61

63 62 HPCSA ANNUAL REPORT 2016/17

64 Part PROFESSIONAL BOARDS

65 PART C: PROFESSIONAL BOARDS OVERVIEW Strategic Role of Professional Boards The Department Professional Boards provides strategic and administrative support to twelve (12) Professional Boards to ensure that the Professional Boards fulfil their responsibilities as determined by the Health Professions Act 56 of The activities of the Professional Boards Department were guided by the Annual Performance Plan which is derived from the four (4) strategic goals of Council, namely: An improved business model to enhance the functioning of the HPCSA; Adequate, effective and efficient support provided to and by Council, Professional Boards and the Secretariat; Improving the role of the HPCSA as an advocate and advisor through enhanced engagement with all key stakeholders; Legislative and regulatory consistency across the HPCSA and its Professional Boards. Objectives of Professional Boards The objectives of professional boards are to consult and liaise with other professional boards and relevant authorities on matters affecting the professional board; to assist in the promotion of the health of the population of the Republic on a national basis; subject to legislation regulating health care providers and consistency with national policy determined by the Minister, to control and to exercise authority in respect of all matters affecting the education and training of persons in connection with any health profession falling within the ambit of the professional board; to promote liaison in the field of the education and training contemplated in paragraph (c), both in the Republic and elsewhere, and to promote the standards of such education and training in the Republic; to make recommendations to the Council, for Council to advise the Minister on any matter falling within the scope of this Act as it relates to any health profession falling within the ambit of the professional board to support the universal norms and values of such profession or professions, with greater emphasis on professional practice, democracy, transparency, equity, accessibility and community involvement; to make recommendations to the Council and the Minister on matters of public importance acquired by a professional board in the performance of its functions under the Act; to maintain and enhance the dignity of the relevant health profession and the integrity of the persons practising such profession; and; to guide the relevant health profession or professions and to protect the public. Strategic Planning All twelve (12) Professional Boards developed their five-year strategic plans that included the Professional Board s vision, mission, strategic goals, objectives and initiatives with time frames to fulfil their respective objectives in terms of Section 15(a) of the Health Professions Act 56 of The Strategic Plans were approved at Professional Board meetings in 2016 and to be reviewed on an annual basis. In the period under review, the Professional Boards finalised their Annual Performance Plans (APP s) for deliverables during the period 1 April 2016 to 31 March 2017 in line with the budget provisions. PERFORMANCE OVERVIEW Achievements in terms of strategic objectives Progress was made in ensuring improved functioning of 64 HPCSA ANNUAL REPORT 2016/17

66 the Secretariat and Boards through role clarification and Delegations of Authority. Memoranda of Understanding (MOU s) were entered into between the Board, Committee Chairpersons and Secretariat to adhere to timelines. Regular secretariat reporting to Boards were introduced as well as Client Satisfaction Evaluations to identify areas for improvement. Board self -assessments were promoted to ensure good governance and to determine areas for compliance and improvement. To enhance the competence and knowledge of Board members and Secretariat, continuous training was conducted in relation to Board specific activities, such as conducting of evaluations, functions in terms of examinations, moderation of examinations and good governance. In order to improve on the effectiveness and efficiency of meetings, agenda items included the necessary research as well as the inclusion of the relevant legislative framework to enhance the decision-making process. Efficiency was further improved by the rationalisation of certain committee structures and Boards reviewed the terms of reference of their Committee structures to avoid duplication and to streamline processes. Specifications were determined for the introduction of a Collaboration Platform for the 12 Boards in July and August The collaboration portal would enable the Council, Professional Boards, Board members and Secretariat to actively collaborate through an online platform which will enable the following: Online creation, editing, sharing and authoring of documents Online Meeting Scheduling and Meeting Management Online Agendas Instant messaging Same accounts for Council and Professional Board members Document storage, retrieval and management Video Conferencing One of the main strategic goals identified was improving the advocacy and advisory role of the HPCSA through enhanced engagement with all key stakeholders. These Professional Boards achieved improvement in this area through publishing Boards newsletters, Boards specific Roadshows and other stakeholder engagements, such as consultations with educational institutions, professional associations and other stakeholders. Enhancing service delivery and improving the reputation and image of the HPCSA was a key objective. The key focus areas were the resolving of complaints and service delivery complaints within 48 hours. In an attempt to ensure a cohesive internal environment among Boards, Secretariat and Council, an Inter-Board Forum was established to discuss issues of common interest. As a Regulator, it was important to ensure legislative and regulatory consistency across the HPCSA and the twelve (12) Professional Boards and therefore a legislative review had to ensure that legislation met the requirements of a changing health care landscape. Most of the Boards commenced with the legislative review of the rules and regulations impacting on the professions under their mandate. The process was ongoing. Board Activities During the period 1 April 2016 until 31 March 2017, a number of meetings and workshops were facilitated as follows: ACTIVITIES FACILITATED NUMBER OF ACTIVITIES Professional Board meetings 31 Subcommittee meetings 121 Workshops 39 Task Team meetings 53 Board Examinations 29 Evaluations conducted 161 Conferences 20 Setting and reviewing of minimum standards for education and training and professional practice Professional Boards undertook the review of standards generated to ensure currency and relevance based on the HPCSA ANNUAL REPORT 2016/17 65

67 health care needs of the population. These standards are used by institutions as the minimum standard set by the Boards for training of health care practitioners. Quality Assurance Functions - Education and Training One of the key responsibilities of Professional Boards was to ensure compliance to the standards developed in terms of the process of evaluation and accreditation of education and training facilities. Professional Boards continued to review guidelines for their quality assurance functions to streamline and standardise processes. Training and orientation of evaluators was undertaken to ensure that members appointed to conduct evaluations successfully executed their mandate according to the approved guidelines and to build capacity for this function. In the year under review, 161 evaluations were conducted at education and training institutions by the various Professional Boards. Review of scopes Due to changes in the education, training and practice requirements of different professions, the Professional Boards undertook a process of scope review. Another issue that required scope reviews was the overlap of scopes. To this end, extensive consultation with stakeholders was undertaken and tested against international and best practice. Promotion of the health of the population In the reporting period, a number of policy developments required active involvement of Professional Boards. These included the publication of the National Policy on the National Health Insurance (NHI) by the National Department of Health (NDoH). Professional Boards engaged actively with the draft policy on the NHI and the strategy for Human Resources for Health (HRH) to promote awareness, engage and support to these critical initiatives which were aimed at enhancing access to and provision of healthcare to the South African population. HIGHLIGHTS Stakeholder Engagement One of the channels of communication for the Professional Boards was the newsletter which was issued once per annum per Board. The newsletter communicated important profession and administrative related issues to registered professionals and students. These included new developments, such as new regulations, policies and procedures. Each Board hosted a dedicated website page as part of the HPCSA website and contributed to the updating of the website with accurate and relevant information. The following stakeholder activities were undertaken by the Boards: NO OF NATURE OF ACTIVITY ACTIVITIES Professional Board for Emergency Care Practitioners met with the National 2 Committee of Emergency Medical Care (NCEMS). Professional Board for Emergency Care Practitioners Executive Committee met 1 with Representatives of DHET and NDoH. Professional Board for Emergency Care Practitioners Executive Committee met with Representatives of the University 1 of Pretoria (UP) and President of the Occupational Health Association of South Africa (OHASA). Professional Board for Emergency Care Practitioners met with Representatives 1 of DUT. Professional Board for Emergency Care Practitioners met with the Central 1 University of Technology (CUT), DHET and NDoH. Radiography Day Celebration HPCSA ANNUAL REPORT 2016/17

68 NATURE OF ACTIVITY NO OF ACTIVITIES NATURE OF ACTIVITY NO OF ACTIVITIES Professional Board for Radiography and Medical and Dental Professions Board Clinical Technology met with Heads of Department, Professional Associations 1 met with the Council of Medical Schemes and the Board of Healthcare 1 and Provincial Coordinators. Funders Professional Board for Psychology met with EPASSA. 1 Professional Board for Dental Therapy and Oral Hygiene met with SADA 1 Professional Board for Psychology met with Medical Aid Schemes. 1 Medical and Dental Professions Board met with Office of the Health Standards 1 Professional Board for Psychology met with PSYSSA and RELPAG Professional Board for Psychology met 2 Compliance (OHSC) Medical and Dental Professions Board met with Medical Protection Society 1 with the Universities of Cape Town (UCT) 1 Professional Board for Dietetics and and the Witwatersrand (Wits) Nutrition met with Stakeholders on 1 Professional Board for Psychology met with UNISA and DHET 1 KUDU Wave device Professional Board for Dietetics and Professional Board for Optometry and Dispensing Opticians Executive Committee met with Universities Heads of Departments (HoDs) (Optometry/ 1 Nutrition met with various HODs, Provincial Clinical Managers for Nutrition, Professional Associations/Societies and UNISA 1 Dispensing Opticianry Programmes) Professional Board for Optometry Professional Board for Dietetics and Nutrition met with NDoH 1 and Dispensing Opticians Executive and Education Committees met with 1 Stakeholder meetings with Heads of Departments 2 Representatives of Dispensing Opticians Professional Board for Optometry Professional Board for Medical Technology Stakeholder meeting 1 and Dispensing Opticians Executive Committee met with Representatives of DHET 1 Professional Board for Environmental Health Practitioners met with practitioners 1 Professional Board for Dental Therapy and Oral Hygiene met with National Department of Health 1 Professional Board for Speech, Language and Hearing Professions met with Stakeholders 1 Professional Board for Dental Therapy and Oral Hygiene Executive Committee met with registered practitioners, Oral 1 Health Provincial Department of Eastern Cape HPCSA ANNUAL REPORT 2016/17 67

69 PROFESSIONAL BOARD FOR DENTAL THERAPY AND ORAL HYGIENE care regulation through public protection and professional advancement. The Mission of the Board is: To promote Oral Health care to all through: Ensuring compliance for professional registrations; Developing appropriate standards for training, education, professional practice and CPD; and Fostering effective stakeholder engagement and participation. EDUCATION AND TRAINING The responsibility of the Board is to ensure that the people of South Africa are assured of appropriately trained, qualified, competent healthcare professionals that practice according to their scopes of practice in accordance with their training and abilities. Dr TA Muslim (Chairperson) OVERVIEW The Professional Board for Dental Therapy and Oral Hygiene (and Dental Assisting) worked with dedication towards upholding the mission and vision of the Health Professions Council of South Africa (HPCSA). The Board implemented the strategic goals that were set at the beginning of its term office and have made significant progress. All this was done against the backdrop of applying financial austerity and cost savings measures, to ensure that the annual fee levied on practitioners remains as affordable as possible. To this end, the Board has minimised the annual fee increases to 4% for the 2017/18 financial year (previously 6%), and this lower-than-inflation increase has resulted in the Board no longer having the highest fee compared to the rest of the HPCSA s 12 Professional Boards. The Board continued to monitor and control costs, in an attempt to further reduce annual fee increases. VISION AND MISSION The Board has adopted the following vision and mission The Vision of the Board is: Ensuring quality oral health This obligation conflicted with some Oral Hygienists, who refused to accept that they need to undergo training at accredited Higher Education Institution in order to perform the many duties that are included in the domain of the profession following the two expansions in the scopes of practice of the Oral Hygiene profession that occurred in the years 2000 and TThe HPCSA has clear ethical rules regarding the performance of professional acts, and in terms of Rule 21 of the Ethical Rules of Conduct for Practitioners Registered under the Health Professions Act, 1974, and contained in Government Notice No. R 717 of 4 August 2006, a practitioner shall perform, in an emergency, only a professional act for which he or she is adequately educated, trained and sufficiently experienced. The Board has engaged with the various universities to offer courses to Oral Hygienists, and these courses have been in place since the early 2000s. The application of Rule (21) has led to challenges within the Board regarding conflict of interest and how it should be managed. The Board is mindful of the fact that any profession involved in self-regulation has inherent conflicts because of the personal, professional and institutional interests in the matters that are regulated. This will always be an ongoing 68 HPCSA ANNUAL REPORT 2016/17

70 challenge, but one that should be managed by appropriate policies and declarations of conflicts of interests whether real or perceived. The Board conducted accreditation visits to two institutions during this financial year the Dental Assisting Programme at the Central University of Technology, Free State (CUT, FS) and the Oral Hygiene Programme at the University of the Witwatersrand were accredited for the next five years. All Board members received training in the various aspects of undertaking an accreditation visit. Additionally, the various documents and processes involved in conducting these visits were reviewed by the Board, and revised to ensure currency and relevance in order to meet the needs of the country. STAKEHOLDER ENGAGEMENT The Professional Board for Dental Therapy and Oral Hygiene held engagements with a number of varied stakeholders. The aim of these interactions was to ensure representivity of stakeholders, engagement with stakeholders, and professional upliftment. The following stakeholder interactions took place in the period under review: Dental Professions Board Task Team meeting; Two presentations at SADTA in Durban and one presentation in the North-West One meeting with representatives of the University of Pretoria; and Presentations at OHASA in Durban, Cape Town and Gauteng, and various other meetings with stakeholders. These interactions were further enhanced through the issuing of the various media releases, newsletters and articles in the HPCSA e-bulletins that the Board produced during the year. PROFESSIONAL PRACTICE AND CONDUCT The Committee of Preliminary Inquiry of the Board made inroads in reducing the number of outstanding cases. In the year under review, over thirty (30) cases have been assessed. The Board wishes to highlight that practitioners practice in an increasing litigious society, and urges practitioners to practice ethically and responsibly. It is the Vision of the Board that not a single case is brought to the Committee of Preliminary Inquiry, and that practitioners render services of the highest standards to the public. Meeting with the Board s Continuous Professional Development Accreditors to reach consensus on matters related to certain aspects of CPD provision; Meetings with the South African Dental Association (SADA); Meetings with the South African Dental Therapists Association (SADTA); Meetings with the Oral Hygienists Association of South African (OHASA); Meeting with the Dental Technicians Association of South Africa (DENTASA); Meetings with the Department of Higher Education and Training (DHET); Representatives of the Board attended two meetings of the Oral Health Stakeholders Consultative Committee (OHSCC); Representatives of the Board attended Medical and SCOPE OF PROFESSIONS The Board is cognisant of the need of the professions registered under its ambit (Dental Therapy, Oral Hygiene and Dental Assisting) to be professionalised. To this end, the Board, as part of its defined strategic objectives, reviewed HPCSA ANNUAL REPORT 2016/17 69

71 the scopes of practice for the dental therapy and oral hygiene professions. Currently, the scope of the profession for Dental Assistants is undergoing review. The Board consulted extensively with various stakeholders, such as education institutions, professional associations, employers, the Department of Health and Dental Assistants for inputs. Once all the stakeholder inputs were received, the Education Committee will review and then finalise the scope of practice. This draft scope will then forwarded to the Minister of Health for promulgation. The revised Scope of Practice of the Profession for Oral Hygiene has been promulgated by the Minister of Health in 2017, and will be reviewed in The Scope of Practice for the Profession of Dental Therapy was revised in 2016, and will be reviewed in COMPLIANCE FOR REGISTRATION The Board continues to express concern that some practitioners are either not registered, or their registration has lapsed. The Board has engaged with the various professional associations to urge them to encourage those practitioners who have failed to pay their annual fee are afforded an opportunity to do so. The Board was made aware that some practitioners were practising without being registered, and has lodged complaints with the HPCSA Inspectorate Office, so that these practitioners are investigated and dealt with appropriately. The Board revised guidelines and registration forms, for all new entrants and foreign qualified graduates and has simplified and standardised these documents, so that registration becomes a simple and non-tedious process. The Board also revised the guidelines related to the restoration of practitioners who were suspended from the registers, to facilitate their return to the workforce. The Board was faced with a challenge that graduates with the recently introduced National Higher Certificate in Dental Assisting (Central University of Technology, Free State) could not register with the HPCSA due to the qualification having not yet been promulgated by the Minister of Health as a registerable qualification. This has since been addressed and resolved. BOARD EXAMINATION The Board conducted one examination for Dental Assistants in 2016, and the other two exams held in In keeping with the revised rules relating to the registration of Dental Assistants, wherein as from 7 April 2017, unqualified but experienced Dental Assistants will have six (6) months to register, and two years from date of registration to complete a Board examination. The fee for the examination of R700 has not been increased, and the results of the examination reveal that candidates are generally well prepared. The success of these candidates is facilitated by the availability of recently revised examination preparation guidelines. GOVERNANCE Council approved the name change from the Professional Board for Dental Therapy and Oral Hygiene to the Professional Board for Dental Assisting, Dental Therapy and Oral Hygiene. This amendment was made to ensure that all three professions registered with the Board are recognised in its name. The Board awaits the Minister of Health to promulgate this name change. HIGHLIGHTS The Board has achieved the following: Facilitated the process to allow unqualified yet experienced Dental Assistants the opportunity to obtain limited registration with the HPCSA. This will allow for these Dental Assistants to be able to practice their profession, subject to passing the Board examination; Facilitated the promulgation of the Oral Hygiene Scope of Practice; Provided input to the Department of Health regarding the National Oral Health Policy and Strategy; Increased stakeholder interaction; and Exercised due diligence and implemented financial austerity measures in order to exercise strict control over fee increases 70 HPCSA ANNUAL REPORT 2016/17

72 PROFESSIONAL BOARD FOR DIETETICS AND NUTRITION Sensitivity and responsiveness to the needs of the public To guide and regulate the profession by Defining and delineating the scope of practice Ensuring relevant and quality education and training standards Enhancing the quality and professionalism of practice To ensure effective communication with all stakeholders and to advocate for the role of nutrition in The health and wellness of all South Africans All sectors of public decision making and policy development Prof SM Hanekom (Chairperson) STRATEGIC OBJECTIVES The Board identified the following as their strategic goals (programmes) for the period under review: Goal (Programme) 1: Protecting the Public Goal (Programme) 2: Regulating and Guiding the Profession Goal (Programme) 3: Advisory, Advocacy and Stakeholder Engagement Goal (Programme) 4: Effective and Efficient Functioning of the Board VISION AND MISSION Vision Ensure quality and equitable nutritional health for all through public protection, guiding the profession and advocacy Mission To protect and serve the public through ensuring Excellence and integrity in dietetics and nutrition delivery The Board embarked on the following activities for the 2016/17: PROFESSIONAL BOARD ACTIVITIES NUMBER OF ACTIVITIES Board meetings 2 Board Strategic Workshop 2 Board Stakeholder engagement: 2 Heads of Departments (Higher Education Institutions) New Dietitian-Nutrition Professional Competencies Education, Training and Registration 4 committee + Special ETR Committee meeting Executive Committee (Budget) 1 Ad-Hoc meetings (Meeting with 1 NDoH) Task Team 0 Training Programme Accreditations 3 Clinical Training Sites Accreditations 5 CPD Committee meeting 1 COMMUNICATION Board Specific Newsletter In the period under review, the Board produced two (2) newsletters which served as a means to communicate and engage with registered practitioners. The Board afforded the practitioners an opportunity to acquire two (2) ethics CEU s by completing an Ethic Multiple Choice Questionnaire HPCSA ANNUAL REPORT 2016/17 71

73 which was included in one of the newsletters. DETERMINING AND UPHOLDING STANDARDS OF EDUCATION AND TRAINING Schedule of cycle of evaluation of Dietetics and Nutrition The schedule of cycle of evaluation of Dietetics and Nutrition at Higher Education Institutions is updated on an on-going basis as a working document. Evaluation of Education and Training Facilities The following documents were finalised and approved by the Board: Application Form for the appointment of evaluators during Evaluation Visits for Dietetics and Nutrition programmes at Higher Education Institutions and Clinical training facilities; Guidelines for evaluators for evaluation of Clinical training facilities; The evaluators/assessors training evaluation form; Form 46C - Criteria for accreditation of training sites for experiential learning in Dietetics and Nutrition, the split of training areas on the form, namely: Therapeutic Nutrition; Community Nutrition; and Food Service Management is still under review. The Board conducted evaluations on education and training facilities of the following institutions: Nelson Mandela Metropolitan University Education, Training and Registration Committee meeting of 27 July 2016; Stellenbosch University - Education, Training and Registration Committee meeting of 27 July 2016; University of Venda - Education, Training and Registration Committee meeting of 27 July 2016; North-West University - Education, Training and Registration Committee meeting of 18 November 2016; Sefako Makgatho Health Sciences University - Education, Training and Registration Committee meeting of 18 November ACCREDITATION OF TRAINING PROGRAMMES The Board accredited programmes of the following Universities for the period under review: Stellenbosch University 18 to 21 April 2016 Nelson Mandela Metropolitan University 22 to 25 August 2016 North-West University 12 to 15 September 2016 Training workshop for Evaluators Training workshops was scheduled in the year under review, however, the Board had to cancel such due to reasons beyond its control. The focus of the training workshop was to train evaluators on report writing after conducting an evaluation visit at Higher Education Institutions, and to standardise the report writing style and format for consistency and uniformity purpose. Review of Form 271 Form Procedure for evaluation and accreditation of Dietetics Training Programmes (guideline) was revised at the Education, Training and Registration Committee meeting of 18 November BOARD EXAMINATION The Board examinations (University entry examinations) are conducted by universities during October/November of each year in accordance with each university s rules and regulations. Three (3) practitioners sat and successfully completed their Board examination at the end of The two (2) practitioners were restored back to the register of Dietitians and the other two are registered to conduct Community Service for a period of 24 months. 72 HPCSA ANNUAL REPORT 2016/17

74 COMPLIANCE FOR REGISTRATION The Board had no new or amended registers for the period under review. PROFESSIONAL BOARD FOR EMERGENCY CARE SCOPE OF PROFESSIONS The Board approved the reviewed Regulations relating to the Scope of Profession of Dietetics as well as the newly developed Scope of Profession of Nutrition. The two are pending promulgation by the National Department of Health. GOVERNANCE In line with the Regulations relating to the functions and functioning of the Professional Boards, the Board co-opted a subject matter expert as a consultant to assist the Board with the new Dietitian-Nutritionist project, in particular consulting and finalising the professional competencies with the higher educational institution. HIGHLIGHTS Approval of the Strategic Plan , Annual Performance Plan and Operational Plan Review of the Strategic Plan, Annual Performance Plan and Operational Plan in January and March 2017; Approval of the Communications Plan for the Board; Approval of the Board s Risk Register Review of the following: Regulations related to qualifications and additional qualifications relating to the registration; Regulations related to the names that may not be used in relation to the profession of Dietetics and Nutrition; Examination guidelines; Evaluation and accreditation guidelines; and Review and approval as follows: Criteria for appointing evaluators of higher educational institutions; and Database of evaluators higher educational institutions; Mr LA Malotana (Chairperson) OVERVIEW During the period under review, the Board reflected on its strategic objectives and is satisfied that the overall goals and objectives as defined at the start of the term of the Board have been met. The focus was on the finalisation of the revised Clinical Practice Guidelines and the quality assurance of the education and training of the professions under the ambit of the Board. A series of meetings with several stakeholders were held to clarify and discuss issues of mutual concern. The Board received and is investigating several complaints and is seriously concerned about complaints received regarding the unprofessional and unethical behaviour of Emergency Care Providers on-scene, such as arguing, quarrelling and even assaulting colleagues. A further concern is the use of social media by Emergency Care Providers. The two major concerns had a potential of bringing the profession and the professional reputation of colleagues into disrepute. HPCSA ANNUAL REPORT 2016/17 73

75 It is the collective responsibility of all the people involved in the profession of emergency care to professionalise, promote and create a positive environment that does not allow for mediocrity within the profession. Working together in a professional, collegial manner with integrity ensured that the services rendered by Emergency Care Providers was patient-centred and was in the best interest of the patients. The provision of emergency care is always a team effort and all must have the patients best interest foremost. VISION AND MISSION Vision Quality, professional and patient orientated emergency care for all. Mission To protect the public and advance Emergency Care through: Guidance and regulation of the emergency care profession Advocacy Accountability STRATEGIC OBJECTIVES During the period of review; the Board pursued the strategic objectives namely: The determination of minimum standards for education and training, Quality assurance of education and training, and Stakeholder engagement. EDUCATION AND TRAINING The Board undertook several evaluations for accreditation and re-accreditation of education and training providers in the three-year cycle period. To comply with the Board s strategic objective to ensure quality education and training and the registration of competent and appropriately trained Emergency Care Providers. The Board conducted 14 evaluations for re-accreditation, three evaluations for the accreditation of new education and training providers and six impromptu inspections. The Board withdrew the accreditation of three education and training providers due to serious quality concerns and non-compliance with the Board s accreditation criteria. In terms of the Board s strategic objectives to align the education and training of Emergency Care Providers with relevant legislation and national imperatives, the Board developed minimum standards for the Diploma and Higher Certificate in Emergency Medical Care for purposes of the registration of Emergency Care Technicians and Emergency Care Assistants with the HPCSA. The Board will also review the minimum standards for the Bachelor in Emergency Medical Care in consultation with the Council on Higher Education (CHE) during the 2018/19 financial year. The revised education and training structure is now a three-tiered system, i.e. the Bachelor in Emergency Medical Care, the Diploma in Emergency Medical Care and the Higher Certificate in Emergency Medical Care, which is in line with relevant legislation and national imperatives, e.g. the Higher Education Act, the Higher Education Qualifications Sub-Framework (HEQSF), the National Emergency Care Education and Training (NECET) Policy, etc. STAKEHOLDER ENGAGEMENT The Board met with an array of stakeholders, such as the Council on Higher Education (CHE), National Department of Health, Department of Higher Education and Training (DHET), Continuing Professional Development Accreditors, etc. to discuss and clarify matters of mutual concern. Representatives of the Board also attended some of the National Emergency Care Education and Training (NECET) Committee meetings, the National Committee of Emergency Medical Care Services meetings, the Advisory Committee meetings of the Higher Education Institutions. The Board arranged a stakeholder meeting for registered Emergency Care Providers in Mpumalanga, but due to lack of interest, the stakeholder meeting was cancelled. The Board met with its approved CPD accreditors to discuss the approval of relevant CPD activities, which would lead to the development of Emergency Care Providers within their specific registration categories and scopes of practice. 74 HPCSA ANNUAL REPORT 2016/17

76 The Board is in the final stages of finalising the revised Clinical Practice Guidelines. The Board will review best modalities of engaging with stakeholders going forward, including aligning the Board s stakeholder engagement with CPD activities. PROFESSIONAL PRACTICE AND CONDUCT The Board is concerned about the increasing number of complaints against Emergency Care Providers towards each other and the general unprofessional behaviour displayed by these healthcare practitioners. A further concern is on the use of social media, which puts the profession and colleagues into disrepute. Complaints were also received regarding Basic Ambulance Assistants (BAAs) working on ambulances, without any support or supervision, which results in poor patient care. Several complaints noted this trend, particularly regarding unethical behaviour, and insufficient patient care. The Committee of Preliminary Inquiry conducted two meetings and considered 89 complaints during the 2016/17 financial year of which 38 were finalised, six (6) referred for professional conduct inquiries, 15 were deferred pending receipt of further information, two (2) matters were referred to the Health Committee and one (1) matter to the Business Practices Committee. The Committee conducted two (2) consultations, issued six (6) cautions and had 14 guilty findings in terms of regulation 4. (9) of the regulations relating to the conduct of inquiries into alleged unprofessional conduct. Four (4) complaints were withdrawn. COMPLIANCE FOR REGISTRATION As seen in the past, there is still a high number of suspension of Emergency Care Providers from the registers due to the non-payment of annual registration fees, in 2016 alone and especially, in the Basic Ambulance Assistant category. In terms of the Regulations relating to the registration of Basic Ambulance Assistants, Ambulance Emergency Assistants, Paramedics and Operational Emergency Care Orderlies,(OECO) the BAA, OECO and Critical Care Assistance (CCA)/Paramedics, qualifications will no longer entitle a person to registration with the HPCSA in these categories as from 1 February However, any person who obtained these qualifications prior to the promulgation of the aforementioned Regulations on 27 January 2017 or within twelve (12) months after the date of the promulgation of the regulations will still be entitled to register as BAAs, OECOs and Paramedics. It should, however, be noted that the Professional Board for Emergency Care requires persons who have not registered within two (2) years of date of having obtained any of the qualifications in emergency care to comply with certain conditions, e.g. successful completion of an examination, etc. Persons whose names are on the BAA, OECO and Paramedic (CCA) register on 31 January 2018 will remain on the relevant HPCSA ANNUAL REPORT 2016/17 75

77 registers if they pay their annual fees. The Board encourages Emergency Care Providers to ensure that their annual fees are paid to avoid penalty fees for the restoration of their names and compliance with any other requirements as may be determined by the Board for the restoration of names to the relevant registers. PROFESSIONAL BOARD FOR ENVIRONMENTAL HEALTH PRACTITIONERS As from 1 February 2020, the Ambulance Emergency Assistant qualification and National Diploma (N Dip) in Emergency Medical Care will no longer entitle Ambulance Emergency Assistants and Paramedics to register with the HPCSA in these categories. GOVERNANCE The Board developed a Risk Register at the commencement of the term and reviewed the register in the year under review. The Board reviewed and updated its policies and guidelines. The Board closely monitored its budget and in the 2017/18 budget, the Board made various austerity and cost cutting measures to curtail spending, which included examples such as holding back to back meetings, etc. HIGHLIGHTS The Board received the revised Clinical Practice Guidelines from the service provider and distributed it to stakeholders for comment. The Board is now in the process of finalising the revised Clinical Practice Guidelines for implementation. The Minister promulgated Regulations relating to the Registration of Basic Ambulance Assistants, Ambulance Emergency Assistants, Paramedics and Operational Emergency Care Orderlies, which provide for the phasing out of these registration categories. Ms DJ Sebidi (Chairperson) OVERVIEW At its full Board meetings, the Professional Board for Environmental Health Practitioners reviewed the composition of Committees in terms of Regulation 2 of the Regulations relating to the functions and functioning of Professional Boards. At its first meeting, the Board appoints Committees that would function until the first meeting of the Board in the following year. The Secretariat reports on progress made in the implementation of strategic objectives and on mechanisms actioned to mitigate identified risks, adopted by the Board, considered and accepted at each Board meeting. During the period under review, the Board has generally seen satisfactory progress in pursuing its set strategic objectives for its term of office. The Board and its structures can report holding ten (10) successful meetings and workshops during the review period. Interactions with stakeholders (practitioners and Heads of Environmental Health departments at institutions offering Environmental Health) were worthwhile. 76 HPCSA ANNUAL REPORT 2016/17

78 VISION AND MISSION Vision A regulatory body that promotes comprehensive, quality and equitable Environmental Health for all Mission The Board protects the interests of the public and guides the profession through: Developing and implementing strategies, policy frameworks and standards for Environmental Health professions; Monitoring the quality of training against set standards; Promoting ethical practice by ensuring on going professional competence and conduct; Aligning to international standards in education and training while adhering to best practice within the South African context; and Ensuring effective communication with all stakeholders. STRATEGIC OBJECTIVES Goal 1: Promote Ongoing and Effective Stakeholder Engagement Develop, implement and monitor a Stakeholder Engagement Plan. Engagement with Heads of Departments of institutions offering EHP education. Communication with the largest employers of EHPs, Metros and District Municipalities.Communication with EHPs Goal 2: Monitor compliance within the Environmental Health Professions Ensure practitioners are registered effectively and efficiently. Address the challenge of Community Service. Advocate for the reporting of offenses unprofessional conduct and ensure that they are dealt with in an efficient and effective manner. CPD Compliance - Compliance in terms of Standards of Examination for restorations Goal 3: Strengthen Education and Guide the Profession Ensure standards of education that address the needs of the profession and country. Advocate / facilitate the Implementation of the EHA qualification. Set standards for the EH Bachelor s degree Review of Board Examinations to ensure alignment with the needs of the profession. Scopes of practice for professions under the ambit of the Board. Review of relevant legislation. Goal 4: Ensure Effective and Efficient Functioning of the Board Review internal Board processes, roles and responsibilities. Ensure effective functioning of the Board. Training of Board Members Effective integration between Board, Council & Offices of Council. EDUCATION AND TRAINING The Education Committee requested all seven (7) institutions accredited to offer Environmental Health to submit Work- Integrated Learning (WIL) portfolios of evidence and logbooks for all third-year students, to determine if these institutions were complying with the minimum standards set by the Board. The Standards Generating meeting was held to discuss the development of a qualification for Environmental Health Assistants, and a task team was set up to develop a needs analysis for this qualification. The Standards Generating Body (SGB) also discussed the development of Accreditation Criteria for the new Bachelor s degree in Environmental HPCSA ANNUAL REPORT 2016/17 77

79 Health, which will henceforth be used by the Board to evaluate institutions. Accreditation of education and training programmes in Environmental Health both the National Diploma and the professional degree had been a priority for the Board and under constant monitoring with the necessary support provided to institutions. Four (4) institutions were evaluated for readiness to offer the Bachelor s degree in Environmental Health, namely: University of Johannesburg Cape Peninsula University of Technology Central University of Technology Mangosuthu University of Technology The Board also scheduled visits to institutions that already introduced the professional degree to evaluate progress made after two years of implementing. Two (2) institutions were evaluated for accreditation to offer the National Diploma in Environmental Health, i.e. Central University of Technology Mangosuthu University of Technology The Board submitted comments on the review of the HPCSA generic CPD guidelines and Maintenance of Licensure. The Board also provided the CPD Department with inputs on the CPD template/questionnaire. Annual reports from accredited service providers and accreditors were received and considered by the Board, with feedback given. The Board specific standard operating procedures (SOP) or guidelines for CPD applications was reviewed. 35 CPD activities were approved during the period of reporting. STAKEHOLDER ENGAGEMENT The Board embarked on a number of stakeholder engagement programmes as follows: Hosted a Stakeholder Engagement Session on 04 October 2016 in Port Alfred, Eastern Cape. The meeting was attended by 194 practitioners. Presentations focused on Professional Ethics, Norms and Standards, HPCSA Registration, Continuous Professional Development and the Board s Strategic Objectives. Practitioners who attended were awarded two general CEUs and two for ethics. Had a meeting with Heads of Department of institutions offering Environmental Health on 05 April 2016 to engage on policy issues around education and training. Held a Standards Generating Workshop on 24 June 2016, to discuss the development of an Environmental Health Assistant qualification. The Board Newsletter was issued; and articles in the Council e-bulletin were provided. Participation of the Board and Board Secretariat in the World Environmental Health Day Celebrations. PROFESSIONAL PRACTICE AND CONDUCT On 19 September 2016, the Committee of Preliminary Inquiry of the Professional Board for Environmental Health Practitioners conducted a meeting for the first time in over five (5) years. In this meeting, the Committee considered six (6) matters which included alleged bribery, practising without registration with the HPCSA and alleged fraudulent issuing of compliance certificate where it shouldn t have been issued. No cases of professional misconduct conduct were reported. SCOPE OF PROFESSIONS The scope of the profession for Environmental Health Practitioners (EHPs) is under review to ensure alignment with the Professional Degree in Environmental Health. The scope of the profession for health promotion practitioners was submitted to National Department of Health for further processing towards promulgation. COMPLIANCE FOR REGISTRATION In its efforts to improve registration processes the Board adopted a strategic objective with a focus in ensuring that practitioners are registered effectively and efficiently within six months of having received their applications. The Board 78 HPCSA ANNUAL REPORT 2016/17

80 further undertook to approach the National Department of Health in order to address the challenges faced with community service placement of Environmental Health graduates. BOARD EXAMINATION The Board conducted thirty-seven (37) examinations during the reporting period, of which twenty - nine (29) practitioners were successful and eight (8) unsuccessful. Restoration 23 Community Service 7 Environmental Health Assistant (EHA) 2 Foreign Qualified 5 The guidelines for conducting of Board examinations were reviewed. GOVERNANCE Accountable The Board implements all the decisions taken at its sittings. All scheduled meetings and workshop dates were honoured. Transparent During the stakeholders engagement, the Board communicated, among others, progress made in implementing its five-year strategic goals. All decisions taken by the Board that affect practitioners registered with the HPCSA under the ambit of this Board were communicated through a newsletter. Follows the rule of law The Board ensures that decisions taken are always in line with the relevant legislations, such as the Health Professions Act (Act 56 of 1974) and its regulations. This was measured by the absence of litigations or complaints received against the Board s decisions during this reporting period. Inspectors to discuss challenges facing the profession within the veterinary environment in the country. Equitable and inclusive The Board had drafted regulations relating to qualifications for registration of Health Promoters as well as regulations defining the scope of the profession for Health Promoters which were both submitted to the Minister of Health for consideration and probable promulgation. This is to ensure that the Health Promoters are included and regulated within this Board. Effective, efficient and participatory To maintain the Board s effectiveness and efficiency, it has included in its special meetings, all relevant stakeholders such as the Institutions of Higher learning, and South African Local Government Association (SALGA) as well as professional associations in finalizing the qualification for Environmental Health Assistants among others. This enabled the Board to include all relevant expertise to arrive at sound and proper decision. HIGHLIGHTS The Professional Board for Environmental Health Practitioners and its structures successfully held ten (10) meetings and workshops between April 2016 and March The strategic plan for the term of office , the Annual Performance Plan for 2016/17 and the Risk Management Register ( ) were developed in line with Council s strategic plan and approved by the Board. Review of relevant rules and regulations and also a number of guidelines and Standard Operating Procedures (SOPs) was done successfully to ensure that the Board functions effectively and efficiently. Responsive The Board Chairperson responded to invitations by both the South African Veterinary Public Health Association as well as South African Council for Veterinary Public Health HPCSA ANNUAL REPORT 2016/17 79

81 PROFESSIONAL BOARD FOR MEDICAL AND DENTAL PROFESSIONS Commit to improved stakeholder engagement; Advise Council and the Minister of Health in the development of strategic policy frameworks. Values The Board will deliver on its mandate through: Expecting honesty and integrity from its members; Acting with respect, fairness and transparency to all; Regulating consistently and decisively; Functioning effectively and efficiently; Ensuring accountability for its actions. EDUCATION AND TRAINING Dr TKS Letlape (Chairperson) VISION AND MISSION Vision To provide quality and equitable healthcare through public protection, professional regulation and advocacy Mission In the execution of its mandate the Education and Registration Committee of the Board has working structures, namely; Subcommittee for Examinations (Medical), Subcommittee for Internship Training, Curriculum Subcommittee, Medical Science Committee, Subcommittee for Postgraduate Medical, Subcommittee for Postgraduate Dental, Undergraduate Education and Training Subcommittee Medical and Dental. The Board through its structures undertook evaluations for accreditation and follow up visits to four (4) universities towards accreditation of undergraduate programmes for medical and dental professions. Twelve (12) postgraduate The mission of the Medical and Dental Professionals Board is to: Ensure appropriate education and training standards; Regulate and ensure compliance for professional registration; Promote and regulate professional as well as ethical practice; Guide the relevant professions and to protect the public; Maintain and enhance the dignity and integrity of the health profession and professionals; 80 Advocate for the promotion of the health of the population; HPCSA ANNUAL REPORT 2016/17

82 Medical programmes and one Dental programme at three higher education institutions accredited by the Board. Only one programme accreditation was suspended due to noncompliance to the minimum requirements as set by the MDB. Thirty-seven (37) clinical facilities have been evaluated and accredited for internship training of medical and dental students. The duration of the accreditation ranges from six months to three years. Monitoring of the quality of education and training is one of the Board s strategic objective to ensure highly competent professionals serving the nation. Re-marking was in November 2016 and 6 applied for remarking and 1 passed. STAKEHOLDER ENGAGEMENT The Board engaged the stakeholders by having meetings and workshops on matters affecting the health professions regulated under its ambit. COMPLIANCE FOR REGISTRATION Upon application for registration by Foreign Qualified Practitioners, an applicant has to meet the requirements prescribed in Regulations Relating to the Registration of persons who hold qualifications not prescribed for registration Published under Government Notice R101 in Government Gazette of 6 February Board Examinations The Board Examinations for Foreign Qualified Practitioners who applied for registrations were held as follows: Medical Board Examination held in May/June and Nov/ Dec 2016 Written part 11 May 2016 (122 candidates: 52 candidates passed and 70 candidates failed) Practical part 15 June 2016 (52 candidates: 22 candidates passed and 30 candidates failed) Written part 21 October 2016 (139 candidates: 136 candidates passed and 3 candidates failed) Practical part 18 November and 2 December 2016 (160 candidates: 115 candidates passed and 45 candidates failed). Dental Board Exam was held in June 2016 On 8 June 2016, 12 candidates were invited, 8 failed and 4 passed. PROFESSIONAL PRACTICE AND CONDUCT The Board delegated the function of advising on professional practice, conduct and ethics matters to the Practice Committee. The Board through the Practice Committee signed a Memorandum of Understanding for collaboration on standards and guidelines with the Office of Health Standards Compliance and is currently in negotiations with the Council of Medical Schemes and Board of Healthcare Funders on clinical discretion of medical practitioners and medical aids and the consideration of cost of intervention options. SCOPE OF PROFESSIONS The Regulations defining the scope of practice of clinical associates was finalised and promulgated in the Government Gazette on 11 November GOVERNANCE The Board developed a Risk Register at the start of the term and reviewed it in the year under review to ensure HPCSA ANNUAL REPORT 2016/17 81

83 that identified risks are adequately mitigated. The Board reviewed and updated its policies and guidelines. PROFESSIONAL BOARD FOR MEDICAL TECHNOLOGY HIGHLIGHTS Changes to rules/regulations/scopes or other statutory provisions The Regulations defining the scope of practice for Clinical Associates promulgation. Waiving Educational Commission for Foreign Medical Graduates (ECFMG) requirements for Medical Practitioners from Tunisia and Iran. Policy regarding foreign qualified practitioners wishing to register with the Medical and Dental Professions Board. Risk Management and Risk Register. Clinical discretion of Medical Practitioners and Medical Aids. Laparoscopic Surgical Interventions Request to consider the cost of this treatment option. Medical Science Committee is in a process of revising its legislative framework. New regulations have been drafted and are currently involved in stakeholder engagements on the proposed regulations. Mr MAW Louw (Chairperson) VISION AND MISSION Vision The Vision of the Board is to ensure that the public has access to quality and affordable medical technology services. Mission As part of its Mission, the Board strived to protect the public and guide the profession by - developing, strengthening, monitoring and evaluating standards for education and training; ensuring quality education, training and Continuing Professional Development (CPD); developing conditions for registration and licensure; ensuring compliance with ethical standards; developing and implementing the Scope of Practice; proactively aligning to the needs of the country through effective Stakeholder Engagement. 82 HPCSA ANNUAL REPORT 2016/17

84 STRATEGIC OBJECTIVES The Board developed a Strategic Plan, which included the following key strategic objectives and initiatives: To ensure the effective and efficient functioning of the Board: The roles, responsibilities, authority and accountability of Secretariat, Board and Council was defined and clarified; 1.2. Conducted training of Board members and Board Secretariat to empower the members and build capacity; 1.3. Developed the skills of evaluators through training initiatives to ensure effective and effective evaluations; 1.4. Meeting agendas, minutes, documents received by Committees, Boards or Council were streamlined to improve the effectiveness and efficiency of meetings. The Board has developed a Stakeholder Engagement Plan to improve communication with its key stakeholders. To protect the public, the Board has ensured that - the review of professional conduct processes and finalisation of misconduct charges are conducted and concluded within acceptable time-lines; registration processes are effective and efficient and that registration occurs timeously. needs of the public. The Professional Board for Medical Technology is constituted of ten (10) members appointed by the Minister of Health in terms of section 15 of the Health Professions Act 1974, (Act 56 of 1974). The Board has one vacancy for a community representative that must be filled. The Board conducted the following meetings during the period under review: Two (2) Professional Board meetings; Three (3) Executive Committee meetings; Three 3 Education Training and Registration Committee meetings; Two (2) meetings for the Committee of Preliminary Inquiry; Two (2) workshops. A workshop on Evaluation of Clinical Facilities and Risk Workshop; and Two (2) task team meetings on the registration of forensic pathology officers. EDUCATION AND TRAINING The Board continued to monitor provision of quality education and training of professionals under its ambit and has ensured that the evaluation of institutions and training facilitates which were due for re-accreditation in the five-year accreditation cycle were conducted. The Board conducted eight (8) National Diploma evaluations, four (4) Bachelor of Health Science (BHSc) in Medical Laboratory Science and fifteen (15) clinical training facilities evaluations. In guiding the profession, the Board ensured that the evaluation of higher education institutions and of clinical training facilities were conducted according to the set minimum standards; fostered compliance to CPD requirements; ensured that the administration of Board examinations was fair and transparent; reviewed the scope of profession in line with best practice and ensure that it meets the HPCSA ANNUAL REPORT 2016/17 83

85 The Board reviewed a number of regulations, policies and guidelines to ensure that they were relevant and current. A task team was appointed to - review accreditation guidelines with a view to develop policies on accreditation and evaluation guidelines for institutions and laboratories; develop guidelines for evaluators and requirements for appointment of evaluators; develop the evaluation feedback tool by the laboratories and institution who were evaluated; create an annual reporting template to be completed by the institutions. A task team was re-appointed to continue with the process of the articulation and Recognition of Prior Learning (RPL) for the Bachelor of Health Science in Medical Laboratory Science. The purpose was to have a seamless articulation from Laboratory Assistant to Medical Laboratory Scientist within the profession of Medical Technology using the principle of articulation and RPL. STAKEHOLDER ENGAGEMENT The Board engaged with its stakeholders through the website, newsletter, e-bulletin and at least one stakeholder meeting per annum in different provinces. The Board held its first stakeholder meeting on 16 August 2016 in Durban. The meeting was attended by 36 stakeholders, which were from the Universities of Technology - Heads of Departments (HoDs), Medical Technologist Coordinators (Provincial Representatives), Laboratory Area Managers and Training Managers. The purpose of this initiative was to discuss professional matters and other matters of mutual concern as part of the communication strategy of the Board. The presentations conducted at the meeting were the following: Council s mandate and structures; Strategic objectives of the Board; Analysis of the national board examinations for the Professional Board for Medical Technology; The process of assessment of training at clinical facilities and universities of technology; and CPD: Accreditor Service Providers. Questions emanating from the presentations were responded to by both the Board members and the Secretariat. The Board Executive Committee convened a meeting with the Society of Medical Laboratory Technologists of South Africa (SMLTSA) in June 2016 to discuss the relationship between the two and Board examinations conducted by SMLTSA. The purpose for the meeting was to review the Memorandum of Understanding (MoU) between the Board and SMLTSA and to ensure that the conditions stated in the MoU were clear with regard to the expectations of the Board. The Board approved that the meeting between the Board and SMLTSA should be conducted annually to reinforce the relationship. The Board sent a delegation to participate in the Annual Laboratory Medicine Congress which was hosted by SMLTSA in May The aim of the Congress was to promote the science, ideas and techniques available at all levels in the Laboratory Medicine fraternity. The Laboratory Medicine Congress created an opportunity for all role players in the industry to meet and exchange best practice guidelines and current information among like-minded colleagues. The Board s Administration arranged an exhibition stand during the SMLTSA congress. The Board provided vital information to practitioners during the Congress. PROFESSIONAL PRACTICE AND CONDUCT The Board considered and acted on seventeen (17) complaints relating to, practicing outside of scope of practice, unprofessional conduct towards clients and colleagues, insufficient treatment of patients, etc. The Board also received quarterly status reports on professional conduct matters to enable the Board to monitor progress, as well as trends in complaints. The Board s Committee of Preliminary Inquiry finalised three (3) complaints, referred two (2) matters for Professional Conduct Inquiries and six (6) matters were deferred to obtain further information. There were two (2) guilty findings and 84 HPCSA ANNUAL REPORT 2016/17

86 one (1) practitioner was cautioned and reprimanded. One (1) consultation was held and one (1) case was withdrawn. SCOPE OF PROFESSION The Task Team for the Registration of Forensic Pathology Officers met in April 2016 and March 2017 to discuss an action plan relating to the promulgation of the register for Forensic Pathology Officers as well as the scope of profession. The Task Team developed and submitted to the Board the following documents for consideration, approval and recommendation to Council to submit to the National Department of Health for publication by the Minister for public comment. Draft regulations relating to the registration of Forensic Pathology Officers; Draft regulations relating to the registration of Student Forensic Pathology Officers; and Draft regulations relating to Scope of Profession of Forensic Pathology Officers. The rationale and the need to establish a Forensic Pathology register within the HPCSA was that for the past 30 years or more, the South African Police Service (SAPS) was the custodian of the bodies presumed to have died from unnatural causes. The SAPS was responsible for the medicolegal mortuaries and for the transport of corpses to these facilities. The Departments of Health have always provided the medical expertise of pathologists and doctors for the medico-legal investigation of death. Currently, in terms of section 27(2) of the Health Act, 2003, the Provincial Departments of Health (Heads of Department) will be responsible for implementation of the entire Forensic Pathology Service, excluding Forensic Laboratories (which is a national responsibility), in compliance with national legislation. This was the culmination of a Cabinet decision on 29th April 1998 to transfer the medico-legal mortuaries from SAPS to the National Department of Health. registered in private practice for conducting a private practice. BOARD EXAMINATIONS The Society of Medical Laboratory Technologists of South Africa (SMLTSA) conducted the National Board examination on behalf of the Board. The Memorandum of Understanding (MoU) between the Board and SMLTSA was reviewed. The total number of professionals/students/interns who wrote the Board Examination in 2016 is DATE NO OF NATURE OF CANDIDATES EXAMINATION WHO WROTE January 2017 BHSC Rewrite 6 Examinations March 2016 Technologist 346 Examinations April 2016 Laboratory 142 Assistant Examinations August/October Technician Examinations October 2016 Phlebotomy 197 Technicians Examinations September 2016 Technologist 145 Examinations November 2016 BHSC Examinations 46 The Board is in the process of reviewing the scope of profession for Medical Technology. COMPLIANCE FOR REGISTRATION The Board appointed a task team to review and develop standards and guidelines relating to medical technologists HPCSA ANNUAL REPORT 2016/17 85

87 A task team appointed to analyse the examination processes reviewed the National Board Examinations conducted by SMLTSA examination on behalf of the Board. The Board developed the criteria and a checklist for the appointment of moderators and examiners for purposes of the examinations. PROFESSIONAL BOARD FOR OCCUPATIONAL THERAPY, AND MEDICAL ORTHOTICS AND PROSTHETICS AND ARTS THERAPY GOVERNANCE The Board developed its Strategic Plan that addressed its mandate in terms of the Health Professions Act, 1974 (Act 56 of 1974). The Board members attended a risk management workshop in March and April 2017 where the Risk Register was finalised. The Board reviewed and updated the Annual Performance Plan (APP) 2016/17 on progress made on the objectives and the Risk Register to ensure the strategic objectives were achieved. The Board reviewed the mandates, roles and responsibilities of its Committees in terms of its strategic objectives. HIGHLIGHTS The Professional Board for Medical Technology held its first stakeholder meeting on 16 August The Board approved the guidelines on the use of titles to be used by practitioners who are registered under the auspices of the Professional Board. The Board approved that all private practice applications be dealt with administratively based on the specific criteria in order to streamline timeous registration processes. The Board appointed evaluators commenced with the conducting evaluations of Laboratories as part of the quality assurance functions of the Board, aiming to protect the public. Ms MS van Niekerk (Chairperson) OVERVIEW The Occupational Therapy, Medical Orthotics and Prosthetics and Art Therapy Professions Board (OCP) set itself to advance the provision of quality and equitable services at all levels of health care. This was evident in the how the Board has improved relations with its stakeholders, how the board has improved its capacity to add value to evaluations and accreditations of training providers, commenced with the processes to review policies, processes and procedures to improve service delivery and efficiencies. In an effort to provide health care services to all, a process was established for a new Orientation and Mobility Register. Several regulations to expand the Arts Therapy profession to include a new drama therapy category were also approved by Council and are in the process of being promulgated by the Department of Health. The Board focused on delivering on its overarching mandate and regulatory responsibility and associated itself with the 86 HPCSA ANNUAL REPORT 2016/17

88 demands and professional challenges of its stakeholders such as the National Department of Health and Professional Associations in providing quality health care service to the community and the training of professionals. In an endeavour to mitigate the risks associated with its functions, a Risk register was adopted and implemented at the end of The first review will be conducted in April Although the Board still has vacancies, the work has not stopped. The Board is comprised of highly skilled, professional individuals, focused on driving continuous innovation at all levels of strategy and operations, ensuring that the professions receive maximum value for the contributions they pay to the Council. VISION AND MISSION Vision To regulate the professions for quality and equitable services at all levels of health care Mission The OCP will achieve its mission by: Guiding and regulating the profession through Scopes of professions and practice Setting minimum training standards and enforce compliance Accreditation and quality assurance of training programmes, facilities and supervisors Setting the standards for registration Protecting the public through Monitoring professional conduct Advocacy, advisory and stakeholder engagement through Consistent and effective advice Responsiveness to the evolving health needs of the country STRATEGIC OBJECTIVES The OCP Board developed its Strategic Plan for the five-year period in 2016, which is aligned to the HPCSA Strategy. The following broad framework were identified: Guiding and Regulating the Profession Review Board specific regulations pertaining to ethical and professional conduct of students Review and update regulations pertaining to the registration of persons holding qualifications not prescribed Finalising the updating of the scopes of profession and scope of practice Advocacy, advisory and Stakeholder Engagement Inter-Board engagement Develop, clarify and engage regarding the position of the Board on key issues Develop a communication strategy Efficient and Effective Functioning of the Board Define and ensure consistent Secretariat support Performance management and accountability EDUCATION AND TRAINING The Board conducted three (3) Education Committee meetings per year to consider all matters related to the qualifications and training of practitioners, matters related to Board examinations, accreditation of institutions, regulations, rules, policies, processes and guidelines related to education, CPD and more. Evaluations of Higher Education Institutions (HEI s) The Board evaluates higher education institutions (HEIs) once every five years (5) and grant accreditation for the training students in accordance with the standards set by the Board. Efficient and effective Board functioning HPCSA ANNUAL REPORT 2016/17 87

89 In the 2016/17 financial year Occupational therapy programme at University of Kwa-Zulu Natal and Medical Orthotics and Prosthetics programme at Walter Sisulu University were evaluated for accreditation. The Board conducted training for its HEI evaluators to improve capacity and broaden the pool of skilled Board members and personnel. The training took into account the development and technological advancements in the training of professionals, applicable processes and regulations. Continuing Professional Development The Board appointed Accredited Service Providers and accreditors in 2016 for the five-year term respectively. Service providers of continuing professional development are encouraged to offer more activities on ethical issues and developments in the professions. STAKEHOLDER ENGAGEMENT AND COMMUNICATION The Board focussed more on improving communication with the all its key stakeholders, such as the education and training institutions, Associations, Department of Health and practitioners regarding professional matters. The first Annual Stakeholders meeting (revised composition) was held at the HPCSA Offices. Stakeholders including the National Department of Health, all associations representing practitioners, Head of Departments of the Institutions of higher learning, Provinces were in attendance. The Board s annual newsletter was also published. PROFESSIONAL PRACTICE AND CONDUCT Professional Conduct The Board over the past year conducted several reported misconduct cases. The basis of the complaints pointed to a breach of ethical rules, and were dealt with by the Committee of Preliminary Inquiry. Complaints ranged from claiming for services not rendered, malpractice, negligence and in some instances practitioners were not effectively communicating with patients. Some serious complaints received alleged that practitioners acted unprofessionally by forwarding fraudulent accounts, as well as practicing outside of their scope. Over and above, the Board received general reports from the Committee of Preliminary Inquiry and Legal Services on professional conduct. The information is used to determine the teething problem areas in the profession and enables the Board to communicate to practitioners through the newsletters to address the conduct and to educate. The introduction of the Inspectorate Office within the Legal Services Department of the HPCSA enabled the Board to raise several issues of suspected misconduct for the Department to investigate and enforce the law in cases of encroaching the scope of practice of different professions and prosecution of any misconduct. SCOPE OF PRACTICE The Occupational Therapy scope of practice was approved by Council after a rigorous process of consultations with the stakeholders. The regulations relating the scope of practice of Occupational Therapy were amended for promulgation by the Minister of Health. The Arts Therapy and Medical Orthotics and Prosthetics review of scope of practice processes are at advance stages will be submitted for approval in COMPLIANCE FOR REGISTRATION HPCSA is focusing on the need to improve and streamline its administrative processes for foreign registration by aligning its functions with the structure and core functions of each 88 HPCSA ANNUAL REPORT 2016/17

90 department through the recently embarked upon Business Process Re-engineering. Part of the process changes was that all applications are now deposited in a single repository at Registrations Department for first verification and capturing before consideration by the Professional Boards. This will assist in expediting and defining roles clearly and service delivery improved. The Board recognized that, as a regulatory body, compliance with its policies and regulatory frameworks is vital to achieving its mandate. A Task Team was established in 2016 to champion the review and alignment of relevant process and relevant policies. In accordance with the strategic plan, a few other task teams are planned to address pertinence issues required to streamline registration and ensure compliance including Arts Therapy Mid-level Worker, MOP Mid-level Worker and upgrade process, completion of the Mobility and Orientation Register processes etc. BOARD EXAMINATIONS The Board conducted examinations twice in the year and a total of 17 candidates participated. Medical Occupational Occupational Arts Orthotics Therapy Therapy Therapy and Technicians Prosthetics 6 candidates 4 1 Candidate 6 Candidates candidates The Board embarked on a process of reviewing the current examinations model to align with the general standards of professional assessments and be equitably applied across the professions registered. document review task team was established to appraise and align current processes, regulations and policies as well as to develop new interventions to enable the Board work better, be more relevant and perform. To date, several processes have been reviewed including accreditation of institutions and foreign qualified applications. The Assistive Devices Task Team has made great inroads in advancing the development of a guiding document to assist practitioners to practice ethically and efficiently. In 2016, the process was opened to other Boards to participate in the task team to ensure that the Assistive Devices guideline document become relevant to all practitioners who may be affected. HIGHLIGHTS The Assistive Devices Project was opened to other Boards at Council to participate and the Position Paper was being finalised Engagements with the Medicines Control Council(MCC) are afoot to adopt the position paper on assistive devices; Regulations pertaining to the amendment of the revised scope of practice for Occupation Therapy will be promulgated by the Minister of Health in 2017; Regulations pertaining to Art Therapy Drama Therapy are expected to be promulgated by the Minister of Health during GOVERNANCE The HPCSA and the Board is committed to and fully endorse the principles of good governance as set out in the King III Report. The Board recognises its responsibility to conduct its affairs with fiscal prudence, transparency, accountability and fairness, thereby safeguarding the interest of all its stakeholders. The Board noted that there were serious challenges regarding the registrations processes and the policies. A HPCSA ANNUAL REPORT 2016/17 89

91 PROFESSIONAL BOARD OPTOMETRY AND DISPENSING OPTICIANS Setting of professional norms and standards; Quality assurance of eye care education and professional practice; Defining Scopes of Practice; Promotion of equitable and accessible eye care service delivery; and Effective stakeholder engagement in order to protect the public and guide the professions. STRATEGIC OBJECTIVES The strategic goals (programmes) identified by the Board were the following: Goal 1. Aligning the Professions to the Needs of the Country To review and enhance quality standards within education and training OVERVIEW Mr M Kobe (Chairperson) The Professional Board for Optometry and Dispensing Opticians, with its structures, achieved most of activities planned for in 2016/17 financial year within the allocated budget. The review of Annual Performance Plans and Risk Management Plans were concluded against constant monitoring on available finances. The achievements realised are a result of effective leadership and an efficient team made up of Board Members and the Board Secretariat. VISION AND MISSION Vision An effective and accountable regulator in the education and practice of eye care professions. Mission To establish and implement a regulatory framework, policies and guidelines for Optometry and Dispensing Optician through: To actively promote specialities within the DO and OP professions To maintain the quality of professionals through National Board Examination To Promote the production and retention of professionals at a rate that serves the needs of the country Keeping socially relevant Strive to promote affordable and accessible eye care services Promotion of Outreach Programs to address the needs of communities, disabled citizens, women, children and the previously disenfranchised Goal 2. Ongoing and Effective Stakeholder Engagement Improve communication with all stakeholders to promote a positive brand image Fostering practitioner compliance Proactively engage with stakeholders to ensure minimum quality standards 90 HPCSA ANNUAL REPORT 2016/17

92 Goal 3. Governance and Regulating Scopes of Practice Review Scopes of Practice Review the Scope of Profession for Dispensing Opticianry and all professions under the ambit of the Board Consider disparities between the professions and membership fees Review of legislation to ensure that there is context and rationale supporting the rules Strengthening of processes & timeframes pertaining to registration Develop Guidelines for NGO s providing Optometry and Dispensing Opticianry Services Ensure effective functioning of the Board (and Council) Improved effectiveness and efficiency of meetings Skills development of Board Members and associated persons Goal 4. Protecting the Public Prescribe professional practice standards for the respective eye care professions Monitor compliance with the minimum standards of care in implementing improvement plans based on the Board s recommendations. The Board further held consultations with relevant stakeholders to provide support and facilitate the implementation of the recommended minimum requirements and outcomes for ocular therapeutics. PBODO with the assistance of the NDoH s intervention, dealt with the challenges emanating from the implementation of Clinical Training for Ocular Therapeutics. During the Standard Generating Workshops organised by the Board with Heads of Departments, the Board continued to encourage institutions to provide programmes in optical dispensing, ocular therapeutics, diagnostics (postgraduate), ethics courses and a more comprehensive fiveyear programme that will include both diagnostics and therapeutics. Continuing Professional Development (CPD) The Board monitored ongoing practitioner education and activities that were accredited by approved education and training institutions. Annual reports submitted by accreditors and accredited service providers were analysed by the Board. CPD providers were encouraged to offer good quality activities including ethics. Advocate for equitable distribution of practitioners Ensure CPD compliance by all registered professionals Continual Ethical commitment An informed public of practitioners ethical duties EDUCATION AND TRAINING The Board did not have evaluations for accreditation scheduled in the period under review however, it provided continuous monitoring and support to higher education institutions accredited to offer Optometry and Dispensing Opticianry programmes. Institutions were requested to submit mid-term and annual progress reports, where applicable. These reports gave the Board an indication of how the institutions were progressing HPCSA ANNUAL REPORT 2016/17 91

93 Practitioners were reminded through the Board s newsletter to ensure that they comply with the CPD requirements to stay abreast of developments and remain on the register as per legislative requirement. Quality assurance at educational institutions The Board continued to monitor the provision of quality education and training of professionals under its ambit and thus provided the necessary support to the institutions. The review of guidelines for evaluations towards accreditation of education programmes was finalised in liaison with higher education institutions. This review was to incorporate transformational issues and a component on therapeutics. Multi-disciplinary practices; Scope infringement by front line staff in practices, etc. A report on this important engagement was shared with the rest of the Dispensing Opticians. Engagement with higher education institutions on policy matters and issues pertaining to the setting of minimum standards of education and training in optometry and dispensing opticianry continued. Monitoring of progress made towards implementation of recommendations of the Board after evaluation visits were done and the Board was satisfied with the reports received. Some of the issues that were being address were regarding the use of relevant and appropriately qualified and experienced external examiners by Institutions. In this regard, the Board developed guidelines for external examiners for use by the institutions when appointing external examiners. Institutions will be given an opportunity to provide input on the guidelines before finalisation. The Board also developed guidelines for Recognition of Prior learning (RPL) for Therapeutics to serve as a guide when higher education institutions assess applications for recognition from foreign qualified practitioners. STAKEHOLDER ENGAGEMENT The Board pursued its endeavour to meaningfully engage with relevant stakeholders as this forms part of the Council s strategic objective. In this regard, the Board met with the stakeholders (representatives of Dispensing Opticians) in May 2016 in Pretoria. The stakeholders meeting was attended by twelve (12) practitioners and two HoDs. Discussions were based on issues raised by Dispensing Opticians which included among others: Employment of Optometrist & current business models for Opticians; Scope expansion for dispensing opticians; PROFESSIONAL PRACTICE AND CONDUCT Higher education institutions were reminded of their role to remind students of ethical conduct. This was in response to concerns that reached the Board that students seemed to have less regard for patients and often engage in unprofessional behaviour. Matters that served before Committee of Preliminary Enquiry at 2 meetings held: Total matters handled 28 Finalised matters 11 Matters referred to Inquiry 4 Deferred matters 4 Consultation 1 Inspection 1 Guilty verdicts 92 HPCSA ANNUAL REPORT 2016/17

94 SCOPE OF PROFESSIONS Since the scope of the profession of optometry has been expanded to include therapeutics, the University of KwaZulu-Natal (UKZN) has offered the therapeutics programme and thus far five practitioners have successfully completed the prorammes and are in the process of being registered with the HPCSA for recognition of therapeutics. Prescription rights for optometrists linked to Scope expansion: The Board continued to engage the Medicines Control Council (MCC) to expand the list of scheduled substances for Optometrists as approved by the MCC and gazetted by the Minister in June This is a list of scheduled substances that optometrists are allowed to use and prescribe as part of the expanded scope. The Board also made another submission to the MCC to have contact lenses registered as medical devices in order to regulate the illegal and online sale thereof. Dispensing Opticians were given an opportunity to submit a proposal to the Board for the expansion of their scope. cope infringement by front line staff in Optometry/ Dispensing Opticianry practice: Following numerous queries and complaints received by the Board regarding the performance of certain clinical and professional acts falling within the scope of the profession of Optometry and Dispensing Optician by persons who are not registered in terms of the Health Professions Act. The Professional Board issued a media statement to remind, inform and educate practitioners and the members of public of the rules and regulations. locums. No new registration categories have been created. BOARD EXAMINATION The Board resolved to put on hold the process to explore an appropriate examination model for the national board examinations pending the finalisation of the five-year Optometry programme. The Board is currently developing guidelines for Board examination in relation to fee structure for the exams to establish a clear process. Only three (3) foreign qualified professionals undertook the Board examination before registration with HPCSA. GOVERNANCE Processes and timeframes regarding registration have been strengthened such that processing of compliant applications should be finalised in less than six months. The Board has through appropriate training, strengthened its effective functioning and that of all its structures. It has updated and reviewed the Annual Performance Plan (APP) 2016/17 on progress made on the objectives and the Risk Register to ensure the strategic objectives were achieved. The Board continued in its endeavour to improve its effectiveness and efficiency in holding its meetings and carrying out its functions. COMPLIANCE FOR REGISTRATION Effective processes were put in place to ensure that only applications that were compliant for registration especially of foreign qualified professionals were attended to by the Board within six months of receipt of an application. The annual monitoring of compliance to minimum requirements before registration with Council by South African graduates was conducted by the Board. The Board has communicated with Universities to re-iterate the importance of final year students or graduates to be registered with the HPCSA before they are employed or do HPCSA ANNUAL REPORT 2016/17 93

95 HIGHLIGHTS The Professional Board for Optometry and Dispensing Opticians and its structures successfully held eight meetings and workshops between April 2016 and March PROFESSIONAL BOARD OF PHYSIOTHERAPY, PODIATRY, AND BIOKINETICS The Strategic Plan for the term of office and the APP 2016/2017 were developed in line with Council s Strategic Plan. The legislative framework pertaining to Optometry and Dispensing Opticians was reviewed and is awaiting Council approval before being forwarded to the National Department of Health for promulgation. The MCC s approval of prescription rights for Optometrists and the publishing of the gazette of the relevant medicines to be used by Optometrists is a great achievement. Ms ND Dantile (Chairperson) OVERVIEW The Physiotherapy, Podiatry and Biokinetics Board has been in office for a period of two years. Over the period; the Board focused its attention on the development and approval of its Strategic Plan, Annual Performance Plan and Risk Register. The alignment between the strategic plans of Council and the Board was a significant exercise to ensure that there was synergy between the plans. The Board determined its Vision as ensuring quality specialised skills in Physiotherapy, Podiatry and Biokinetics for all. PPB s Mission is to: Guide, set standards and regulate the professions in line with national and international practices; Protect the public; Proactively address the needs of the community and relevant stakeholders; 94 HPCSA ANNUAL REPORT 2016/17

96 Advocate for the professions and advise relevant policy formulation; and Ensure efficient and effective functioning of the Board. To achieve this, the Board. among other things, improved relations with the stakeholders, improved its capacity to add value to evaluations and accreditations of training providers, commenced with the processes to review policies, processes and procedures to improve service delivery and efficiencies. To mitigate the risks associated with Board functions, a Risk Register was adopted and implemented in With only one vacancy that needs to be filled, the Board is empowered with highly skilled, professional individuals, focused on driving continuous innovation at all levels of strategy and operations and ensuring that the professions receive maximum value for the contributions they pay to the Council. STRATEGIC OBJECTIVES In terms of alignment between Council and Professional Boards, a tripartite relationship characterised by interdependence exists between Council, the Professional Boards and the Secretariat, established to achieve the mandate of the HPCSA. This has resulted in alignment and adequate coordination of resources. The Professional Board strategies align with the Council s strategy through the following three overarching themes, namely: Goal 1. Guiding and Regulating the Profession Review the ethical rules and guidelines and provide feedback to the Board; The review and update of the scopes of the professions and / or practice for Physiotherapy/ Podiatry and Biokinetics Set clinical standards for practitioners; Review legislation, policies, procedures and preceding work of the PPB Board to determine areas of improvements e.g. registrations of practitioners; Assess the role of the Board in quality assurance of the accreditors providing continuing professional development (CPD) and accreditation of short learning programmes; Accredit of short learning programmes; Audit of Professionals regarding CPD; Ensure institutional accreditation / endorsement (On-going according to accreditation cycle) and curricula aligns with the minimum standards and exit outcomes; Ensure the training of evaluators for accreditation of institutions; and Define career paths of professions under the ambit of the Board. Goal 2. Protecting the Public Empower, inform and educate the public on their rights and expectations with respect to podiatry, physiotherapy and biokinetics services. Goal 3. Advocacy, Advisory and Stakeholder Engagement Develop and implement a communication plan to effectively communicate with stakeholders; Advocate for the strategic positioning of the podiatry, physiotherapy and biokinetics professions in the national health care system; Engage with relevant stakeholders to encourage research that will influence policy; and HPCSA ANNUAL REPORT 2016/17 95

97 Improve internal communication. Goal 4. Effective and Efficient Functioning of the Board Define, implement and enforce defined roles and responsibilities between Council; Secretariat and the Board; Performance evaluation/ monitoring and evaluation (M&E) of the Board and Board members; The following forms were revised and finalised: the process document, self-evaluation form, the final report form and the template for remedial actions, with the exception of Form 206C. Develop targets and processes for the Board and Secretariat (including turnaround times); Define adequate and competent Secretariat; Infrastructure and resources to support the podiatry, physiotherapy and biokinetics Board; Guidelines and feedback processes regarding external and additional activities as it pertains to the functioning of the Board; Define communication etiquette among Board Members, including through protocol and investigate methods of communication to enhance efficiency of the Board (informed by communication plan / strategy); Ensure that all Professional Conduct cases are resolved effectively and efficiently; and Identify skills gaps and continuous training of Board Members. The strategic planning process sought to ensure that a comprehensive and integrated strategy is developed; and that, through this process, alignment of outcomes and expectations is achieved for all relevant internal and external stakeholders. EDUCATION AND TRAINING Review of accreditation documents The Board approved the review of the evaluation documentation and forms used for accreditation of higher education institutions across all professions. The following forms were revised and finalised: The new forms will now be tested and used in the upcoming evaluation visits to the training institutions. Student Staff Ratio Following a lengthy process to determine student staff ratios at training institutions, the Board approved the draft guidelines determined by the Board s Task Team in consultation with other stakeholders. The approved student staff ratio guidelines document will serve at the next Heads of Departments meeting. Biokinetics Internship Committee (BKIN) Accredited training centres The Board continued to advance the process of training of Biokineticists in the country. To date, over 50 clinical training facilities have been accredited for training of Interns Biokinetics. Work-Integrated Learning in the Biokinetics programme There is a need to guide the Biokinetics programme leaders at institutions with regard to Work-Integrated Learning and experiential learning and how it is integrated into the fouryear qualification. The Board then established a Task Team to develop a Guidelines document, which is in the process 96 HPCSA ANNUAL REPORT 2016/17

98 of being finalised before it is sent out for comments. Accreditation of Universities In accordance with its mandate, the Board is required to evaluate higher education institutions (HEIs) once every five years and determine accreditation for the students in training in accordance with the standards set by the Board. The following HEIs were evaluated during the 2016/17 financial year: PROFESSION/ INSTITUTION PROGRAMME Physiotherapy University of Witwatersrand University of KwaZulu-Natal Podiatry University of Johannesburg Biokinetics North-West University STAKEHOLDER ENGAGEMENT To improve the means of communication, the Board issued one newsletter publication per annum to communicate important developments in the profession and administrative issues to all registered professionals and students. Annually, the Board facilitates a meeting with stakeholders as part of its Stakeholder Engagement Strategy. Stakeholders were invited to a meeting that comprised of University Heads of Departments (offering professional training in Physiotherapy, Biokinetics and Podiatry), Professional Associations, National Department of Health and Provinces. In the period under review, the HODs meeting was conducted in August This meeting is of strategic importance to the Board as it serves as a forum to discuss matters of mutual concern for all professions under the ambit of the Professional Board. The Board conducted a Practitioner Roadshow in the Limpopo province in October The roadshow was attended by PPB practitioners from throughout the province and neighbouring areas in public and private practice and institutions of higher learning. Practitioners were rewarded with CPD points for in recognition of their attendance. PROFESSIONAL PRACTICE AND CONDUCT Over the past year, the Board presided over several reported cases of misconduct. Complaints ranged from breach of ethical rules, claiming for services not rendered, malpractice, negligence and, in some instances, practitioners were not effectively communicating with patients. Through its roadshows across provinces, the Board annually addresses and warn practitioners of the trends of misconducts dealt with at the Preliminary Committee meetings. The 2016 Roadshow was hosted in Polokwane in October and practitioners received five CEUs and ethical points. In an effort to circumvent misconduct, the Board promotes that practitioners exercise professionalism and display ethical behaviour that is of the highest standard. PPB Board, in accordance with its Strategic Plan, placed emphasis on quality assurance of the Accreditors approved to accredit programmes and ensure that all practitioners are audited at least once during the term of office. SCOPE OF PROFESSIONS In the past year, the Board set up a Task Team that was subdivided into three professions, namely; Physiotherapy, Podiatry and Biokinetics to look at profession specific changes and development into the individual scopes. A workshop, which was facilitated by an independent facilitator who brought wealth of knowledge and experience to deal with issue relating to overlaps and similarities among the three professions and decide on delineations. At the end of the financial year, the Task Team was finalising the scopes document ensuring alignment and legal compliance. The next step would be to present the scope to the stakeholders, receive Council s endorsement on all the three scopes of practice and ultimately submit it for promulgation by the Minister of Health. As per the Strategic Plan of the Board, the subsequent step would be to review and update the scopes of practice/ profession of the other categories under the ambit of the Board. This process will be enhanced by the development of the Clinical Standards and Career Pathing process planned for the 2018/19 financial year. HPCSA ANNUAL REPORT 2016/17 97

99 COMPLIANCE FOR REGISTRATION Apart from ensuring that only appropriately qualified practitioners were registered within the respective professions, the Board also had to ensure that foreign qualified practitioners were registered in terms of the relevant legislation and the latest policies of both the Board and the Department of Health. PROFESSIONAL BOARD FOR PSYCHOLOGY The Board practiced a strict process of reviewing foreign applications to ensure that only properly trained and qualified practitioners are registered with the HPCSA. BOARD EXAMINATIONS The Board successfully conducted two theoretical and practical Board examinations for foreign qualified Physiotherapists and Podiatrists. The first exam was held in March/April and the second one in September/October. 19 candidates sat for the examination during 2016/2017 financial year in total. Foreign qualified Foreign qualified Physiotherapists Podiatrists 17 candidates 2 candidates The mid-level workers category was another concern for the Board. Efforts were made to engage the Department of Health regarding its plans to advance this category. At the recent meetings of the Board and the Education Committee, it was acknowledged that there was a need to upgrade the current Physiotherapy Assistance (PTA) to Physiotherapy Technician level. It was resolved that the Board would need to align the scope of practice and minimum standards of the current technicians and assistance, to advance the issue of training of technicians. GOVERNANCE The Board is fully committed to and endorses the principles of corporate governance as set out in the King III Report on Corporate Governance. It recognised its responsibility to conduct its affairs with fiscal prudence, transparency, accountability and fairness, thereby safeguarding the interests of all stakeholders. Prof PJ Pillay (Chairperson) OVERVIEW AND STRATEGIC OBJECTIVES The Professional Board for Psychology is comprised of twenty (20) members appointed by the Minister of Health in terms of section 15 of the Health Professions Act 1974, (Act 56 of 1974). The Board developed a Strategic Plan, which included the following objectives: 1. to review and clarify the scope of practice and scope of profession in line with best practice and ensure that it meets the needs of the public; 2. to review and update the ethical rules, regulations, guidelines and policies applicable to the profession; 3. to improve inter-sectoral relations and engage with international bodies to ensure that best practice and benchmarking is incorporated locally; 4. to improve communication with stakeholders and inter-sectoral relations; 5. to ensure quality of training programmes, adherence to minimum standards for training and training facilities, compliance to CPD requirements and 98 HPCSA ANNUAL REPORT 2016/17

100 the conducting of examinations that are enforcing standards and that are fair and transparent; and 6. to streamline the classification process of psychometric tests in line with the legislative framework. VISION AND MISSION Vision To guide, regulate and advocate for quality psychological healthcare. Mission Statement The Professional Board will strive to protect the public and guide the profession through- Legislation, regulations, guidelines and policies; Effective, efficient and transparent procedures and processes; Relevant and progressive standards; Engaging the public, training institutions, practitioners and other relevant stakeholders. EDUCATION AND TRAINING One of the primary functions of the Board is to determine and uphold standards of education and training. This was done though the system of evaluation and accreditation of education and training against a set of criteria and guidelines. The Board continued to monitor the provision of quality education and training of professionals under its ambit as well as providing the necessary support to institutions. In the period under review, the Board evaluated ten (10) university programmes and sixteen (16) internship training facilities. In determining and maintaining standards of education, training and practice, in January 2017, the Board held workshops to guide the training institutions to work on the following: Review the SGB documents in line with the Scope of Practice; Outline the competencies for each registration category; Align qualifications with the South African Qualifications Authority (SAQA) and Council on Higher Education (CHE) requirements. The workshops were attended by programme coordinators of the training institutions offering programmes from specific categories and members of the Education, Training and Registration Committee. STAKEHOLDER ENGAGEMENT One of the Board s key strategic objectives was to improve communication with stakeholders and inter-sectoral relations. This is to promote dialogue with the stakeholders in order to address the needs of the public and to provide guidance to professionals. To this end, the following engagement sessions were held: 22 nd Annual Psychological Society of South Africa (PsySSA) Congress The Board participated in the 22nd Annual Psychological Society of South Africa (PsySSA) Congress which was held in September 2016 at Emperors Palace, Johannesburg under the theme Response Ability? The Chairperson of the Psychometrics Committee participated in the round table discussion on Test Classification Guidelines as did the Chairperson of the Education, Training and Registration Committee, who participated in another round table on training of Registered Counsellor in psychometric assessments as well as the list of tests in Form 258. Exchange Programme by the Health Professions Council of Namibia (HPCNA) The Health Professions Council of Namibia visited the Professional Board for Psychology on 22 July 2016 for an exchange programme. The Social Work and Psychology Council of the HPCNA registers Social Workers, Educational Psychologists, Clinical Psychologists, Counselling Psychologists and Psychological Counsellors. The purpose of the visit was to establish the following: Minimum requirements for registration and the scope of practice for Industrial Psychologists; Minimum requirements for registration and the scope of practice for Psychometrists; HPCSA ANNUAL REPORT 2016/17 99

101 Policies, guidelines and procedures pertaining to international and national qualifications; Policies, guidelines and procedures pertaining to evaluation and accreditation of training institutions; Structure of the CPD Department and Committee; CPD guidelines; System used for random selection of practitioners for CPD audit; Structure of the ETQA Committee; and Responsibilities of the ETQA Committee. The HPCSA Council recommended that continuous interaction and relationship be maintained between the two regulatory bodies. HEADS OF DEPARTMENT STAKEHOLDER MEETING The Board is responsible for the oversight for quality of education and training in psychology and accredited institutions as well as the programmes offered by such institutions. This was done through setting standards for education and training and ensuring that the standards were adhered to. The Board therefore has a statutory obligation to act on behalf of the profession by providing guidance to the profession to ensure that practitioners acted in the interest of the public. A meeting with the Heads of Departments, Intern Coordinators / Intern Supervisors at Higher Educational Institutions as well as Internship Training Facilities offering training in Psychology was held in April The aim of the meeting was to discuss and guide the supervisors and coordinators on issues and challenges related to internship training and related matters. Other issues of discussion included: The role of the Board in quality assurance of education and training; The National Mental Health Action Plan for the period to support the Human Resources Health Plan; Update on the regulation relating to the establishment of the Neuropsychology Register; Common concerns raised in Evaluation Reports; The purpose and nature of an internship; The requirements for a tailored internship programme; Academic and professional prerequisites for an internship in Psychology; The roles and obligations of the training institutions, collaborating universities and interns; Time lines for completion of the academic and internship programme and registration; and Specific internship requirements for each category with break-away discussion sessions. In order to achieve the strategic objectives to improving communication with stakeholders as referred above, the following additional engagements were held in the period under review: ENGAGEMENTS Two consultations with EPASSA Meeting with medical aid schemes, to discuss nonpayment of educational psychologists by Medical aids. Three facilitation meetings with PSYSSA and RELPAG Meeting with the Universities of Cape Town and Witwatersrand Training workshop for programme evaluators Training of test evaluators Perusal of Educational Psychology paper question papers by university representatives SGB Workshops to set minimum standards for educational and training UNISA and DHET to clarify on the evaluation and accreditation processes of the Board Meeting with CPD accreditors Workshop with Council on Higher Education HPCSA Roadshows The requirements for the training of Registered Counsellors and Psychometrists; 100 HPCSA ANNUAL REPORT 2016/17

102 ENGAGEMENTS Two consultations with EPASSA Meeting with medical aid schemes, to discuss nonpayment of educational psychologists by Medical aids. Three facilitation meetings with PSYSSA and RELPAG Meeting with the Universities of Cape Town and Witwatersrand Training workshop for programme evaluators Training of test evaluators Perusal of Educational Psychology paper question papers by university representatives SGB Workshops to set minimum standards for educational and training UNISA and DHET to clarify on the evaluation and accreditation processes of the Board Meeting with CPD accreditors Workshop with Council on Higher Education HPCSA Roadshows PROFESSIONAL PRACTICE AND CONDUCT In terms of the mandate of the Committee of Preliminary Inquiry, the Committee is authorised within the current policy parameters as determined by the Board, to deal with all matters relating to preliminary inquiries regarding complaints in terms of Section 41(2) of the Health Professions Act, Act 56 of 1974 and to report thereon to the Professional Board. Complaint withdrawn 3 Found guilty and imposed fine/penalty 10 Not to proceed with complaint 2 Referred to Pro-forma Complainant 2 Fine reduced 0 SCOPE OF PROFESSIONS In September 2011, the Minister of Health published the Regulations Defining the Scope of the Profession of Psychology (GNR 704 in Government Gazette 34581). The effect of the amendment was: (a) to introduce two new scopes of practice to the psychologists profession, namely forensic psychology and neuropsychology; and (b) to define the individual scopes of practice for each registration category for psychologists. The Regulations codified the various functions that each registration category could lawfully perform within their respective scopes of practice. They also expanded the scope of practice for educational psychologists. However, these Regulations were challenged by the Recognition of Life Long Learning in Psychology Action Group Alliance (ReLPAG) and the Justice Alliance of South Africa (JASA) at the Western Cape High Court. The parties involved, which included the Minister of Health, Health Professions Council of South Africa (HPCSA), Professional Board for Psychology, ReLPAG and JASA entered into an agreement in November 2016, which stated that: The Committee of Preliminary Inquiry has held seven (7) meetings within this reporting period and the following matters were dealt with: Matters that served before the Committee 133 Explanations noted/accepted 48 Cautioned/ Reprimanded 9 Inspections 5 Consultations 13 Disciplinary Inquiry with option of fine 17 Disciplinary Inquiry 8 Further consideration deferred 16 (a) (b) (c) the Court would declare the Regulations invalid; the Court would suspend the declaration of invalidity for 24 months to afford the Minister, HPCSA and Professional Board for Psychology an opportunity to correct the defects; and during those 24 months, the HPCSA and Professional Board for Psychology will be obligated to consider, on a case-by-case basis, suspending pending disciplinary proceedings against psychologists, charged with practising outside the scope of practice of their registered category, until the Regulations have been corrected. HPCSA ANNUAL REPORT 2016/17 101

103 This agreement was made as order of court in November The practical consequences of the order were that all psychologists shall remain bound by the content of the Regulations, despite the declaration of invalidity, for the 24-month period of suspension. The Professional Board for Psychology was in the process of reviewing the Regulations and in order to finalise Regulations with the 24-month period, the Professional Board for Psychology established a Working Group on the Promulgation of Regulations. Part of its mandate was to conduct stakeholder engagements where inputs into the scope of practice would be received from psychology practitioners and associations. There would be further engagements with relevant stakeholders. BOARD EXAMINATION As part of the mandate of the Board to ensure that qualified and competent persons are registered, the Board conducted three Board Examinations. The purpose of Board examinations was to measure the capacity of graduates, foreign qualified practitioners and practitioners applying for restoration to enter the profession for community service, supervised practice and independent practice. Details are provided in the Table below: DATE OF EXAMINATION EXAMINATION CATEGORY NUMBER OF CANDIDATES WHO WROTE NUMBER OF CANDIDATES WHO PASSED NUMBER OF CANDIDATES WHO FAILED June 2016 Clinical Psychology Counselling Psychology Educational Psychology Industrial Psychology Research Psychology Registered Counsellor Psychometrist Independent Practice Total DATE OF EXAMINATION EXAMINATION CATEGORY NUMBER OF CANDIDATES WHO WROTE NUMBER OF CANDIDATES WHO PASSED NUMBER OF CANDIDATES WHO FAILED October 2016 Clinical Psychology Counselling Psychology Educational Psychology Industrial Psychology Research Psychology Registered Counsellor Psychometrist Independent Practice Psychometrist Supervised Practice Total HPCSA ANNUAL REPORT 2016/17

104 DATE OF EXAMINATION EXAMINATION CATEGORY NUMBER OF CANDIDATES WHO WROTE NUMBER OF CANDIDATES WHO PASSED NUMBER OF CANDIDATES WHO FAILED February 2017 Clinical Psychology Counselling Psychology Educational Psychology Industrial Psychology Research Psychology Registered Counsellor Psychometrist Independent Practice Psychometrist Supervised Practice Total Total number of candidates that wrote and passed the National Board Examinations candidates wrote the Board Examination, 840 candidates passed the Board Examination and 221 candidates failed the Board Examination during the period under review. GOVERNANCE The Board finalised and adopted the Annual Performance Plan (APP) and Operational Plan that directed how the Board should conduct its strategic and day to day activities and ensuring that it meets its goals. A Risk Register was also developed alongside the APP to identify and mitigate potential risks. HIGHLIGHTS To achieve the strategic objectives as referred to above, the following meetings and Board activities were conducted between April 2016 and March 2017: BOARD ACTIVITIES NUMBER OF ACTIVITIES Professional Board meetings 2 Risk Register Planning Workshop 2 HPCSA Roadshows 1 Executive Committee meetings 4 Education, Training and Registration Committee meetings 8 Examinations Committee meetings 3 Committee for Preliminary Inquiry meetings 7 Psychometrics Committee meetings 4 Accreditation and Quality Assurance Committee meetings 4 HPCSA ANNUAL REPORT 2016/17 103

105 BOARD ACTIVITIES NUMBER OF ACTIVITIES Heads of Departments/Stakeholder meeting 1 Workshops on the review of SGB documents 1 Task Team meetings/ad Hoc meetings 11 National Board Examinations 3 Accreditations 21 Congresses and Conferences 2 CPD Accreditors meeting 1 Workshop with Council on Higher Education 1 Central marking of examinations 1 PROFESSIONAL BOARD FOR RADIOGRAPHY AND CLINICAL TECHNOLOGY MEETING WITH THE MEDICAL AIDS In August 2016, the Board representatives held a meeting with representatives from the Board of Healthcare Funders, Polmed, Profmed, Discovery Health and the Chartered Accountants Medical Aid Fund. The meeting was held on request from the professional associations as well as Medical Aids. The purpose of the meeting was to discuss issues related to non payment of claims from Educational Psychologists, interpretation of the scope of practice and on performance of neuropsychological assessments by Educational Psychologists. The Board advised that the scope of the profession was developed to delineate acts that specifically pertained to the Psychology profession and to protect those acts from being performed by non-psychologists. The scope of practice was to demarcate acts for the different Psychology professions. They were further advised that practitioners should be remunerated for claims that were within their scope of practice. At that time, the Board was developing practice guidelines for Educational Psychologists based on the current regulations defining the scope of the profession for psychology. These guidelines would clarify the scope of Educational Psychologists. OVERVIEW Mr A Speelman (Chairperson) The Professional Board for Radiography and Clinical Technology is constituted by thirteen (13) members appointed by the Minister of Health in terms of section 15 of the Health Professions Act 1974, (Act No. 56 of 1974). The Board had vacancies that will be filled through a nomination for two (2) Radiographers, two (2) Clinical Technologists and one (1) vacancy for a Community Representative. The Board conducted the following meetings during the period under review: Two (2) Professional Board meetings; Two (2) Executive Committee meetings; Two (2) Education Training and Registration Committee meetings; Two (2) meetings for the Committee of Preliminary Inquiry; Two (2) Workshops on Evaluation of Clinical Facilities and a Risk Workshop; and 104 HPCSA ANNUAL REPORT 2016/17

106 Two (2) task team meetings to revise the scope of the Profession of Radiography. The Board developed and reviewed the evaluation and accreditation criteria, guidelines and policies on the basis of which education and training providers would be evaluated and accredited. There were concerns raised regarding the breach of confidentiality prior to accreditation reports being finalised. These were addressed at the Education Committee meeting. Payment of accreditation fees by universities also posed a challenge as the Board could not recover all expenses incurred as part of its quality assurance function. The Board developed policies, guidelines for the candidates, examiners and moderators to ensure consistency and a transparency in examinations conducted by the Board. The Board functioned within its budget provision during the period under review. VISION AND MISSION Vision The Vision of the Board is to be an effective regulator of the radiography and clinical technology professions Mission The Professional Board for Radiography and Clinical Technology strived to achieve the following: Set and monitor compliance to quality norms, standards and guidelines; Promote ethical practice and protection of the public; Proactively engage and collaborate with all stakeholders (internal & external); Timeously respond to the needs of stakeholders; Function in an effective and efficient manner. STRATEGIC OBJECTIVES The Board has set clear strategic objectives that must be achieved during the current term of office. The following strategic objectives were set as priorities: Goal 1. Protect the public through ensuring adherence to standards, regulations and requirements by practitioners: Review all current regulations related to Radiography and Clinical Technology; Ensure that governance documents relating to ethics and practice are clearly defined; Promote participation, access and compliance to CPD; Develop the regulation of medical devices related to the RCT professions; Educate the public on their ethical rights; and Ensure ethical conduct by professionals. Goal 2. Guide the Professions through Promoting Competent, Quality Practitioners: Maintain the quality of education and training standards; Training of Evaluators; Review and update the Scopes of Profession, Scopes of Practice and Standards of Practice; Review guidelines and policies relating to Role Extension; and Review Restoration Policy and non-clinical practice. Goal 3. Ensure Effective Communication and Collaboration with Stakeholders: Develop, implement and monitor a stakeholder engagement plan; and Advocate for the creation of additional positions and career pathing. HPCSA ANNUAL REPORT 2016/17 105

107 Goal 4. A Board that Functions in an Effective and Efficient Manner: Review current systems, processes and internal Board policies to improve efficiency Ensure all roles and responsibilities within the Board are clearly defined Improved effectiveness and efficiency of meetings Development and Training of Board Members Ensure the effective and efficient registration of professionals These strategic objectives were aligned with those of the HPCSA and are intended to provide direction and set priorities for the Board. It is anticipated that these strategic objectives will bring about an improved service delivery to practitioners, the public and hopefully take both professions to greater heights. EDUCATION AND TRAINING Application for approval to conduct a private practice (Form 165). A new pool of evaluators for Radiography and Clinical Technology were appointed to improve on capacity and transparency. The Board made recommendations to Council that the regulations relating to the qualifications for the registration of Radiographers and Clinical Technologists be amended to include the 4-year Radiography professional degree. These were approved for submission to the Minister of Health for promulgation. The Board was finalising the minimum education and training standards for image interpretation and contrast media administration. The Board also set the minimum education and training standards for Electro-Cardiographic (ECG) and Electro-Encephalographic (EEG) and Spirometry. The Board was in the process of reviewing its ethical rules to ensure that they are in line with the scope of profession. The Board continued to monitor the provision of quality education and training of professionals under its ambit and has ensured that the evaluation of institutions and training facilitates which were due for re-accreditation in the fiveyear accreditation cycle were conducted. The Board conducted thirty (30) Radiography clinical training facilities evaluations and four (4) Radiography educational programmes. Twenty-six (26) evaluations for the accreditation of Clinical technology training facilities were conducted. 106 The Board reviewed all the Board s policies and guidelines to ensure that they remained relevant and current. The following accreditation/evaluation documents were reviewed: Report on the HPCSA accreditation programmes; Guidelines for the evaluation and accreditation of clinical training facilities for Radiographers (Form 184 Annexure B); Guidelines for the accreditation of educational and training institutions; Procedure for accreditation of Radiography and Clinical Technology education and training (Form 184/197); and HPCSA ANNUAL REPORT 2016/17 STAKEHOLDER ENGAGEMENT The Board communicates with its stakeholders through the website, newsletter, e-bulletin and at least two stakeholder meetings per annum in different provinces. Once a year, the Board facilitates a meeting with University Heads of Departments offering Radiography Training, Professional Associations, and the Directorate for Radiation Control as well as Deputy Directors for Radiography of the Provincial Departments of Health as part of its stakeholder engagement. The stakeholder engagement meeting is of strategic importance to the Board as it serves as a forum to engage on matters of mutual concern for both professions.

108 All provinces and HODs were represented at the Board Stakeholder Meeting held in May 2016 in Kempton Park. Among the issues discussed were the following: The Strategic Plan of the Board; The role extension for radiographers; The Degree in Health Professions Education for the Professional Board for Radiography and Clinical Technology; Work-integrated learning the role of simulation in attaining clinical competence; Electro-cardiographic technicians and electroencephalographic technicians training; The minimum total clinical hours required for the new Bachelor degrees in Radiography; Conditions of the hospitals and its impact on student training; and Funding for radiographers and clinical technologists. The Radiography and Clinical Technology Day was held on 11 November 2016 attended by 61 practitioners. The theme for 2016 RCT Day celebration was Social Determinants of Health: The Role of Health Professionals. The annual celebration is meant to commemorate the discovery of X-radiation by William Roentgen in 1895, as well as the Clinical Technology Profession. Speakers included members from the Board, Council and representatives from the Western Cape Department of Health. Practitioners who attended were further awarded with CPD points. The Board s Committee of Preliminary Inquiry finalised eleven (11) complaints, referred five (5) matters for professional conduct inquiries, one (1) matter was deferred to obtain further information and there were two (2) guilty findings. SCOPE OF PROFESSIONS Radiography The document on draft regulations defining the scope of profession of Radiography was gazetted for public comment in August 2016 for a period of three (3) months. The document on Draft Regulations defining the scope of profession of Radiography was revised by the Board taking into consideration comments received from the public which were submitted by the Department of Health. Some of the comments were incorporated into the revised Draft Regulations defining the scope of profession of Radiography. The Board was in the process of finalising the scope of profession of Radiography which will in future include image interpretation and contrast media administration. The Registration Department was available at the conference venue to enable practitioners to update their details, pay their annual fees and answer any questions practitioners might have regarding their registration with the Council. PROFESSIONAL PRACTICE AND CONDUCT Clinical Technology The regulations relating to registration of Technicians The Board considered and acted on seventeen (17) Technology in Electro-Cardiographic (ECG) and Electrocomplaints relating to, practicing outside of scope of Encephalographic (EEG) and Spirometry were published practice, unprofessional conduct towards clients and for comment on 24 February The Board will revise colleagues, insufficient treatment of patients, etc. The the regulations relating to registration of Technicians Board also received quarterly status reports on professional Technology in Electro-Cardiographic (ECG) and Electroconduct matters to enable the Board to monitor progress, Encephalographic (EEG) and Spirometry taking into as well as trends in complaints. HPCSA ANNUAL REPORT 2016/17 107

109 consideration comments from the Public submitted by the Department of Health. The Board was in the process of reviewing the scope of profession and ethical rules for Clinical Technology. BOARD EXAMINATIONS The Board reviewed the following guidelines for Board examination to establish clear process. Guidelines for the examinations of foreign qualified Radiographers in the category: Diagnostic; Theory examination answer book; Examination register; Instructions and guidelines for invigilators and Practical assessors; and Diagnostic clinical competency assessment form. The total number of professionals/students/interns who wrote the Board Examination in 2016 is nineteen (19). DATE October 2016 NATURE OF EXAMINATION Radiography (Foreign Qualified) NO OF CANDIDATES WHO WROTE 8 GOVERNANCE The Board developed a Strategic Plan, which addressed its mandate in terms of the Health Professions Act, 1974 (Act 56 of 1974). The Board also attended a risk management workshop where a Risk Register was finalised. The Board reviewed and updated the Annual Performance Plan (APP) 2016/17 on progress made on the objectives and the Risk Register to ensure that the strategic objectives were achieved. HIGHLIGHTS he Open Day Outreach to practitioners, which was generally well received. Progress made with the revision of the Scope of Profession and revision of Ethical Rules to promote ethical practice and protection of the public within set quality norms, standards and guidelines. Progress made regarding the establishment of the register for ECG Technicians and Spirometry Technicians. The regulations relating to the registration of Technicians Technology in Electro- Cardiographic (ECG) and Electro-Encephalographic (EEG) and Spirometry were published for comment in February April 2016 Radiography (Foreign Qualified) October Electro Encephalographic (EEG) 7 4 The Board amended the restoration policy and delegated the function to be conducted administratively based on the specific criteria to function in an effective and efficient manner and to streamline timeous registration. 108 HPCSA ANNUAL REPORT 2016/17

110 PROFESSIONAL BOARD FOR SPEECH, LANGUAGE AND HEARING PROFESSIONS Develop and monitor regulations and standards for education, training and practice; Regulate registrations, professional conduct and training; Register students and professionals; Accredit training programmes; Strengthen the monitoring of CPD compliance; Improve collaboration with all relevant stakeholders; and To promote the health, development and well-being of the nation. The Board actively engaged and reviewed the following regulations: Proposed amendments of the Regulations relating to the qualifications for registration of Speech Therapists, Speech Therapists and Audiologists, Audiologists and Hearing Aid Acousticians. Dr S Balton (Chairperson) OVERVIEW The Professional Board for Speech, Language and Hearing is responsible for guiding the profession and protecting the public by focusing on continuous best practice governance output. The Professional Board comprises of highly skilled, professional individuals, charged with an oversight function which carries with it several specific responsibilities, namely: understanding, developing, reviewing and monitoring the Board s strategy, annual performance plans, risk management and budgets with the view to ensuring that the profession receives maximum value for the contributions paid to the Council. VISION AND MISSION Vision A leader in regulating the education, training and practice of Speech, Language and Hearing professions. Mission Proposed amendments of the Regulations relating to the registration of additional qualifications by speech therapists, speech therapists and audiologists, and audiologists. Proposed amendments of the Regulations relating to the constitution of the professional board for speech, language and hearing professions. STRATEGIC OBJECTIVES The Board embarked on a careful analysis of the SWOT factors, with a view of aligning the strategic plan, vision, mission and objectives; to regulating and guiding the profession; stakeholder engagement initiatives; and effective functioning of the Board EDUCATION AND TRAINING The Board provided continuous support and monitoring to institutions accredited to offer the speech language and hearing programmes. Furthermore, the institutions were provided support in terms of ensuring that the clinical training hours, demographic profiles etc are in alignment The Speech, Language and Hearing Board strives to: HPCSA ANNUAL REPORT 2016/17 109

111 with the minimum requirements of the board as outlined in the speech therapy and audiology regulations. PROFESSIONAL BOARD ACTIVITIES NUMBER OF ACTIVITIES The Board revised the following educational and training related regulation to ensure that the accredited institutions and programmes are updated namely; Regulations relating to the qualifications for registration of Speech Therapists, Speech Therapists and Audiologists, Audiologists and Hearing Aid Acousticians; Regulations relating to the registration by speech therapists, speech therapists and audiologists, and audiologists of additional qualifications. The Board engaged with the higher education institutions and reviewed the following documents: 2016/17 HIGHER EDUCATIONAL INSTITUTIONS RELATED MATTERS ACTIVITY NUMBER OF INSTITUTIONS Curriculum review 2 Board meetings 2 Board Strategic Workshop 2 Board Stakeholder Workshops 1 Education, Training and Registration 3 committee Executive Committee (Budget) 1 Ad-Hoc meetings 3 Task Teams Board Workgroup Task Team 2 Language and Culture Speech 3 Therapy & Audiology Telepractice 0 Training Programme Accreditations 0 Clinical Training Sites Accreditations 0 Total 17 Demographic profile template 6 Clinical hour template 6 BOARD EXAMINATION The Board approved the following Professional Board Examinations during the reporting period: BRD CODE REG CODE GRAND TOTAL SLH AU SLH ST SLH ST&A SLH Total HPCSA ANNUAL REPORT 2016/17

112 STAKEHOLDER ENGAGEMENT The Board identified stakeholder engagement as one of its strategic goals. This was intended to improve\ stakeholder engagement to promote the Speech, Language and Hearing Professions. The stakeholder engagement initiatives are intended to forge collaborations and to keep stakeholders abreast regarding matters affecting the profession and the Board. The following stakeholder engagements took place for the period under review: STAKEHOLDER ENGAGEMENT DESCRIPTION The Board representatives met with the Universities representatives and emoyo relating to the KUDUwave device. The Board aims to formulate a Position Statement in relation to the Programme and the KUDUwave device. DATE ENGAGEMENT HELD 20 June 2016 The Professional Board Newsletter Published on 01 September 2016 The discussion regarding the use of KUDUwave for Ototoxicity Monitoring 05 December 2016 SCOPE OF PROFESSIONS The proposed regulations defining the scope of the profession of Audiology was submitted to the National Department of Health (NDOH) and is underway for promulgation by the Minister of Health. GOVERNANCE In line with the Regulations relating to the functions and functioning of the Professional Boards, the Board co-opted two (2) subject matter experts to the Board, in particular, to enhance expertise in the education training and registration committee and executive committee of the Board. The purpose was to fill the vacancies while awaiting the Minister of Health to make permanent appointments. The Board deliberated on amending the constitution of the Professional Board, which will have an impact on the current regulation relating to the constitution of the Board. Broader consultation was undertaken to ensure that inputs of the different Professional Boards were taken into consideration prior to the proposed amendment being tabled to Council for endorsement. The Board developed and approved the Stakeholder Engagement Plan for the Board in November 2016; The Board developed and approved the Risk Register of the Board in November 2016; The Board reviewed the regulations relating to qualifications and additional qualifications relating to the registration; The Board approved the reviewed supervised practice guidelines as recommended by the Education, Training and Registration Committee; The Board approved the reviewed examination guidelines as recommended by the Education, Training and Registration Committee; The Board approved the reviewed evaluation and accreditation guidelines as recommended by the Education, Training and Registration Committee; The Board approved nominations of Board representatives to the OCP Assistive Devices Task Team. HIGHLIGHTS The Board approved the Strategic Plan for in November 2016; The Board reviewed the Strategic Plan and Annual Performance Plan in January 2017; HPCSA ANNUAL REPORT 2016/17 111

113 112 HPCSA ANNUAL REPORT 2016/17

114 Part GOVERNANCE

115 PART D: GOVERNANCE 1. INTRODUCTION Corporate governance embodies processes and systems that allows public entities directed, controlled and held to account. In addition to the legislative requirements based on enabling legislation, corporate governance with regard to the HPCSA is applied through the precepts of the Health Professions Act and is run in tandem with the principles contained in the King s Reports on Corporate Governance. The Council Members have pleasure in submitting their report on the annual financial statements of Health Professions Council of South Africa for the year ended 31 March THE EXECUTIVE AUTHORITY The HPCSA s accounting authority (Council) accounts to the National Minister of Health as its Executive Authority who in turn accounts to Parliament and the Portfolio Committee on Health. In terms of Section 3 (p) of the enabling legislation, the HPCSA has to submit to the Minister i. a five-year strategic plan within six months of the council coming into office which includes details as to how the council plans to fulfil its objectives under this Act; ii. every six months a report on the status of health professions and on matters of public importance that have come to the attention of the council in the course of the performance of its functions under this Act; and iii. an annual report within six months of the end of the financial year; The above stated information was submitted to the Minister during the reporting period. 114 HPCSA ANNUAL REPORT 2016/17

116 3. THE ACCOUNTING AUTHORITY/ COUNCIL The Health Professions Act requires that the Council Members exercise the duty of utmost care to ensure reasonable protection of the assets and records of the HPCSA. They must act with fidelity, honesty, integrity and in the best interests of the HPCSA in managing the financial affairs of the HPCSA be able to disclose on request from the National Department of Health all material facts, including those reasonably discoverable, which in any way may influence the decisions or actions of the Department. The role of the Council is as follows: The Council is ultimately accountable and responsible for the performance and affairs of the HPCSA and the Council has responsibility in the following areas: Strategic Role Determination of Policy and Procedures and Levels of Materiality to ensure the Integrity of the HPCSA s Risk Management and Internal Controls Monitoring of Operational Performance and Management Chairperson / Council Member Orientation and Induction Conflict of Interest and Independence 4. COUNCIL CHARTER The Council Charter is in accordance to the Health Professions Act and run in tandem with the principles contained in the King s Report on Corporate Governance. Compliance to the Charter is handled effectively and transparently. 5. COMPOSITION In terms of Regulation 10 (1) (a) 2 of the Regulations relating to the establishment, objects, functions and powers of the Health Professions Council of South Africa, the Council may from time to time establish committees to assist in the execution of its responsibilities. The tables in the next pages reflects committees utilized by the Council. During the year under review, apart from the members, the Registrar and Executive Management also attended the meetings of Council & its committees and participated actively. HPCSA ANNUAL REPORT 2016/17 115

117 COUNCIL STRUCTURES COUNCIL COUNCIL MANAGEMENT COMMITTEE EXECUTIVE COMMITTEE AUDIT AND RISK MANAGEMENT FINANCE AND INVESTMENT COMMITTEE TENDER COMMITTEE PROPERTY COMMITTEE HUMAN RESOURCES AND REMUNERATION COMMITTEE ICT STEERING COMMITTEE PENSION AND PROVIDENT FUND COMMITTEE HUMAN RIGHTS, ETHICS AND PROFESSIONAL PRACTICE COMMITTEE BUSINESS PRACTICE COMMITTEE PROFESSIONAL CONDUCT REVIEW COMMITTEE CONTINUING PROFESSIONAL DEVELOPMENT COMMITTEE EDUCATION, TRAINING AND QUALITY ASSURANCE COMMITTEE HEALTH COMMITTEE (SECTION 51) ACRONYM COUNCIL MANCO EXCO ARCOM FINCOM TENDER PROPCOM REMCO ICT COM PPFCOM HRP BPC PCR CPD ETQA HEALTH NOTE: Designations of all members depicted on Page 06 of this Annual Report 116 HPCSA ANNUAL REPORT 2016/17

118 COUNCIL MANCO EXCO ARCOM FINCOM TENDER PROPCOM REMCO ICT PPFCOM HRP COM BPCOM PCR COM CPD COM ETQA COM HEALTH COM MEMBER NO. OF MEETINGS HELD Dr T. K. S. Letlape Mr L. A. Malotana Ms X Bacela 4 4. Dr S Balton Dr T Carter* Maj Gen Z Dabula* 2 7. Ms N. D. Dantile Ms R. M. Gontsana Prof N. S. Gwele Prof S. M. Hanekom Ms M. M. Isaacs Mr M Kobe Mr M. A. W. Louw Adv T Mafafo Prof N. J. Mekwa Prof K. O. Mfenyana Dr R. L. Morar Mrs D Muhlbauer Dr T. A. Muslim HPCSA ANNUAL REPORT 2016/17 117

119 COUNCIL MANCO EXCO ARCOM FINCOM TENDER PROPCOM REMCO ICT PPFCOM HRP COM BPCOM PCR COM CPD COM ETQA COM HEALTH COM MEMBER NO. OF MEETINGS HELD Ms J. M. Nare Prof Y. I. Osman Prof B. J. Pillay Mr S Ramasala Ms D. J. Sebidi Mr S Sobuwa Mr A Speelman Dr A Thulare** Mr K. O. Tsekeli Ms M. S. van Niekerk Dr E Van Stade* Prof G. J. Van Zyl 5 1 * Dr E Van Stade appointed in February 2016 * Major General Z Dabula appointed in June 2016 * Dr T Carter Resigned as representative of National Department of Health in October 2016 ** Dr A Thulare appointed as representative of National Department of Health on 01 February 2017 Further to the above and in accordance with the relevant terms of reference, persons who are not members of Council have been co-opted to serve on the Council Committees. Attendance of the co-opted members of the committees was as follows 118 HPCSA ANNUAL REPORT 2016/17

120 ARCOM HRP HEALTH CPD ETQA TENDER FINCOM REMCO ICT STEERING MEMBERS NO. OF MEETINGS HELD Ms M. Baruth 3 2. Dr P Brijlal 1 3. Mr G. Ferreira 4 4. Dr T. Fish 1 5. Ms RJ Ganda 2 6. Dr G. P. Grobler 7 7. Adv S. Gugwini-Peter 4 8. Prof T. Guse 2 9. Dr V. Harilall Dr K Khoza-Shangase Mr W. Kuperus Prof B Luke Dr S.S. Maharaj Prof TB Mashego Ms V. Mbhatsani Prof D. McQuoid-Mason Dr T. P. Moloi Ms J. Mthombeni Dr Z. Ngobese 6 HPCSA ANNUAL REPORT 2016/17 119

121 ARCOM HRP HEALTH CPD ETQA TENDER FINCOM REMCO ICT STEERING MEMBERS NO. OF MEETINGS HELD Mr S. Ngwenya Mr P Nkukwana Mr S Ntuli Ms I. Nzotta Dr J. Oosthuysen Prof M. E. Parker Ms A. Pinto-Prins Ms B Pule Mr C. Qoto Mr C. Qoto Prof S. Rataemane Mr J. Segole Ms F Segooa Ms B. Shongwe BV Shongwe Dr N. Tsotsi Mr W. van der Net Prof L. Van Niekerk 3 1 Remuneration Remuneration of Council and its Committee members is embodied in the Annual Financial Statements of this report. 120 HPCSA ANNUAL REPORT 2016/17

122 6. RISK MANAGEMENT The underlying principle of the HPCSA s risk management philosophy is to have a thorough understanding of its risk exposures in order for Council to be appropriately informed to make strategic decisions in the interests of all stakeholders. Council has approved the Enterprise Risk Management (ERM) Policy Framework that addresses the structures, processes and standards implemented to manage risks on an enterprise-wide basis in a consistent manner. These range from strategic risk management, operational risk management, IT risk management, compliance processes, internal audit systems, financial risk management, and a range of other line management interventions. The policy framework further addresses specific responsibilities and accountabilities for the ERM process and the reporting of risks and incidences at various levels within the HPCSA, ensuring thorough and transparent governance processes. The Compliance function is centralised under the leadership of the Risk Management Officer, and the organisation is currently in the process of appointing a dedicated Compliance Officer. Operational risks are defined as risk associated with losses resulting from breakdowns in internal processes, procedures, people and systems. This risk category is managed through a system of internal controls, based on approved policies and procedures for initiation, verification and reconciliation of transactions, and adequate segregation of duties and delegated authorities. The operational risk category includes fraud and financial misconduct, as well as risks pertaining to legal, human resources and information and communication technology. 6.1 Governance of Risk Council has an overall strategic accountability for the total process of the HPCSA risk management, and ensures that an adequate and effective risk management system is in place. This means that Council has a responsibility to decide and approve the HPCSA risk appetite and its tolerance levels. The Enterprise Risk Management (ERM) Policy Framework delegated the responsibility of overseeing the management of the HPCSA s risks to the Audit and Risk Committee (ARCOM) of Council. ARCOM s role is to ensure that the approved risk management policies and processes are embedded across the HPCSA and implemented by the Secretariat. ARCOM assists Council in discharging its duty to ensure that the HPCSA maintains adequate accounting records, internal controls and systems to provide reasonable assurance on the integrity and reliability of financial information and to safeguard its assets. Strategic and operational risks are managed through the ERM Policy Framework, which dictates formal annual strategic, Professional Boards and departmental risk assessments, to ensure that HPCSA has a comprehensive view of its risk exposure. The Registrar/CEO is the Accounting Officer and is responsible for ensuring that the HPCSA maintains an effective, efficient and transparent systems of financial management, risk management and internal control. The Internal Management Committee (IMC) is a senior management structure responsible for identifying, managing and control risks inherent to the operations of their various departments. The IMC is also responsible for establishing what the residual risk levels are and areas that need special focus by management. 7. INTERNAL AUDIT AND AUDIT COMMITTEES Internal audit is an element of the internal control framework established by the Council to examine, evaluate and report on accounting and other controls on operations. Internal audit assists the Council in the effective discharge of its responsibilities and functions by examining and evaluating controls. The objectives of internal audit include promoting effective control at reasonable cost and assisting the Council generally in the pursuit of value for money. The internal audit generally entails: HPCSA ANNUAL REPORT 2016/17 121

123 review of information systems and related internal controls; /17 Risk Management Key Focus Areas and Achievements examination of financial and operating information for management; review of the economy, efficiency and effectiveness of operations and of the functioning of non-financial indicators and controls in this regard; review of the implementation of corporate policies, plans and procedures; special investigations. The audits comprise of planning, execution, reporting, risk assessment; The audit programmes and working papers are approved by Freedom Park before audits commence; Liaise with the external auditors to reduce the scope of work. The HPCSA has outsourced the Internal Audit function. Internal Audit provides assurance regarding the ERM processes and standards from both design and functional perspectives. Internal Audit independently audits the adequacy and effectiveness of the organisation s risk management, control and governance processes. STRATEGIC OBJECTIVE To establish HPCSA wide risk awareness culture of identifying, quantifying managing and reporting of risks within all levels of the organisation To establish a system that can identify, monitor and track compliance of the HPCSA with all relevant governance, laws, regulatory and other requirements. OBJECTIVE STATEMENTS (ACTIVITIES) Development of Enterprise Risk Management Policy Framework and Strategy Risk awareness training throughout the HPCSA Council Strategic risk assessment, Professional Boards strategic risk assessments and operational risk assessments Development of the Compliance Management Policy Framework The Audit and Risk Management Committee of the Council is an independent committee chaired by an independent non- executive Chairperson. It was established to provide additional assurance on the reliability and integrity of both financial and non-financial activities of Council. Council has delegated responsibility for the oversight of risk management to the Audit and Risk Management Committee. This Committee monitors that the internal controls are in place, ensures that effective internal audit is in place and that roles and functions of external and internal audit are sufficiently clarified. The Committee also provides an objective overview of the operational effectiveness of Council s internal controls, risk management, governance and reporting and monitors the process of addressing significant matters that might impact on internal controls arising out of the internal and external audit reports In the year under review, the HPCSA Enterprise Risk Management function gained maturity. To this end, Council approved the Enterprise Risk Management Policy Framework. This was to ensure that the HPCSA sustains a comprehensive risk management framework and strategy to meet both legislative and best business practice requirements. During the period under review, risk management capabilities were strengthened through risk assessments and developments of the HPCSA Strategic Risk Register, Professional Boards Strategic Risk Registers and Departmental Risk Registers. During these assessments, the risks that each area was exposed to were identified, quantified, and are continuously mitigated, controlled and monitored. As part of implementing the HPCSA ERM Policy Framework, the HPCSA also developed and approved a Compliance 122 HPCSA ANNUAL REPORT 2016/17

124 Management Policy Framework in ensuring that the HPCSA s compliance risks are identified and effectively managed on an ongoing basis. A number of Risk Awareness workshops were held across the HPCSA /17 Key Risks Facing the Organisation The HPCSA identified key inherent risks that affected the organisation. The risks and strategies taken to mitigate these risks are outlined below: RISK Compliance Negative Impact on HPCSA s reputation emanating from noncompliance with applicable laws and/or regulations Strategic Misalignment between IT strategy and the HPCSA strategy negatively impacting on HPCSA s ability to deliver on its mandate) Strategic Insufficient capabilities to implement Council s strategy Strategic Lack of role clarification (Council, Professional Boards & Secretariat) IMPLEMENTED STRATEGIES Compliance Management Policy Framework Development of compliance risk management plans for applicable legislations Ensuring compliance with relevant legislations and regulations IT Governance Framework IT road map IT Steering Committee of Council Recruitment process Training and development planning IT infrastructure and systems Charter for Councillors Delegation of Authority Framework Rules and regulations Reviewed terms of reference for established committees RISK Strategic Ultra-vires acts and inconsistent decisions making (Board and Council) Strategic Misaligned legislation, regulations, rules, policies and procedures to national health imperatives Operational Failure to attract and retain critical skills Strategic Lack of synergy between functions in the HPCSA (administration, professional Boards and Council) Operational Unethical behaviour by employees leading to employees getting involved into acts of committing fraud, theft and/or corruption IMPLEMENTED STRATEGIES Conducted Professional Boards Training workshops Induction of Council and professional boards members Governance structures meeting are attended by internal legal advisors Ensuring that Rules and Regulations are complied with when making decisions Ensuring compliance with the Health Professions Act 56 of 1974 Ongoing development, reviews or rules and regulations Development and implementation of Skill Attraction - Retention and Succession Planning Framework Strengthening of the interboard forum function Improved dissemination of execution of resolutions of Professional Boards (including respective boards committees) and Council (including its committees) Internal audit Delegation of Authority Ethics Code of conduct policy Segregation of duties Develop and implement fraud prevention policy HPCSA ANNUAL REPORT 2016/17 123

125 RISK Strategic The absence of stakeholder engagement strategy and plan resulting to HPCSA image and reputational damage. IMPLEMENTED STRATEGIES Communication framework and strategy Develop and implement a comprehensive stakeholder engagement strategy and plan in order to ensure effective communication with all stakeholders. 7.3 Planned Areas of Future Focus STRATEGIC OBJECTIVE To establish HPCSA wide risk awareness culture of identifying, quantifying managing and reporting of risks within all levels of the organisation. To establish and develop fraud risk management policy and strategy that include a fraud prevention plan and track progress on its performance. To review and roll out a Business Continuity framework across HPCSA. OBJECTIVE STATEMENTS (ACTIVITIES) Development of a risk appetite framework that includes multiple HPCSA s strategic key risk indicators. Development of fraud prevention policy, strategy and fraud response plan. Undertake a Business Impact Assessment (BIA). Development and implementation of business continuity policy framework. 8. COMPLIANCE WITH LAWS AND REGULATIONS To ensure compliance with all relevant legislation, policies and procedures Through monitoring the compliance within the organisation. Providing training, advising and providing guidance. Training on: Contract Management, Health Professions Act and Good Governance. Ensure the effective, efficient and economical implementation of organisational strategies and policies in accordance with relevant legislation and policies. To draft and advise on policies as well as compiling manuals and procedural guidelines to ensure good governance. To provide guidance and advice within the organisation on matters of ethics, good governance, compliance and legal matters in order to promote compliance and good governance. Ensuring all applicable Statutory Registers are in place and updated. Review and updating authority Structure and Terms of Reference of said structure Communicate Key Statutory Deadlines timeously to Council, Committees of Council and Management Review and update Delegations of Authority of the HPCSA. Ensuring the availability of well researched legal opinions and advice. Management, through the HPCSA s Attorneys of litigation by and against HPCSA 9. FRAUD AND CORRUPTION The Fraud Policy of the HPCSA was developed and it was still undergoing the internal approval policies. In addition, all fraud and corruption allegations will be investigated and followed up by the application of all remedies available within the full extent of the law and the implementation of appropriate prevention and detection controls. These prevention controls include the existing financial and other controls and checking mechanisms as prescribed in the systems, policies and procedures of HPCSA. The Fraud Response Plan takes into account the risks of fraud and corruption as identified in risk assessments initiated by HPCSA; a review of other pertinent documentation and interviews with selected HPCSA officials. The Plan addresses 124 HPCSA ANNUAL REPORT 2016/17

126 strategic fraud and corruption risks that must be addressed and which could jeopardise the successful implementation of each component of the Plan. The Plan is dynamic and it will continuously evolve as HPCSA makes changes and improvements in its drive to promote ethics, as well as to fight fraud and corruption. Steps to be taken when fraud is detected: It is the responsibility of all employees to immediately report all allegations or incidents of fraud and corruption to their immediate manager. All managers are responsible for the detection, prevention and investigation of fraud and corruption and must report all incidents and allegations of fraud and corruption to the Chief Executive Officer. The Chief Executive Officer will initiate an investigation into the matter. Should employees wish to report allegations of fraud and corruption anonymously, they can contact any member of management, the CEO or the Chairperson of the Audit and Risk Committee or phone the fraud prevention hotline. 10. MINIMISING CONFLICT OF INTEREST A policy is in place regulating Conflict of Interest which states, inter alia, that: Council members and Executive Management shall annually declare direct or indirect business interests that he/ she or a family member may have in any matter which is relevant to HPCSA Council members and officials of HPCSA shall declare, by way of a notice in writing, direct or indirect business interests that he/she or a family member may have in any contract/tender or proposed contract/tender which has been or is to be entered into by the HPCSA or who so becomes interested in any such contract/ tender after it has been entered into. Before every meeting a declaration of interest is signed and should any member declare any interest he will be recused from the meeting. 11. CODE OF CONDUCT The Code of Conduct refers to Ethical philosophical study of values and rules that humans live by. Within the environment of HPCSA, ethics refers to our Institution s values and rules, as it execute its mandate individually and as a team. Ethical conduct refers to correct, fitting, decent, honourable and principled behaviour. HPCSA must ensure that official relationships reflect integrity, respect for human dignity, the rights of others, honesty and commitment to do what is right, fair, legal and just. Keeping in mind that ethics refers to the Institutions principles of conduct, employees of HPCSA must at all times comply with the following values in the execution of their tasks and official interactions: Honesty / Integrity; Respect; and Professionalism 12. HEALTH AND SAFETY AND ENVIRONMENTAL ISSUES Aligned with the related guidelines in King III, HPCSA is committed to ensuring that its activities do not compromise environmental, health and safety legislation. Although its major activities do not pose a significant threat to the environment, the organisation s management activities focus on compliance with the key features of existing regulations. Council has appointed a Health and Safety Officer who, in turn, established the Health and Safety Committee. The Health and Safety Committee ensures that the HPCSA s buildings comply with the Department of Labour requirements related to the Occupational Health and Safety Act and the Compensation for Occupational Injuries and Diseases Act (COIDA). Other responsibilities of the Health and Safety Committee included conducting the audits in relation to lighting and ventilation, noise, asbestos, electricity stability, as well as conduct at least one evacuation drill and routine safety inspections. HPCSA ANNUAL REPORT 2016/17 125

127 13. COUNCIL SECRETARIAT The role and responsibilities of the Council Secretariat is: To ensure compliance and good Corporate Governance throughout the Institution by providing legal guidance and support to the Council, management and employees to enable them to discharge their fiduciary and other responsibilities effectively. To provide guidance and advice within the Institution on matters of ethics, good governance, compliance and legal matters in order ensure compliance and good governance. To ensure compliance with all relevant legislation, policies and procedures through monitoring the compliance within the Institution. To promote compliance and good Corporate Governance within the Institution by amongst others training, advising and providing guidance. To provide effective and efficient support to Council, Management and Staff by, amongst others, effective minute taking, co-ordination of statutory meetings and distribution of relevant information. To ensure the effective, efficient and economical implementation of Institutional strategies and policies in accordance with relevant legislation and policies. and development. In this manner, Council regards Social Responsibility as a strategic initiative and not only as an extension of its marketing and public relations activities. Council also appreciates the development side of social responsibility and committed to give it as much attention as any other strategic initiatives in order for the Corporate Social Investment (CSI) to be a real contributor towards Council s stakeholder social upliftment. Everyday, thousands of teenage girls in rural areas miss out on their education due to menstruation. It is estimated that of these girls in South Africa between the ages of 13 and 19 are at the age of menstruating. Their Education is hindered by 25%, as these girls do not go to school whilst they are menstruating as they have no access to sanitary wear. That is one week every month, which is a massive set back in their school careers. In responding to this social need, Council, through one of its Professional Boards, the Professional Board for Radiography and Clinical Technology donated sanitary towels to St Thomas School for the Deaf in the Eastern Cape province, where the majority of the school girls could not afford to purchase sanitary towels. The HPCSA also contributed sanitary wear to Enhlube Combined School at Nomponjwane, in Empangeni, in Kwa Zulu-Natal. Council s campaign on sanitary wear is ongoing and is to ensure that these young girls can attend school in comfort and dignity. To draft and advise on policies as well as compiling manuals and procedural guidelines to ensure good governance. To formulate and manage the departmental budget and business plan in order to ensure achievement of Institutional strategies. To manage the Human Resource functions within department to ensure optimal departmental performance. 14. SOCIAL RESPONSIBILITY Social Responsibility is viewed by Council as part of the strategic environment, contributing to real social upliftment 126 HPCSA ANNUAL REPORT 2016/17

128 Part HUMAN RESOURCE MANAGEMENT

129 PART E: HUMAN RESOURCE MANAGEMENT 1. INTRODUCTION 2 PENSION AND PROVIDENT FUND The approach to human resources is to ensure that human capital management is part of the overall organisation s strategic plan, because organisations depend on people to perform effectively and efficiently. The HPCSA strives to create a high performance competitive working environment by providing training and development for employees, thus upskilling its employees especially with the rapidly changing organisational environment and technological advancements and trends. Workforce planning framework and key strategies to attract and recruit a skilled and capable workforce The HPCSA too has an incentive scheme that awards excellence to Departments and individuals on an annual basis. The incentive scheme is aimed at driving and sustaining performance and used as a retention strategy awarding staff that have worked long for the organisation. Human Resources priorities for the year under review and the impact of these priorities 1.1 Administrative Matters Leave and Personnel Records Management In an effort to move towards a paperless environment, SAGE was appointed to implement an automated HR information system in August Online VIP self - service system was introduced and proved to be an efficient method as compared to the previous paper based annual leave application process. However, there had been some challenges relating to the management and the accuracy of the leave. The prevailing systemic glitches were resolved constantly, thus improving the VIP system self -service process. The Fund received the approval for distribution of the surplus apportionment from the Financial Services Board. The Surplus apportionment exercise will be implemented in the next financial year, with the employer assisted tracing exercise. The Trustees will be engaging on a second level tracing exercise until 31 March The Fund is currently awaiting approval of the Section 14 application. Fund Assets will be transferred to the NMG Umbrella Pension Fund within 60 days after the receipt of the Section 14 transfer approval. The Trustees will embark on the process of closing the Fund after the Section 14 approval has been received. 3 EMPLOYEE PERFORMANCE MANAGEMENT FRAMEWORK The HPCSA performance management model is based on the SMART principle of performance management. The operational plans of the HPCSA are aligned to the strategic goals of the organisation and departmental contracting is therefore based on the operational plans. By setting goals (strategic and operational goals) for the HPCSA, it enables employees in the various departments to plan and organise their work in accordance with what needs to be achieved. Thus; employees are better able to: Develop job knowledge and skills that help them thrive in their work, take on additional responsibilities, or pursue their career aspirations; Support or advance the organisation s vision, mission, values, principles, strategies, and goals; Collaborate with their colleagues with greater transparency and mutual understanding; Plan and implement successful projects and initiatives Employee Leave disputes received: 19 Employee Leave disputes resolved: HPCSA ANNUAL REPORT 2016/17

130 4 EMPLOYEE WELLNESS PROGRAMMES The purpose of the employee wellness programme is to provide additional support for employees in the workplace to employees. An external service provider ICAS, was contracted to render a 24- hour professional employee wellness assistance service to staff, on a confidential basis. The ICAS Wellness Programme had an engagement rate of 13.1% whereby 35 individual cases were attended and 9 group intervention participants were attended. The number of problems managed were 60 and the number of services provided were 49. Three (3) wellness screening events were held in the period under review. Two (2) were in partnership with Discovery Health and were aimed at the entire HPCSA s employees, while one (1) was done in partnership with Best Med Medical Aid specifically for its members. Three (3) sporting codes (soccer/ netball/ athletics) participated in the relevant events. The soccer sporting code participated in two leagues namely, Intercompany Soccer League which saw the HPCSA taking the first place and the Corporate Soccer League, in which they received the fourth position. Two races were coordinated namely the Spar Women s Race which had 89 participants and the 702 Walk the Talk, which had 58 participants. However, interest in netball and athletics has declined and efforts are made to encourage staff participation in order to improve the situation in the next financial year. 5 POLICY DEVELOPMENT - SICK LEAVE The sick leave policy was amended with effect from 01 April 2016, as per the resolution of Council of reducing paid sick leave from 90 days to 45 days per 36 months cycle. The purpose was to provide a fair sick leave policy which will encourage improved attendance and discourage employees from taking excessive sick leave, at the same time, provide the facility for the extension of sick leave in the event of a serious illness or accident. 6 HR PRIORITIES FOR THE YEAR UNDER REVIEW AND THE IMPACT OF THESE PRIORITIES Filling of all newly created and approved positions to support the Councils core functions, Professional Boards Department has eight (8) newly appointed Administrators. The appointment of General Manager: CRR Effective stakeholder management and monitoring of EAP Programme to sustain healthy, productive, dedicated staff employees. The HR priorities in terms of training & development was to capacitate staff in terms of their portfolios with the requested skillset which is categorised into technical skills/soft skills or professional updates. Compliance with training as required by the Department of Labour annually Staff training on Labour Law 7 CHALLENGES FACED BY THE HPCSA ON HR MATTERS Inability to fill Senior Management and Scarce Skills positions, attributed to salary packages not being market related Turnaround time for filling positions attributable to the manual processing of applications. Filing of SARS Company Reconciliations also attributable to the manual payments of Boards Members 8 FUTURE HR PLANS /GOALS Sourcing of e-recruitment system. Filling of the Registrar s position HPCSA ANNUAL REPORT 2016/17 129

131 9. HUMAN RESOURCE OVERSIGHT STATISTICS PERSONNEL COST BY SALARY BAND LEVEL PERSONNEL EXPENDITURE (R 000) NO. OF EMPLOYEES AVERAGE PERSONNEL COST PER EMPLOYEE (R 000) Top Management , Senior Management , Professional qualified , Skilled , Semi-skilled , Unskilled , TOTAL , PERFORMANCE REWARDS PROGRAMME/ACTIVITY/ OBJECTIVE PERFORMANCE REWARDS PERSONNEL EXPENDITURE (R 000) % OF PERFORMANCE REWARDS TO TOTAL PERSONNEL COST (R 000) Top Management 2 -B Rating % Senior Management 0 Professional qualified 5- A Rating and 3 B Rating , % Skilled 35- A Rating and 39- B Rating , % Semi-skilled 31- A Rating and 53-B Rating ,73 1,05% Unskilled 3- A Rating , % TOTAL , % TRAINING COSTS Career progression and development are increasingly becoming an attractive or even basic requirement for employees. In today s environment where all sectors are experiencing staff and skills shortages, organisations are faced with stiff internal and external competition for quality employees. For the HPCSA, the objective for training and development, is to create a learning organisation that ensures that employees are able to perform their jobs effectively, Over and above, this training and development, allow employees to gain competitive advantage, to seek self-growth as well as to enhance organisational development. Employers who invest in employee training and development programmes experience enriched working environment with higher levels of staff retention, increased productivity and performance and general dividends in terms of return-on-investment (ROI), To this end, the following training and development interventions were undertaken in the year under review: 130 HPCSA ANNUAL REPORT 2016/17

132 TRAINING PROGRAMME NO. OF EMPLOYEES PER TRAINING INTERVENTION TRAINING EXPENDITURE (R Bid Committees 3 R Advanced Project Management 1 R Basic Electrical 2 R Business Etiquette & Professional Behaviour 13 R Change Management 11 0 Code of Conduct 15 0 Comptia A+ 1 R Comptia Network 1 R Conflict Management 16 0 Consumer Complaints Management 1 R Crisis Communications & Media Relations 1 R Effective Communication Skills 4 R Effective Stakeholder Management 1 R Effective Supervision & Management Training 14 R Emergency Evacuation Training 14 0 Employment Equity Training 10 R Financial Awareness 44 R First Aid 16 R Forensic Investigation & Report Writing 16 R Health & Safety Rep Training 15 R Health Professions Act 12 0 HTML & CSS 1 R Induction 29 0 Introduction to VIP 2 R King IV Report 3 0 Labour Relations for Shop Stewards 12 R Media Training 7 0 Medical Doctors Coding 1 R Medical Negligence &Health Sector Mediation Training 3 R Microsoft Excel 15 R Microsoft Word Basic and Intermediate 10 R Mid - Year Payroll Seminar 1 R Minute Taking 5 R HPCSA ANNUAL REPORT 2016/17 131

133 TRAINING PROGRAMME NO. OF EMPLOYEES PER TRAINING INTERVENTION TRAINING EXPENDITURE (R 000 Office Online Training 74 0 Oracle 20 0 Oracle Fixed Assets Training 3 R People Report Customization 2 R Performance Management 38 0 POPI Compliance 2 R Project Management 27 R Record Management 3 R Report Writing 5 R Risk Management Sabinet 9 0 Sage Conference 1 R SAGE VIP Annual Seminar Update 1 R Sick Leave Policy Training 57 0 Time& Stress Management 15 R VIP 1 VIP People Basic 1 R Web google Analytics 1 R Total 766 R EMPLOYMENT AND VACANCIES The total staff complement at the HPCSA as at the 31 March 2017 was 255 employees. Recruitment for period 1 April 2016 to 31 March 2017 is depicted in the Table below: FOREIGN MALE FEMALE OCCUPATIONAL LEVEL NATIONAL TOTAL A C I W A C I W MALE FEMALE Top Management (E1 - F) Senior Management (D4 -D5) Experienced Specialists and Midmanagement (D2 -D3) Junior management and supervisors (C2 - D1) Semi-skilled and discretionary decision making (B3 - C1) HPCSA ANNUAL REPORT 2016/17

134 FOREIGN MALE FEMALE OCCUPATIONAL LEVEL NATIONAL TOTAL A C I W A C I W MALE FEMALE Unskilled and defined decision making (A - B2) Total Permanent Employee with Disability Grand Total There was a slight decrease in the number of positions filled in the year under review when compared to the previous financial year. The reason was that there was a moratorium by the Human Resources and Remuneration Committee (REMCO) on the filling of vacant positions pending the execution of the Business Re-engineering Process (BRP), which affected the filling of positions including the ones that were already advertised. The moratorium, however, did not affect the filling of positions identified as critical to the effective and efficient performance of the organisation during the BRP process. Total number of Vacancies for period 01 April 2016 to 31 March 2017 PROGRAMME HEADCOUNT AT END OF HEADCOUNT AT END OF APPROVED POSTS VACANCIES FILLED Top Management Senior Management Professional qualified Skilled Semi-skilled Unskilled TOTAL EMPLOYMENT CHANGES EMPLOYMENT EMPLOYMENT SALARY BAND AT BEGINNING APPOINTMENTS TERMINATIONS AT END OF THE OF PERIOD PERIOD Top Management (E1 F) Senior Management (D4 -D5) Professional qualified (D2 -D3) Skilled (C2 D1) Semi-skilled (B3 C1) Unskilled (A B2) Total HPCSA ANNUAL REPORT 2016/17 133

135 REASONS FOR STAFF LEAVING REASON NUMBER % OF TOTAL NO. OF STAFF LEAVING Death 0 0% Resignation % Dismissal 0 0% Retirement % Ill health 0 0% Expiry of contract 0 0% Other 1 (Abscond) 0.39% Total % LABOUR RELATIONS: MISCONDUCT AND DISCIPLINARY ACTION NATURE OF DISCIPLINARY ACTION NUMBER Verbal Warning 02 Written Warning 02 Final Written warning 03 Dismissal 0 CCMA 05 Grievances Bargaining Forum The HPCSA has a Bargaining Forum which was established in terms of the Recognition Agreement entered into with the National Education, Health and Allied Workers Union (NEHAWU). The Forum deals with matters of mutual interest and conducts annual salary negotiations. In the period under review, the Forum finalised salary negotiations on time and entered into a three (3) years) multi-term agreement. The Forum held ten (10) monthly meetings in the period under review to focus on the annual salary negotiations at the later stage of the financial year. Six (6) formal grievances were lodged during the reporting period. 134 HPCSA ANNUAL REPORT 2016/17

136 EQUITY TARGET AND EMPLOYMENT EQUITY STATUS Employment Equity (EE) Report as at 31 March The EE report includes temporary staff members who have been in the employment of HPCSA for more than three (3) months. LEVELS MALE AFRICAN COLOURED INDIAN WHITE CURRENT TARGET CURRENT TARGET CURRENT TARGET CURRENT TARGET Top Management Senior Management Professional qualified Skilled Semi-skilled Unskilled TOTAL FEMALE LEVELS AFRICAN COLOURED INDIAN WHITE CURRENT TARGET CURRENT TARGET CURRENT TARGET CURRENT TARGET Top Management Senior Management Professional qualified Skilled Semi-skilled Unskilled TOTAL DISABLED STAFF LEVELS MALE FEMALE CURRENT TARGET CURRENT TARGET Top Management 0 N/A 0 N/A Senior Management Professional qualified Skilled Semi-skilled Unskilled TOTAL HPCSA ANNUAL REPORT 2016/17 135

137 136 HPCSA ANNUAL REPORT 2016/17

138 Part FINANCIAL INFORMATION

139 INDEX The reports and statements set out below comprise the annual financial statements presented to the Health Professions Council of South Africa: PAGE Audit and Risk Committee Report Auditors Report Councilors Report Statement of Financial Position Statement of Profit or Loss and Other Comprehensive Income Statement of Changes in Equity Statement of Cash Flows Accounting Policies Notes to the Annual Financial Statements The following supplementary information does not form part of the annual financial statements and is unaudited: Detailed Income Statement Published 29 September HPCSA ANNUAL REPORT 2016/17

140 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 AUDIT AND RISK COMMITTEE REPORT 1. MEMBERS OF THE AUDIT AND RISK COMMITTEE The members of the Audit and Risk Committee of the Health Professions Council of South Africa comprise of the following independent and non-executive members: Name Office Designation Ms B Shongwe Chairperson Independent Adv S Gugwini-Peter Member Independent Mr S Ngwenya Member Independent Prof GJ van Zyl Member Non-Executive Dr RL Morar Member Non-Executive Dr E van Staden Member Non-Executive The committee is satisfied that the members thereof have the required knowledge and experience as set out in King III, principle 3.2 paragraph 5 to 10. Report of the Audit and Risk Committee is in terms of Health Professions Act 56 of 1974 as amended, section 13. The Audit and Risk Committee has adopted appropriate formal terms of reference which have been approved by Council Members, and has performed its responsibilities as set out in the terms of reference. In executing its duties during the reporting period, the Committee has performed the following: Audit Monitored the effectiveness of the scope, plans, budget, coverage, independence, skills, staffing, overall performance and position of the internal audit and compliance functions within the organisation. Recommend to Council the appointment of the external auditors Monitored the effectiveness of the external auditors - including their skills, independence, audit plan, budget, reporting, over performance - and approved external audit fees. Reviewed audit findings and management s action plans. Reviewed whether the work performed by internal audit and by external audit is appropriate. Obtained an assessment of the strength and weaknesses of systems, controls and other factors from the auditors and management that might be relevant to the integrity of the financial statements. Ensured that the external auditors and internal auditors had direct access to the Audit and Risk Committee and the Chairperson of the Audit and Risk Committee. Financial Reviewed the annual financial statements for proper and complete disclosure of timely, reliable and consistent information. Evaluated the appropriateness, adequacy and efficiency of the accounting policies and procedures, compliance with overall accounting standards and any changes thereto. Reviewed the annual financial statements before submission to Council for any change in accounting policies and practices, significant areas of judgement, significant audit adjustments, the internal control and going concern statements, the risk management report, the corporate governance report, compliance with accounting and disclosure standards, and compliance with statutory and regulatory requirements. Reviewed the recommendations of the external auditor and those of any regulatory authority for significant findings and management s proposed remedial actions. Enquired about the existence and substance of significant acounting accruals, impairments or estimates that could have a material impact on the financial statements. Reviewed any pending litigation, contingencies, claims and assessment, and the presentation of such matters in the financial statements. Considered qualitative judgements by management on the acceptabilitity and appropriateness of current HPCSA ANNUAL REPORT 2016/17 139

141 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 or proposed accounting principles and disclosures. Obtained an analysis from management and the auditors of significant financial reporting issues and practices in a timely manner. Governance Provided a channel of communication between Council and management and the internal and external auditors. Received regular reporting from each of the above functions and monitored that issues and concerns raised were resolved by management in a timely manner. For the year ended 31 March 2017 The Committee s assessments is that overall control environment of Council needs improvements. The Committee is satisfied that since the previous year of reporting significant progress has been made in improving the internal control environment to prevent, detect and report areas of non-compliance. Accordingly, the full disclosure requirements of the Health Professions Act 56 of 1974 as amended have been met during the financial year under review. This is supported by the findings from the internal auditors as well as the external auditors. The effectiveness of the aforementioned measures continues to be in a constant state of improvement. The Committee has resolved to ensure that the comprehensive implementation of and adherence to the internal control environment reforms be expedited. The Committee is satisfied that the annual financial statements are based on appropriate accounting policies, and supported by reasonable and prudent judgements and estimates. The Committee evaluated Council s annual financial statements for the year ended 31 March 2017 and, based on the information provided therein, believes that the financial statements comply, in all material respects, with the relevant provisions of the Health Professions Act 56 of 1974 and International Financial Reporting Standards. 2. MEETINGS HELD BY THE AUDIT COMMITTEE The Audit and Risk Committee performs the duties laid upon it by Section 94(7) of the Companies Act, 2008 by holding meetings with the key role players on a regular basis and by the unrestricted access granted to the external auditors. The committee held 4 scheduled meetings during the financial year ending 31 March Name Office Meeting 1 Meeting 2 Meeting 3 Meeting 4 27/05/ /09/ /12/ /02/2017 Total 4 of 4 Ms B Shongwe Chairperson P P P P 4 of 4 Adv S Gugwini-Peter Member P P P P 4 of 4 Mr S Ngwenya Member P P P P 4 of 4 Prof Prof GJ van Zyl Member A/P A/P P A/P 1 of 4 Dr RL Morar Member P P P P 3 of 4 Dr E van Staden Member P A/P P P 3 of 4 P = Present A/P = Absent 140 HPCSA ANNUAL REPORT 2016/17

142 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March FINANCE FUNCTION We believe that the Finance Department possess the appropriate expertise and experience to meet their responsibility. 4. DISCHARGE OF RESPONSIBILITIES The Committee agrees that the adoption of the goingconcern premise is appropriate in preparing the annual financial statements. The Audit and Risk Committee has therefore recommended the adoption of the annual financial statements by Council Members on the 29 September The Audit and Risk Committee agreed to the terms of the engagement. The audit fee for the external audit has been considered and approved taking into consideration such factors as the timing of the audit, the extent of the work required and the scope. 5. ANNUAL FINANCIAL STATEMENTS Following the review of the annual financial statements the Audit and Risk Committee recommend Council approval thereof. On behalf of the Audit and Risk Committee Ms B Shongwe Chairperson Audit and Risk Committee Pretoria 29 September 2017 HPCSA ANNUAL REPORT 2016/17 141

143 AUDITORS REPORT 1. AUDITOR S REPORT: PREDETERMINED OBJECTIVES INDEPENDENT AUDITOR S REPORT Reg. No: 2000/008551/21 To the Members of the Council of the Health Professions Council of South Africa (HPCSA) UNQUALIFIED OPINION We have audited the Financial Statements of the Health Professions Council of South Africa (HPCSA) set out on pages 147 to 176, which comprise the Statement of Financial Position as at 31 March 2017, and the Statement of Comprehensive Income, Statement of Changes in Equity and Statement of Cash Flows for the year then ended, and notes to the Financial Statements, including a summary of significant accounting policies. In our opinion, the Financial Statements present fairly, in all material respects the financial position of the Council as at 31 March 2017, and its financial performance and cash flows for the year then ended in accordance with International Financial Reporting Standards and the requirements of the Health Professions Act No: 56 of IRBA Reg. No: Eco Fusion 6, Block C, Unit 25, 324 Witch Hazel Street, Highveld, Centurion, 0157 Tel: Fax: P O Box Highveld Park info@morar.co.za website: BASIS FOR OPINION We conducted our audit in accordance with International Standards on Auditing (ISAs). Our responsibilities under those standards are further described in the Auditor s Responsibilities for the Audit of the Financial Statements section of our report. We are independent of the Council in accordance with the Independent Regulatory Board for Auditors Code of Professional Conduct for Registered Auditors (IRBA Code) and other independence requirements applicable to performing audits in South Africa. The IRBA code is consistent with the International Ethics Standards Board for Accountants code of Ethics for Professional Accountants (Parts A and B). We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. OTHER REPORTS REQUIRED As part of our audit of the annual financial statements for the year ended 31 March 2017, we have read the Councillors report for the purpose of identifying whether there are material inconsistencies between the report and the audited annual Financial Statements. The report is the responsibility of the preparers. Based on the reading of the report we have not identified material inconsistencies between the report and the audited annual Financial Statements. However, we have not audited the report and accordingly do not express an opinion thereon. OTHER MATTER Without qualifying our opinion, we draw attention to the fact that supplementary information set out on pages 177 to 178 does not form part of the annual financial statements and is presented as additional information. We have not audited this information and accordingly do not express an opinion thereon. Offices In: Centurion Pietermaritzburg Kimberley Cape Town East London Durban Bloemfontein Polokwane Rustenburg Mbombela Directors: R. Morar CA (S.A.), CFE Z. Zikalala CA (S.A.) C. Machiri CA (S.A.) S. Mahadea CA (S.A.) S. Rabichand CA (S.A.) K. Naidoo CA (S.A.) V. Samarjith CA (S.A.) J. Reddy CA (S.A.) T. Mudamburi CA (S.A.) L. Van der Walt CA (S.A.) N. Cupido CA (S.A.) E. Potgieter CA (S.A.) A. Singh CA (S.A.) B. Temba CA (S.A.) M. Naicker CA (S.A.) A. Bikram CA (S.A.) J. Van der Walt CA (S.A.) S Oosthuizen CA (S.A.) 142 HPCSA ANNUAL REPORT 2016/17

144 RESPONSIBILITIES OF THE COUNCILORS FOR THE FINANCIAL STATEMENTS The secretariat is responsible for the preparation and fair presentation of the financial statements in accordance with IFRS and for such internal control as the Councillors determine is necessary to enable the preparation of Financial Statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, management is responsible for assessing the Council s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the Councillors either intends to liquidate the Council or to cease operations, or have no realistic alternative but to do so. The Councillors are responsible for overseeing the Council s financial reporting process. AUDITOR S RESPONSIBILITIES FOR THE AUDIT OF THE FINANCIAL STATEMENTS Our objectives are to obtain reasonable assurance about whether the Financial Statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these Financial Statements. Morar Incorporated Chartered Accountants (S.A) Registered auditors Centurion 15 September 2017 Per: Vishall Samarjith Director HPCSA ANNUAL REPORT 2016/17 143

145 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 COUNCILORS REPORT The Council Members have pleasure in submitting their report on the annual financial statements of Health Professions Council of South Africa for the year ended 31 March MAIN BUSINESS AND OPERATIONS The Health Professions Council of South Africa is a nonprofit making statutory body governed by the Health Professions Act No 56 of 1974.The objectives of the Council (as contained in the Act) may be summarised as follows: (a) (b) (c) To promote the health of the population; Determine standards of professional education and training; and Set and maintain excellent standards of ethical and professional practice. The operating results and state of affairs of the Council are fully set out in the attached annual financial statement. There have been no material changes to the nature of the Council s business from the prior year. 2. REVIEW OF FINANCIAL RESULTS AND ACTIVITIES The annual financial statements have been prepared in accordance with International Financial Reporting Standards and the requirements of the Health Professions Act no 56 of The accounting policies have been applied consistently. 3. COUNCILLORS The Council Members in office as at 31 March 2017 are as follows: Council Office Designation Members Dr TKS Letlape President Non-executive Mr LA Malotana Prof K Mfenyana Ms MM Isaacs Mr S Sobuwa Ms MS van Niekerk Mr KO Tsekeli Mr A Speelman Ms ND Dantile Mr S Ramasala Ms DJ Sebidi Dr S Balton Ms RM Gontsana Prof SM Hanekom Mr M Kobe Mr MAW Louw Mrs D Muhlbauer Adv T Mafafo Prof GJ van Zyl Ms X Bacela Dr RL Morar Prof N Gwele Prof NJ Mekwa Dr TA Muslim Ms JM Nare Prof YI Osman Prof BJ Pillay Vice President Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Non-executive Dr E van Staden Non-executive Appointed April 2016 Dr AM Thulare Non-executive Appointed February 2017 Major-General Z Dabula Non-executive Appointed June 2016 Dr T Carter Non-executive Resigned October HPCSA ANNUAL REPORT 2016/17

146 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March EVENTS AFTER THE REPORTING PERIOD The Council Members are not aware of any material event which occurred after 31 March 2017 and up to the date of this report. 5. AUDITORS Morar Incorporated continued in office as auditors for the Council for the financial year ending 31 March SECRETARY The Council Secretary is Ms Sadicka Butt. HPCSA ANNUAL REPORT 2016/17 145

147 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 STATEMENT OF FINANCIAL POSITION Figures in Rand Note(s) Restated Assets Non-Current Assets Property, plant and equipment 3 28,397,658 20,647,262 Intangible assets 4 3,193,971 2,022,886 Other financial assets 5 1,081,019 1,098,991 32,672,648 23,769,139 Current Assets Trade and other receivables 7 20,924,772 19,120,996 Cash and cash equivalents 8 335,230, ,173, ,154, ,294,830 Total Assets 388,827, ,063,969 Equity and Liabilities Equity Revaluation reserve 1,132,830 - Fair value adjustment reserve 838, ,124 Retained income 161,652, ,948, ,623, ,804,262 Liabilities Current Liabilities Trade and other payables 10 25,290,956 20,631,469 Income received in advance ,729, ,480,394 Provisions 9 5,183,102 4,147, ,204, ,259,707 Total Equity and Liabilities 388,827, ,063, HPCSA ANNUAL REPORT 2016/17

148 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME Figures in Rand Note(s) Restated Revenue ,688, ,530,290 Other income 13 19,277,567 13,645,666 Loss on disposal of assets 14 (112,701) (8,574) Operating expenses (279,697,176) (228,131,421) Operating loss (47,843,380) (22,964,039) Investment income 15 22,547,741 20,729,233 Deficit for the year (25,295,639) (2,234,806) Other comprehensive income: Items that will not be reclassified to profit or loss: Gains on work-at-art revaluation 1,132,830 - Items that may be reclassified to profit or loss: Available-for-sale financial assets adjustments (17,971) (158,535) Other comprehensive income for the year net of taxation 17 1,114,859 (158,535) Total comprehensive deficit for the year (24,180,780) (2,393,341) HPCSA ANNUAL REPORT 2016/17 147

149 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 STATEMENT OF CHANGES IN EQUITY Fair value Figures in Rand Revaluation reserve adjustment assetsavailable-for- Total reserves Retained income Total equity sale reserve Opening balance as previously reported - 1,014,659 1,014, ,016, ,030,775 Adjustments Prior period error - Depreciation ,166,828 2,166,828 Restated* Balance at 1 April ,014,659 1,014, ,182, ,197,603 Surplus for the year as previously stated (1,963,224) (1,963,224) Prior period error - Amortisation (215,646) (215,646) Prior period error - Amortisation (9,312) (9,312) Prior period error - Intangible asset cost , ,344 Prior period error - Council, professional (240,968) (240,968) boards and committees expenses Other comprehensive income - (158,535) (158,535) - (158,535) Total comprehensive surplus for the year - Restated - (158,535) (158,535) (2,234,806) (2,393,341) Opening balance as previously reported ,052, ,052,892 Adjustments Prior period error - Depreciation ,166,828 2,166,828 Prior period errors - Amortisation (215,646) (215,646) Prior period errors - Amortisation (9,312) (9,312) Prior period errors - Intangible asset cost , ,344 Prior period error - Council, professional (240,968) (240,968) boards and committees expenses Balance at 1 April 2016 as restated - 856, , ,948, ,804,262 Deficit for the year (25,295,639) (25,295,639) Other comprehensive income 1,132,830 (17,971) 1,114,859-1,114,859 Total comprehensive (deficit) / surplus for the year 1,132,830 (17,971) 1,114,859 (25,295,639) (24,180,780) Balance at 31 March ,132, ,153 1,970, ,652, ,623,482 Note(s) HPCSA ANNUAL REPORT 2016/17

150 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 STATEMENT OF CASH FLOWS Figures in Rand Note(s) Restated Cash flows from operating activities Cash receipts from customers 230,162, ,944,173 Cash paid to suppliers and employees (263,576,354) (206,801,069) Cash generated from (used in) operations 18 (33,413,634) (9,856,896) Interest income 22,547,741 20,729,233 Net cash from operating activities (10,865,893) 10,872,337 Cash flows from investing activities Purchase of property, plant and equipment 3 (8,345,042) (5,359,497) Purchase of other intangible assets 4 (1,732,805) (194,344) Net cash from investing activities (10,077,847) (5,553,841) Total cash movement for the year (20,943,740) 5,318,496 Cash at the beginning of the year 356,173, ,855,338 Total cash at end of the year 8 335,230, ,173,834 HPCSA ANNUAL REPORT 2016/17 149

151 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES PRESENTATION OF FINANCIAL STATEMENTS The annual financial statements have been prepared in accordance with International Financial Reporting Standards, and the Health Professions Act 56 of The annual financial statements have been prepared on the historical cost basis, and incorporate the principal accounting policies set out below. They are presented in South Africa Rands. The annual financial statements for the year ended 31 March 2017 were authorised for issue in accordance with a resolution of Council on 29 September SIGNIFICANT ACCOUNTING POLICIES The principal accounting policies applied in the preparation of these annual financial statements are set out below. 1.1 Significant judgements and sources of estimation uncertainty The preparation of annual financial statements in conformity with IFRS requires management, from time to time, to make judgements, estimates and assumptions that affect the application of policies and reported amounts of assets, liabilities, income and expenses. These estimates and associated assumptions are based on experience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates. The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimates are revised and in any future periods affected. Trade receivables, Held to maturity investments and Loans and receivables The Council assesses its trade receivables, held to maturity investments and loans and receivables for impairment at the end of each reporting period. In determining whether an impairment loss should be recorded in profit or loss, the Council makes judgements as to whether there is observable data indicating a measurable decrease in the estimated future cash flows from a financial asset. Available-for-sale financial assets The Council follows the guidance of IAS 39 to determine when an available-for-sale financial asset is impaired. This determination requires significant judgment. In making this judgment, the Council evaluates, among other factors, the duration and extent to which the fair value of an investment is less that its cost; and the financial health of and near-term business outlook for the investee, including factors such as industry and sector performance, changes in technology and operational and financing cash flow. Fair value estimation The fair value of financial instruments traded in active markets (such as trading and available-for-sale securities) is based on quoted market prices at the end of the reporting period. The quoted market price used for financial assets held by the Council is the current bid price. Impairment testing The recoverable amounts of cash-generating units and individual assets have been determined based on the higher of value- in-use calculations and fair values less costs to sell. These calculations require the use of estimates and assumptions. The Council reviews and tests the carrying value of assets when events or changes in circumstances suggest that the carrying amount may not be recoverable. Assets are grouped at the lowest level for which identifiable cash flows are largely independent of cash flows of other assets and liabilities. If there are indications that impairment may have occurred, estimates are prepared of expected future cash flows for each group of assets. Expected future cash flows used to determine the value in use of goodwill and tangible assets are inherently uncertain and could materially change over time. Provisions Provisions were raised and management determined an estimate based on the information available. Additional 150 HPCSA ANNUAL REPORT 2016/17

152 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES 1.1 Significant judgements and sources of estimation uncertainty (continued) disclosure of these estimates of provisions are included in note 9 - Provisions. Prior year comparatives When the presentation or classification of items in the Annual Financial Statements is amended, prior period comparative amounts are also reclassified and restated, unless such comparative reclassification and / or restatement is not required by a International Financial Reporting Standards. The nature and reason for such reclassifications and restatements are also disclosed. When material accounting errors, which relate to prior periods, have been identified in the current year, the correction is made retrospectively as far as it is practicable and the prior year comparatives are restated accordingly. Where there has been a change in accounting policy in the current year, the adjustment is made retrospectively as far as is practicable and the prior year comparatives are restated accordingly. Critical judgements in applying accounting policies 1.2 Property, plant and equipment Property, plant and equipment are tangible assets which the company holds for its own use or for rental to others and which are expected to be used for more than one year. An item of property, plant and equipment is recognised as an asset when it is probable that future economic benefits associated with the item will flow to the company, and the cost of the item can be measured reliably. Property, plant and equipment is initially measured at cost. Cost includes all of the expenditure which is directly attributable to the acquisition or construction of the asset, including the capitalisation of borrowing costs on qualifying assets and adjustments in respect of hedge accounting, where appropriate. The initial estimate of the costs of dismantling and removing an item and restoring the site on which it is located is also included in the cost of property, plant and equipment, where Council is obligated to incur such expenditure, and where the obligation arises as a result of acquiring the asset or using it for purposes other than the production of inventories. Expenditure incurred subsequently for major services, additions to or replacements of parts of property, plant and equipment are capitalised if it is probable that future economic benefits associated with the expenditure will flow to the company and the cost can be measured reliably. Day to day servicing costs are included in profit or loss in the year in which they are incurred. Major inspection costs which are a condition of continuing use of an item of property, plant and equipment and which meet the recognition criteria are included as a replacement in the cost of the item of property, plant and equipment. Any remaining inspection costs from the previous inspection are derecognised. Major spare parts and stand by equipment which are expected to be used for more than one year are included in property, plant and equipment. Property, plant and equipment is subsequently stated at cost less accumulated depreciation and any accumulated impairment losses, except for land which is stated at cost less any accumulated impairment losses. Subsequent to initial recognition, property, plant and equipment is measured at cost less accumulated depreciation and any accumulated impairment losses, except for land and buildings which are stated at revalued amounts. The revalued amount is the fair value at the date of revaluation less any subsequent accumulated depreciation and impairment losses. Property, plant and equipment is subsequently stated at revalued amount, being the fair value at the date of revaluation less any subsequent accumulated depreciation and subsequent accumulated impairment losses. HPCSA ANNUAL REPORT 2016/17 151

153 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES 1.2 Property, plant and equipment (continued) Revaluations are made with sufficient regularity such that the carrying amount does not differ materially from that which would be determined using fair value at the end of the reporting year. When an item of property, plant and equipment is revalued, the gross carrying amount is adjusted consistently with the revaluation of the carrying amount. The accumulated depreciation at that date is adjusted to equal the difference between the gross carrying amount and the carrying amount after taking into account accumulated impairment losses. Depreciation of an asset commences when the asset is available for use as intended by management. Depreciation is charged to write off the asset s carrying amount over its estimated useful life to its estimated residual value, using a method that best reflects the pattern in which the asset s economic benefits are consumed by the company. Leased assets are depreciated in a consistent manner over the shorter of their expected useful lives and the lease term. Depreciation is not charged to an asset if its estimated residual value exceeds or is equal to its carrying amount. Depreciation of an asset ceases at the earlier of the date that the asset is classified as held for sale or derecognised. The useful lives of items of property, plant and equipment have been assessed as follows: 152 When an item of property, plant and equipment is Depreciation revalued, any accumulated depreciation at the date of the Item method Useful life revaluation is eliminated against the gross carrying amount Buildings Straight line 50 years of the asset. Furniture and fixtures Straight line 20 years Office equipment Straight line 10 years Any increase in an asset s carrying amount, as a result of a IT equipment Straight line 5 years revaluation, is recognised in other comprehensive income and accumulated in the revaluation reserve in equity. The Works of art Straight line 30 years increase is recognised in profit or loss to the extent that it The residual value, useful life and depreciation method reverses a revaluation decrease of the same asset previously of each asset are reviewed at the end of each reporting recognised in profit or loss. year. If the expectations differ from previous estimates, Any decrease in an asset s carrying amount, as a result of the change is accounted for prospectively as a change in a revaluation, is recognised in profit or loss in the current accounting estimate. year. The decrease is recognised in other comprehensive Each part of an item of property, plant and equipment with income to the extent of any credit balance existing in the a cost that is significant in relation to the total cost of the revaluation reserve in respect of that asset. The decrease item is depreciated separately. recognised in other comprehensive income reduces the amount accumulated in the revaluation reserve in equity. The depreciation charge for each year is recognised in profit or loss unless it is included in the carrying amount The revaluation reserve related to a specific item of of another asset. property, plant and equipment is transferred directly to retained income when the asset is derecognised. Impairment tests are performed on property, plant and equipment when there is an indicator that they may The revaluation reserve related to a specific item of property, be impaired. When the carrying amount of an item of plant and equipment is transferred directly to retained property, plant and equipment is assessed to be higher income as the asset is used. The amount transferred is than the estimated recoverable amount, an impairment equal to the difference between depreciation based on the loss is recognised immediately in profit or loss to bring the revalued carrying amount and depreciation based on the carrying amount in line with the recoverable amount. original cost of the asset, net of deferred tax. HPCSA ANNUAL REPORT 2016/17

154 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES An item of property, plant and equipment is derecognised upon disposal or when no future economic benefits are expected from its continued use or disposal. Any gain or loss arising from the derecognition of an item of property, plant and equipment, determined as the difference between the net disposal proceeds, if any, and the carrying amount of the item, is included in profit or loss when the item is derecognised. Assets which the company holds for rentals to others and subsequently routinely sells as part of the ordinary course of activities, are transferred to inventories when the rentals end and the assets are available-for-sale. These assets are not accounted for as non-current assets held for sale. Proceeds from sales of these assets are recognised as revenue. All cash flows on these assets are included in cash flows from operating activities in the cash flow statement. The Council s management determines the estimated useful lives and related depreciation charges for these assets. These estimates are based on industry norms and then adjusted to be Council s specific. Management will increase the depreciation charge where useful lives are less than previously estimated useful lives and vice versa. Depreciation and amortisation recognised on property, plant and equipment and intangible assets are determined with reference to be useful lives and residual values of the underlying items. The useful lives and residual values of assets are based on management s estimation of the asset m condition, expected condition at the end of the period of use, its current use, expected future use and the Council s expectations about the availability of finance to replace the asset at the end of its useful life. In evaluating the how the condition and use of the asset informs the useful life and residual value management considers the impact of technology and minimum service requirements of the assets. 1.3 Intangible assets An intangible asset is recognised when: it is probable that the expected future economic benefits that are attributable to the asset will flow to the entity; and the cost of the asset can be measured reliably. Intangible assets are initially recognised at cost. Expenditure on research (or on the research phase of an internal project) is recognised as an expense when it is incurred. An intangible asset arising from development (or from the development phase of an internal project) is recognised when: it is technically feasible to complete the asset so that it will be available for use or sale. there is an intention to complete and use or sell it. there is an ability to use or sell it. it will generate probable future economic benefits. there are available technical, financial and other resources to complete the development and to use or sell the asset. the expenditure attributable to the asset during its development can be measured reliably. Intangible assets are carried at cost less any accumulated amortisation and any impairment losses. An intangible asset is regarded as having an indefinite useful life when, based on all relevant factors, there is no foreseeable limit to the period over which the asset is expected to generate net cash inflows. Amortisation is not provided for these intangible assets, but they are tested for impairment annually and whenever there is an indication that the asset may be impaired. For all other intangible assets amortisation is provided on a straight line basis over their useful life. The amortisation period and the amortisation method for intangible assets are reviewed every period-end. Reassessing the useful life of an intangible asset with a finite useful life after it was classified as indefinite is an indicator that the asset may be impaired. As a result the asset is tested for impairment and the remaining carrying amount is amortised over its useful life. HPCSA ANNUAL REPORT 2016/17 153

155 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES Internally generated brands, mastheads, publishing titles, customer lists and items similar in substance are not recognised as intangible assets. Amortisation is provided to write down the intangible assets, on a straight line basis, to their residual values as follows: Item Computer software 1.4 Financial instruments Classification Useful life 12 years The Council classifies financial assets and financial liabilities into the following categories: Held-to-maturity investment Loans and receivables Available-for-sale financial assets Classification depends on the purpose for which the financial instruments were obtained / incurred and takes place at initial recognition. Classification is re-assessed on an annual basis, except for derivatives and financial assets designated as at fair value through profit or loss, which shall not be classified out of the fair value through profit or loss category. Initial recognition and measurement Financial instruments are recognised initially when the Council becomes a party to the contractual provisions of the instruments. Financial instruments are measured initially at fair value, except for equity investments for which a fair value is not determinable, which are measured at cost and are classified as available-for-sale financial assets. For financial instruments which are not at fair value through profit or loss, transaction costs are included in the initial measurement of the instrument. Subsequent measurement Dividend income is recognised in profit or loss as part of other income when the Council s right to receive payment is established. Loans and receivables are subsequently measured at amortised cost, using the effective interest method, less accumulated impairment losses. Held-to-maturity investments are subsequently measured at amortised cost, using the effective interest method, less accumulated impairment losses. Available-for-sale financial assets are subsequently measured at fair value. This excludes equity investments for which a fair value is not determinable, which are measured at cost less accumulated impairment losses. Gains and losses arising from changes in fair value are recognised in other comprehensive income and accumulated in equity until the asset is disposed of or determined to be impaired. Interest on available-for-sale financial assets calculated using the effective interest method is recognised in profit or loss as part of other income. Dividends received on available-for-sale equity instruments are recognised in profit or loss as part of other income when the Council s right to receive payment is established. Derecognition Financial assets are derecognised when the rights to receive cash flows from the investments have expired or have been transferred and the Council has transferred substantially all risks and rewards of ownership. Fair value determination The fair values of quoted investments are based on current bid prices. Impairment of financial assets At each reporting date the Council assesses all financial assets, other than those at fair value through profit or 154 HPCSA ANNUAL REPORT 2016/17

156 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES loss, to determine whether there is objective evidence that a financial asset or group of financial assets has been impaired. For amounts due to the Council, significant financial difficulties of the debtor, probability that the debtor will enter bankruptcy and default of payments are all considered indicators of impairment. In the case of equity securities classified as available-forsale, a significant or prolonged decline in the fair value of the security below its cost is considered an indicator of impairment. If any such evidence exists for available-forsale financial assets, the cumulative loss - measured as the difference between the acquisition cost and current fair value, less any impairment loss on that financial asset previously recognised in profit or loss - is removed from equity as a reclassification adjustment to other comprehensive income and recognised in profit or loss. Impairment losses are recognised in profit or loss. Impairment losses are reversed when an increase in the financial asset s recoverable amount can be related objectively to an event occurring after the impairment was recognised, subject to the restriction that the carrying amount of the financial asset at the date that the impairment is reversed shall not exceed what the carrying amount would have been had the impairment not been recognised. Reversals of impairment losses are recognised in profit or loss except for equity investments classified as availablefor-sale. Impairment losses are also not subsequently reversed for available-for-sale equity investments which are held at cost because fair value was not determinable. Where financial assets are impaired through use of an allowance account, the amount of the loss is recognised in profit or loss within operating expenses. When such assets are written off, the write off is made against the relevant allowance account. Subsequent recoveries of amounts previously written off are credited against operating expenses. Trade and other receivables Trade receivables are measured at initial recognition at fair value, and are subsequently measured at amortised cost using the effective interest rate method. Appropriate allowances for estimated irrecoverable amounts are recognised in profit or loss when there is objective evidence that the asset is impaired. Significant financial difficulties of the debtor, probability that the debtor will enter bankruptcy or financial reorganisation, and default or delinquency in payments (more than 90 days overdue) are considered indicators that the trade receivable is impaired. The allowance recognised is measured as the difference between the asset s carrying amount and the present value of estimated future cash flows discounted at the effective interest rate computed at initial recognition. The carrying amount of the asset is reduced through the use of an allowance account, and the amount of the loss is recognised in profit or loss within operating expenses. When a trade receivable is uncollectable, it is written off against the allowance account for trade receivables. Subsequent recoveries of amounts previously written off are credited against operating expenses in profit or loss. Trade and other receivables are classified as loans and receivables. Trade and other payables Trade payables are initially measured at fair value, and are subsequently measured at amortised cost, using the effective interest rate method. Cash and cash equivalents Cash and cash equivalents comprise cash on hand and demand deposits, and other short-term highly liquid investments that are readily convertible to a known amount of cash and are subject to an insignificant risk of changes in value. These are initially and subsequently recorded at fair value. HPCSA ANNUAL REPORT 2016/17 155

157 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES 1.4 Financial instruments (continued) Held to maturity These financial assets are initially measured at fair value plus direct transaction costs. At subsequent reporting dates these are measured at amortised cost using the effective interest rate method, less any impairment loss recognised to reflect irrecoverable amounts. An impairment loss is recognised in profit or loss when there is objective evidence that the asset is impaired, and is measured as the difference between the investment s carrying amount and the present value of estimated future cash flows discounted at the effective interest rate computed at initial recognition. Impairment losses are reversed in subsequent periods when an increase in the investment s recoverable amount can be related objectively to an event occurring after the impairment was recognised, subject to the restriction that the carrying amount of the investment at the date the impairment is reversed shall not exceed what the amortised cost would have been had the impairment not been recognised. Financial assets that the company has the positive intention and ability to hold to maturity are classified as held to maturity. 1.5 Leases A lease is classified as a finance lease if it transfers substantially all the risks and rewards incidental to ownership. A lease is classified as an operating lease if it does not transfer substantially all the risks and rewards incidental to ownership. Operating leases - lessor Operating lease income is recognised as an income on a straight-line basis over the lease term. Initial direct costs incurred in negotiating and arranging operating leases are added to the carrying amount of the leased asset and recognised as an expense over the lease term on the same basis as the lease income. Income for leases is disclosed under revenue in profit or loss. Operating leases lessee Operating lease payments are recognised as an expense on a straight-line basis over the lease term. The difference between the amounts recognised as an expense and the contractual payments are recognised as an operating lease asset. This liability is not discounted. Any contingent rents are expensed in the period they are incurred. 1.6 Impairment of assets The Council assesses at each end of the reporting period whether there is any indication that an asset may be impaired. If any such indication exists, the Council estimates the recoverable amount of the asset. Irrespective of whether there is any indication of impairment, the Council also: tests intangible assets with an indefinite useful life or intangible assets not yet available for use for impairment annually by comparing its carrying amount with its recoverable amount. This impairment test is performed during the annual period and at the same time every period. tests goodwill acquired in a business combination for impairment annually. If there is any indication that an asset may be impaired, the recoverable amount is estimated for the individual asset. If it is not possible to estimate the recoverable amount of the individual asset, the recoverable amount of the cashgenerating unit to which the asset belongs is determined. The recoverable amount of an asset or a cash-generating unit is the higher of its fair value less costs to sell and its value in use. If the recoverable amount of an asset is less than its carrying amount, the carrying amount of the asset is reduced to its recoverable amount. That reduction is an impairment loss. 156 HPCSA ANNUAL REPORT 2016/17

158 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES An impairment loss of assets carried at cost less any accumulated depreciation or amortisation is recognised immediately in profit or loss. Any impairment loss of a revalued asset is treated as a revaluation decrease. An entity assesses at each reporting date whether there is any indication that an impairment loss recognised in prior periods for assets other than goodwill may no longer exist or may have decreased. If any such indication exists, the recoverable amounts of those assets are estimated. The increased carrying amount of an asset other than goodwill attributable to a reversal of an impairment loss does not exceed the carrying amount that would have been determined had no impairment loss been recognised for the asset in prior periods. A reversal of an impairment loss of assets carried at cost less accumulated depreciation or amortisation other than goodwill is recognised immediately in profit or loss. Any reversal of an impairment loss of a revalued asset is treated as a revaluation increase. 1.7 Employee benefits Defined contribution plans Contributions made towards the fund are recognised as an expense in the Statement of Financial Performance in the period that such contributions become payable. This contribution expense is measured at the undiscounted amount of the contribution paid or payable to the fund. A liability is recongised to the extent that any of the contributions have not yet been paid. Conversely an asset is recognised to the extent that any contributions have been paid in advance. Payments to defined contribution retirement benefit plans are charged as an expense as they fall due. 1.8 Revenue Revenue from membership fees, registration fees, examinations fees and penalties are recognised when all the following conditions have been satisfied: the amount of revenue can be measured reliably; it is probable that the economic benefits associated with the transaction will flow to the Council; and the costs incurred or to be incurred in respect of the transaction can be measured reliably. When the outcome of a transaction involving the rendering of services can be estimated reliably, revenue associated with the transaction is recognised by reference to the stage of completion of the transaction at the end of the reporting period. The outcome of a transaction can be estimated reliably when all the following conditions are satisfied: the amount of revenue can be measured reliably; it is probable that the economic benefits associated with the transaction will flow to the company; the stage of completion of the transaction at the end of the reporting period can be measured reliably; and the costs incurred for the transaction and the costs to complete the transaction can be measured reliably. When the outcome of the transaction involving the rendering of services cannot be estimated reliably, revenue shall be recognised only to the extent of the expenses recognised that are recoverable. Service revenue is recognised by reference to the stage of completion of the transaction at the end of the reporting period. Stage of completion is determined by. Revenue is measured at the fair value of the consideration received or receivable and represents the amounts receivable for goods and services provided in the normal course of business, net of trade discounts and volume rebates, and value added tax. Interest is recognised, in profit or loss, using the effective interest rate method. Dividends are recognised, in profit or loss, when the Council s right to receive payment has been established. Unidentified credit balances which are older than one HPCSA ANNUAL REPORT 2016/17 157

159 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 ACCOUNTING POLICIES year and cannot be traced to the individual members are recognised as revenue. 1.9 Irregular expenditure Irregular expenditure is expenditure that is contrary to the HPCSA Act 56 of 1974 or is in contravention of the entity s supply chain management policies. Irregular expenditure excludes unauthorised expenditure. Irregular expenditure is accounted for as expenditure in the Statement of profit and loss or other comprehensive income Related parties The Council has processes and controls in place to aid in the identification of related parties. A related party is a person or an entity with the ability to control or jointly control the other party, or exercise significant influence over the other party, or vice versa, or a Council that is subject to common control, or joint control. Related party relationships where control exists are disclosed regardless of whether any transactions took place between the parties during the reporting period. Where transactions occured between the entity and any one or more related parties, and those transactions were not wihtin: Normal supplier and / or client / receipt relationships on terms and conditions no more or less favourable than those which it is reasonable to expect the entity to have adopted if dealing with that individual entity or person in the same circumstance; and Terms and conditions within the normal operating parameters established by the reporting entity s legal mandate; Further details about those transactions are disclosed in the notes to the financial statements Subsequent events after the reporting date Events after the reporting date are those events both favorable and unfavorable that occur between the reporting date and the date when the annual financial statements are authorised for issue, and are treated as follows: The Council adjust the amounts recognised in its annual financial statements to reflect adjusting events after the reporting date for those events that provide evidence of conditions that existed at the reporting date, and The Council does not adjust the amounts recognised in its annual financial statements to reflect nonadjusting events after the reporting date for those events that are indicative of conditions that arose after the reporting date. 2. NEW STANDARDS AND INTERPRETATIONS 2.1 Standards and interpretations not yet effective The company has chosen not to early adopt the following standards and interpretations, which have been published and are mandatory for the company s accounting periods beginning on or after 1 April 2017 or later periods: 158 Standard/ Interpretation: Effective date: Years beginning on or after Expected impact: IFRS 16 Leases 1 January 2019 Unlikely there will be a material impact IFRS 9 (AC 146) Financial Instruments 1 January 2018 Unlikely there will be a material impact IFRS 15 Revenue from Contracts with Customers 1 January 2018 Unlikely there will be a material impact Amendments to IFRS 15: Clarifications to IFRS 15 1 January 2018 Unlikely there will be a material impact Revenue from Contracts with Customers Amendments to IFRS 2: Classification and 1 January 2018 Unlikely there will be a material impact Measurement of Share-based Payment Transactions Amendments to IFRS 4: Applying IFRS 9 Financial 1 January 2018 Unlikely there will be a material impact Instruments with IFRS 4 Insurance Contracts HPCSA ANNUAL REPORT 2016/17

160 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 3. PROPERTY, PLANT AND EQUIPMENT Cost or revaluation 2017 Accumulated depreciation Carrying value Cost or revaluation 2016 Restated Accumulated depreciation Carrying value Land 3,545,008-3,545,008 3,545,008-3,545,008 Buildings 8,211,023 (2,226,266) 5,984,757 7,767,091 (2,068,157) 5,698,934 Furniture and fixtures 4,801,075 (2,742,390) 2,058,685 4,277,943 (2,634,989) 1,642,954 Office equipment 9,542,226 (4,893,987) 4,648,239 8,502,375 (4,312,255) 4,190,120 IT equipment 20,891,635 (9,962,804) 10,928,831 14,799,537 (9,232,878) 5,566,659 Works of art 1,237,312 (5,175) 1,232, ,482 (100,896) 3,586 Presidential badge Total 48,228,280 (19,830,622) 28,397,658 38,996,437 (18,349,175) 20,647,262 Reconciliation of property, plant and equipment Opening balance Additions Disposals Revaluations Reclassification Depreciation Total Land 3,545, ,545,008 Buildings 5,698, , (158,108) 5,984,757 Furniture and fixtures 1,642, ,133-55,912 (59,184) (104,130) 2,058,685 Office equipment 4,190,120 1,105,975 (40,364) - - (607,492) 4,648,239 IT equipment 5,566,659 6,272,003 (33,520) - - (876,311) 10,928,831 Works of art 3, ,076,918 59,184 92,449 1,232,137 Presidential badge ,647,262 8,345,042 (73,884) 1,132,830 - (1,653,592) 28,397,658 Reconciliation of property, plant and equipment Opening balance Additions Disposals Depreciation Total Land 3,545, ,545,008 Buildings 5,854, (155,342) 5,698,934 Furniture and fixtures 1,599, ,559 - (97,462) 1,642,954 Office equipment 3,721, ,940 - (502,305) 4,190,120 IT equipment 1,774,711 4,247,998 (29,899) (426,151) 5,566,659 Works of Art 3, (132) 3,586 Presidential badge ,499,056 5,359,497 (29,899) (1,181,392) 20,647,262 Compensation received for losses on property, plant and equipment is included in operating surplus. HPCSA ANNUAL REPORT 2016/17 159

161 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 3. PROPERTY, PLANT AND EQUIPMENT (CONTINUED) Depreciation rates The depreciation methods and average useful lives of property, plant and equipment have been assessed as follows: Restated Buildings Straight line basis - years Furniture and fixtures Straight line basis - years Office equipment Straight line basis - years Computer software Straight line basis - years 5 5 Computer servers Straight line basis - years Works of Art Straight line basis - years INTANGIBLE ASSETS Restated Cost / Valuation Accumulated amortisation Carrying value Cost / Valuation Accumulated amortisation Carrying value Computer software 9,528,956 (6,334,985) 3,193,971 7,852,062 (5,829,176) 2,022,886 Reconciliation of intangible assets Opening balance Additions Reclassification Amortisation Total Computer software 2,022,886 1,732,805 (55,912) (505,808) 3,193,971 Reconciliation of intangible assets Opening balance Additions Amortisation Total Computer software 2,297, ,344 (468,774) 2,022,886 The HPCSA upgraded the oracle system and purchased new software licenses. 160 HPCSA ANNUAL REPORT 2016/17

162 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand Restated 5. OTHER FINANCIAL ASSETS Available-for-sale Listed Shares Sanlam Shares Free shares allocated to Council during Sanlam s demutualisation process 1,081,019 1,098,991 Non-current assets Available-for-sale 1,081,019 1,098, RETIREMENT BENEFITS Defined contribution plan The HPCSA provides retirement benefits through independent funds under the control of trustees and all contributions on those funds are charged to profit and loss. The HPCSA pension and provident funds are governed by the Pensions Fund Act, The total group contribution to such schemes 7,337,750 5,724, TRADE AND OTHER RECEIVABLES Trade receivables before provision for bad debts 13,118,421 6,679,182 Less: Provision for bad debts (5,956,455) (5,296,290) Trade receivables after provision for bad debts 7,161,966 1,382,892 Advances to Council members, managers and employees 113,265 87,557 Prepayments 3,347,005 2,996,644 Deposits 214,059 92,510 VAT 447,161 6,485,887 AMCOA loan account 721,365 47,386 Accrued interest 8,919,951 8,028,120 20,924,772 19,120,996 Trade receivables ageing Current (0-30 days) 5,612, , days 324, , days 1,224,912 96,143 7,161,966 1,382,892 HPCSA ANNUAL REPORT 2016/17 161

163 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand Restated 8. CASH AND CASH EQUIVALENTS Cash and cash equivalents consist of: Cash on hand 2,500 2,500 Bank balances 84,031, ,631,705 Short-term deposits 251,196, ,539, ,230, ,173,834 Cash and cash equivalents pledged as collateral Total financial assets pledged as collateral for guarantee to SA Post Office Limited 2,000,000 2,000,000 No expiry date and no special conditions apply. Limited Cession of Absa Bank Ltd Fixed Deposit no for R 500, 000 Limited Cession of Absa Bank Ltd Fixed Deposit no for R 1, 500, PROVISIONS Reconciliation of provisions Opening balance Additions Utilised during the year Total Provisions for accrued leave 4,147,844 3,878,968 (2,843,710) 5,183,102 Reconciliation of provisions Opening balance Additions Utilised during the year Total Provisions for accrued leave 4,567, ,843 (1,369,071) 4,147,844 Provision for accrued leave This provision represents the liability for the total amount of leave days due to employees. Figures in Rand Restated 10. TRADE AND OTHER PAYABLES Trade payables 13,477,845 12,254,240 Other payables 385, ,842 Accruals and other payables 11,427,873 7,571,387 25,290,956 20,631, HPCSA ANNUAL REPORT 2016/17

164 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand Restated 11. INCOME RECEIVED IN ADVANCE Unapplied receipts 190,554, ,847,820 Unidentified receipts 4,175,648 2,632, ,729, ,480,394 Unapplied receipts Represents receipts in advance from members for their next years membership fees. These receipts are allocated when bulk billing is done in the next financial year. Unidentified receipts Represents receipts from members who cannot be identified at this stage. These members normally claim these receipts when their fees remain unpaid and they receive reminders. Included in this amount is also practitioners who paid, but are not yet registered. Receipts can only be applied once registration is complete. 12. REVENUE Unidentified receipts recognised 784, ,743 Annual fees - Current year 177,481, ,352,012 Restoration fees 5,252,746 4,968,369 Examination fees 1,752,380 2,159,915 Evaluations fees 939,534 1,851,168 Other professional fees 2,883,823 1,917,691 Registration Fees 18,826,462 17,268,954 Annual fees - Prior year 2,773,000 2,881,913 Fees from penalties imposed 1,995,500 2,346, ,688, ,530, OTHER OPERATING INCOME RAF management fees 2,048,505 2,184,392 Asset Revaluation Surplus 1 - Other rental income 188, ,803 Other recoveries 16,783,469 11,009,794 Sundry revenue 109, ,802 Register sales 14,514 79,115 Tender fees 20,659 17,655 Insurance compensation 111,655 36,105 19,277,567 13,645,666 HPCSA ANNUAL REPORT 2016/17 163

165 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand Restated 14. OPERATING (DEFICIT) SURPLUS Operating (deficit) surplus for the year is stated after accounting for the following: Operating surplus (deficit) Auditors remuneration 311, ,263 Operating lease charges - rental machines 1,572, ,338 Amortisation on intangible assets 505, ,775 Loss on disposal of fixed asset 112,701 8,574 Legal expenses 13,944,726 12,611,931 Council, professional board and committee meetings 45,503,348 46,516,784 Road Accident Fund expenses 12,144,719 6,901,575 Depreciation on property, plant and equipment 1,653,592 1,181,392 Employee costs 153,736, ,904,128 Strategic projects 4,734,048 3,735,423 IT expenses 7,314,500 5,420,978 Postage 3,345,773 3,675,366 Printing and stationery 5,216,997 5,310, INVESTMENT INCOME From investments in financial assets: Interest received 22,502,639 20,700,511 Dividend income - Sanlam 45,102 28,722 Total interest and dividend income 22,547,741 20,729, TAXATION No provision has been made for tax as the Council is exempt from normal tax. 164 HPCSA ANNUAL REPORT 2016/17

166 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 17. OTHER COMPREHENSIVE INCOME AND LOSS Components of other comprehensive income Items that will not be reclassified to profit (loss) Gross Tax Net Movements on revaluation Gains (losses) on work-at-art revaluation 1,132,830-1,132,830 Items that may be reclassified to profit (loss) Available-for-sale financial assets adjustments Gains and losses arising during the year on Sanlam shares (17,971) - (17,971) Total 1,114,859-1,114,859 Components of other comprehensive income Items that may be reclassified to profit (loss) Gross Tax Net Available-for-sale financial assets adjustments Gains and losses arising during the year on Sanlam shares (158,535) - (158,535) Figures in Rand Restated 18. CASH USED IN OPERATIONS Surplus / (Loss) for the year (25,295,639) (2,234,806) Adjustments for: Depreciation and amortisation 2,159,400 1,650,166 Losses on disposals, scrappings and settlements of assets and liabilities 112,701 8,574 Interest income (22,547,741) (20,729,233) Movement in provisions 1,035,260 (419,230) Loss / (profit) on stolen assets (38,817) (21,325) Asset reclassification 55,912 - Changes in working capital: Trade and other receivables (1,803,776) (8,231,783) Trade and other payables 4,659,487 8,901,412 Income received in advance 8,249,579 11,176,679 (33,374,817) (9,878,221) HPCSA ANNUAL REPORT 2016/17 165

167 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand Restated 19. RELATED PARTIES `Relationships Acting Registrar and CEO - Adv P Khumalo Refer to note 20 President of Council - Dr TKS Letlape Refer to note 21 Council members - 30 members Refer to Councilor s report Association of Medical Councils of Africa (AMCOA) - HPCSA Refer to note 7 is a member of AMCOA and manages the day-to-day financial affairs of AMCOA Minister of Health and Department of Health Refer to Health Professions Act no 56 of Related party transactions Council / Professional Board members fees Members fees 12,629,654 12,631,319 Preparation fees 3,444,405 2,740,590 Subsistence expenses 4,244,545 4,693, HPCSA ANNUAL REPORT 2016/17

168 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 20. EXECUTIVE REMUNERATION 2017 Emoluments Performance CCMA Retirement Medical aid Settlement Arbitration bonus benefits contribution labour cost Award Total Registrar / CEO (April 2016) 186,663-9,919-2,267,145-2,463,727 General Manager Legal (April 2016) 127, ,339 6,931 1, ,448 Acting Registrar & CEO (May March 2017) 2,170,047-90,372 20, ,280,575 Chief Operations Officer (April - May 2016) 522,272-18,558-3,651, ,557 4,296,908 Ombudsman (April - June 2016) 418, ,945 22, ,828 Acting Chief Operations Officer (July March 1,729,158-66, ,795, ) Interim Ombudsman 499, ,400 Chief Information Officer 1,244, ,608 16, ,371,944 Chief Financial Officer 1,701,208-87,314 26, ,814,840 Acting General Manager: Legal (May March 1,496,744-52,747 21, ,570, ) General Manager: CPD, Registrations and Records 664,989-32,539 29, ,192 (April - August 2016) Acting General Manager: CPD, Registrations and Records (September - 215,348-5,926 4, ,682 November 2016) General Manager: CPD, Registrations and Records (November March 562,765-24, , ) Acting General Manager: Professional Boards 1,400,961-81, ,482,111 Senior Human Resources Manager 1,052,395-48,197 34, ,134,908 Senior Public Relations 1,004,760-56,173 48, ,109,087 Manager Manager: Support Services 503,332-24, ,955 (June January 2017) Acting Manager: Support 266,195-8, ,001 Services (April - June 2016 & February - March 2017) 15,766, , , ,078 5,918,66 104,557 23,039,579 HPCSA ANNUAL REPORT 2016/17 167

169 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 2016 Emoluments Performance bonus Retirement benefits Medical aid contribution Registrar and CEO 1,904, , ,238 34,135 2,297,950 Chief Operations Officer 1,846, , ,773-2,273,968 Ombudsman 1,519, ,549 79,970-1,743,743 Chief Information Officer (March 2016) 94,916-8, ,474 Acting Chief Information Officer (October 2015 to February 2016) 626,559-30,800 7, ,603 General Manager: CPD, Registrations and Records (October March 622,914-36,431 43, , ) Acting Senior Manager: CPD, Registrations and Records (April - 267,383-21,224 9, ,693 September 2015) Acting Senior Manager: CPD, Registrations and Records (April - 303,278-14,600 10, ,793 September 2015) General Manager: Legal 1,344, ,468 71,909 20,328 1,573,554 Acting General Manager: Professional Boards (April - May 2015) 286,030-22,177 18, ,379 Manager: Support Services (Retired December 2015) 893,322-47, ,040 Acting Manager: Support Services (January - March 2016) 176,209-5, ,669 Senior Public Relations Manager (December March 2016) 299,982-17,485 15, ,904 Senior Public Relations Manager (Resigned June 2015) 203,821-11,356 7, ,215 Acting Public Relations Manager (July 2015, September 2015 and November 184,716-7,225 6, , ) Acting Public Relations Manager (August 2015 and October 2015) 118,889-4, ,520 Senior Human Resources Manager 896,043 91,576 49,510 33,216 1,070,345 Interim General Manager: Professional Boards (June to December 2015) 592, ,739 Interim Chief Financial Officer (April 2015 to March 2016) 1,381, ,381,454 13,563, , , ,859 15,357,617 Total 168 HPCSA ANNUAL REPORT 2016/17

170 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 21. COUNCILORS EMOLUMENTS The following emoluments, allowances and travel costs have been paid to Council members attending Council, Board, Committee meetings and Board activities Members Fees President Subsistence Allowance Allowance Travel Costs Total Dr TKS Letlape 468,335 98, ,556 31, ,820 Mr LA Malotana 141,285-54,600 3, ,571 Mr S Ramasala 168, , ,200 Prof K Mfenyana 67, ,478 72,648 Ms MM Isaacs 42, ,410 58,795 Mr S Sobuwa 89, ,590 Ms X Bacela 18, ,840 20,010 Ms MS van Niekerk 101, , ,607 Mr KO Tsekeli 29, ,293 31,243 Mr A Speelman 88, ,001 89,166 Prof N Gwele 15, ,329 30,554 Ms ND Dantile 113, , ,500 Ms JM Nare 34, ,678 46,718 Ms DJ Sebidi 135, , ,792 Dr S Balton 93, ,821 96,166 Ms RM Gontsana 41, ,058 Prof SM Hanekom 86, , ,448 Mr M Kobe 118, , ,473 Mr MAW Louw 104, , ,143 Mrs D Muhlbauer 129, , ,211 Adv T Mafafo 24, ,182 Prof GJ van Zyl 49, ,235 Prof NJ Mekwa 82, ,013 Dr RL Morar 84,655-31, ,970 Prof YI Osman 63, ,187 65,677 Prof BJ Pillay 118, , ,696 Dr TA Muslim 123,600-32,078 23, ,332 2,634,828 98, , ,871 3,265,816 HPCSA ANNUAL REPORT 2016/17 169

171 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 21. COUNCILORS EMOLUMENTS The following emoluments, allowances and travel costs have been paid to Council members attending Council Committee meetings 2016 Members President Subsistence Fees Allowance Allowance Travel Costs Total Dr TKS Letlape 122,130 31,125-14, ,212 Prof MS Mokgokong 27,050 28,539 19,405-74,994 Prof T Sodi 39, ,600 42,210 Prof K Mfenyana 25, ,126 34,996 Ms MM Isaacs 61, ,736 83,356 Mr S Sobuwa 23, ,168 Ms TS Mtshali 21, ,596 Ms MS van Niekerk 33, ,500 35,590 Mr KO Tsekeli 26, ,046 27,146 Mr A Speelman 38, ,989 Prof N Gwele 21, ,417 50,807 Ms ND Dantile 43, ,321 45,861 Mr LA Malotana 76, ,929 80,289 Ms DJ Sebidi 32, ,334 37,194 Dr S Balton 43, ,484 47,724 Ms RM Gontsana 28, ,550 31,430 Prof SM Hanekom 33, ,564 38,674 Mr M Kobe 70, ,325 74,975 Mr MAW Louw 50, ,844 Mrs D Muhlbauer 13, ,158 Adv T Mafafo 16, ,101 Prof GJ van Zyl 25, ,020 Prof NJ Mekwa 40, ,246 41,476 Dr RL Morar 39, ,049 Ms X Bacela 8, ,221 9,561 Dr TA Muslim 49, ,980 54,080 Ms JM Nare 29, ,283 40,243 Prof YI Osman 23, ,117 Prof BJ Pillay 32, ,494 39,464 Ms B Pule 16, ,756 Mr S Ramasala 91, ,646 98,226 Prof E Wentzel-Viljoen 19, ,654 24,114 Ms V Amrit 23, ,057 24,147 Mr R Naidoo 25, , HPCSA ANNUAL REPORT 2016/17

172 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 21. COUNCILORS EMOLUMENTS 2016 Members President Subsistence Fees Allowance Allowance Travel Costs Total Mr J Chaka 25, ,354 27,974 Prof UME Chikte 29, ,057 30,787 Ms R Bridgemohan 18, ,047 Prof TA Ramukumba 20, ,145 21,455 Ms VR Moodley 32, ,819 Prof NP Taukobong 36,500-26,619 1,495 64,614 Prof S Singh 46,790-19,405 3,346 69,541 Mrs RM Kekana 31, ,254 Mr DN Serenyane 13, ,706 20,606 Mr RL Mjethu 17, ,530 Mr KP Legodu 38, ,357 52,277 Rev G Moerane 23, ,090 Mr MD Mhlanga 25, ,531 37,551 Dr LM Moja 49,350-19,405 26,443 95,198 Ms L Dikweni 28, ,249 Mr VM Mkhombo 17, ,323 37,313 1,730,270 59,664 84, ,033 2,114,801 A new Council was appointed on 01 October 2015 when the old Council s term ended 30 September Figures in Rand Restated 22. ROAD ACCIDENT FUND (RAF) The surplus recovered from the agreement between HPCSA and the Road Accident Fund can be reconciled as follows: Cost incurred by HPCSA 16,783,468 11,026,224 Employee costs 4,081,273 2,564,209 RAF legal, tribunal expenditure, sheriff and disbursements 12,479,007 7,927,349 HPCSA overheads (Stationery, telephone and training) 223, ,666 Amounts received from RAF 18,797,630 13,377,419 Amounts invoiced to RAF iro costs incurred 16,560,281 11,026,224 Management accounts 2,048,505 2,184,392 Rental income 188, ,803 Surplus 2,014,162 2,351,195 HPCSA ANNUAL REPORT 2016/17 171

173 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 23. RISK MANAGEMENT Fair value of financial instruments The carrying amounts of the following financial instruments approximate their fair value due to the fact that these instruments are: Cash and cash equivalent include bank balances and investments with commercial interest rates. Short trade and other receivables - due to the short term nature of Health Professions Council of South Africa s receivables, amortised cost approximates its fair values. Trade and other payables - are subject to normal trade credit terms and short payment cycles. The cost of other payables approximates its fair value. No financial instrument is carried at an amount in excess of its fair value. Liquidity risk The Health Professions Council of South Africa manages liquidity risk through the compilation and monitoring of cash flow forecasts as well as ensuring that there are adequate banking facilities. At 31 March 2017 Less than 1 year Financial Assets Cash and cash equivalents 335,230,094 Trade and other receivables 20,924,772 Financial Liabilities Trade and other payables 25,290,956 Income received in advance 194,729,974 At 31 March 2016 Less than 1 year Financial Assets Cash and cash equivalents 356,173,834 Trade and other receivables 19,120,996 Financial Liabilities Trade and other payables 20,631,469 Income received in advance 186,480,394 Interest rate risk The Health Professions Council of South Africa does have investments which are interest-bearing assets. The Council is however funded through different income streams received from members. Interest rate flunctuations will therefore notn have a material impact on income and operating cash flows. 172 HPCSA ANNUAL REPORT 2016/17

174 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS 23. RISK MANAGEMENT (CONTINUED) Credit risk Potential concentrations of credit risk consist mainly of cash and cash equivalents, trade receivables and other receivables. At 31 March 2017, the Health Professions Council of South Africa did not consider there to be any significant concentration of credit risk which had not been insured or adequately provided for. Figures in Rand restated 24. UNAUTHORISED, IRREGULAR AND FRUITLESS AND WASTEFUL EXPENDITURE Irregular expenditure - - Opening balance - 1,101,472 Condonement - (1,101,472) 25. CONTINGENT LIABILITIES Matter regarding former Legal Advisor (Mr. Mosiane) A former employee lodged complaint against Council with CCMA for unfair dismissal and he won the matter at CCMA. The CCMA Award was reviewed and set aside by the Labour Court. The Labour Court referred the matter back to the CCMA to be heard anew. The former employee has resuscitated the matter by following the Labour Court ruling to remit matter back to CCMA. The Labour Court has directed the CCMA commissioner to issue an award on the matter. A maximum award of 12 months compensation may be made, which will be equal to R 520, 581. The HPCSA has not made any provisions in this fnancial year and will continue to review this decision on an on-going basis. Matter regarding former General Manager: Professional Boards (Dr Mbhele) The employee has referred matter to CCMA following an unsuccessful appeal to MANCO. The first hearing was on 21 August 2015 and Commissioner agreed to postpone matter for re-enrolment after 30 September In the even that CCMA rules in employee s favor a maximum award of 12 months compensation may be made, which will be equal to R 1, 381, 812. The HPCSA has not made any provisions in this financial year and will continue to review this decision on an on-going basis. HPCSA ANNUAL REPORT 2016/17 173

175 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand restated Matter regarding Practitioner: Mr RP McMahon Mr McMahon has instituted an action against Council in the Kwazulu-Natal High Court, Pietermaritzburg, in which he claims payment of the sum of R 11 million plus interest and costs. There is currently no movement on this matter. The HPCSA has not made any provisions in this financial year and will continue to review this decision on an ongoing basis. The summons against HPCSA was issued on 24 August Matter regarding Practitioner: Ms CJ Grobbler The practitioner experienced slow reaction of the Council to complaints against Dr Gordon. She is claiming damages estimated R 768, 000. Dr Gordon who is the second defendant is currently being sequestrated and the proceedings are currently affected by the sequestration proceedings. There is currently no movement on the matter. The HPCSA has not made any provisions in this financial year and will continue to review this decision on an on-going basis. Matter regarding Practitioner: Dr JF Scholtz A claim has been lodged against the Council of the HPCSA due to incorrect registration status provided on behalf of a registered practitioner resulting in the loss of employment opportunity of the registered practitioner. The practitioner is claiming payment of the sum of R 49, 173, Matter regarding Modise v Flora Clinic, Minister of Health and HPCSA Plaintiff has instituted action against the Respondents for R 15 million for damages suffered as a result of treatment that was administered by Flora Clinic. It is not clear why the HPCSA was cited as a party to the proceedings. The summon was issued on 30 June PRIOR PERIOD ERRORS The Council identified the prior period errors during the process of preparation of the annual financial statements. The errors have been corrected through retrospectively restatement of the comparative figures in the current financial year s financial statements Council, professional boards and committee meetings Council, professional boards and committee meeting travel expenditure not recorded in the financial year ending 31 March 2016 as expenditure. Statement of Comprehensive Income Increase in council, professional boards and committee travel expenses - 240,968 Statement of Financial Position Increase in creditors - (240,968) 174 HPCSA ANNUAL REPORT 2016/17

176 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES TO THE ANNUAL FINANCIAL STATEMENTS Figures in Rand restated 26.2 Assets accumulated depreciation The Council identified the prior period errors during the process of reviewing the asset register of fully depreciated assets. The errors have been corrected through retrospectively restatement of the comparative figures in the current financial year s financial statements. Statement of Comprehensive Income Increase in amortisation - 215,646 Decrease in depreciation - (2,166,828) Statement of Financial Position Increase in accumulated amortisation - (215,646) Decrease in accumulated depreciation - 2,166, Intangible assets The VIP payroll development costs was expensed under consultation fees instead of intangible asset account. The errors have been corrected through retrospectively restatement of the comparative figures in the current financial year s financial statements. Statement of Comprehensive Income Decrease in consultation fees - (194,344) Increase in intangible amortisation - 9,312 Statement of Financial Position Increase in intangible assets - 194,344 Increase in intangible amortisation - (9,312) HPCSA ANNUAL REPORT 2016/17 175

177 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 DETAILED INCOME STATEMENT Figures in Rand Note(s) restated Revenue Annual Fees Current year before suspensions 185,676, ,746,932 Less: Suspension of membership (8,195,357) (7,394,920) Annual fees - Current year 177,481, ,352,012 Annual fees - Prior year 2,773,000 2,881,913 Fees from penalties imposed 1,995,500 2,346,525 Registration fees 18,826,462 17,268,954 Unidentified receipts recognised 784, ,743 Restoration fees 5,252,746 4,968,369 Examination fees 1,752,380 2,159,915 Evaluation fees 939,534 1,851,168 Other professional fees 2,883,823 1,917, ,688, ,530,290 Other operating income RAF management fees 2,048,505 2,184,392 Asset Revaluation Surplus 1 - Other rental income 188, ,803 Other recoveries 16,783,469 11,009,794 Sundry revenue 109, ,802 Register sales 14,514 79,115 Tender fees 20,659 17,655 Insurance compensation 111,655 36, ,277,567 13,645,666 Other operating gains (losses) Losses on disposal of assets or settlement of liabilities (112,701) (8,574) Expenses (Refer to page 37) (279,697,176) (228,131,421) Operating loss (47,843,380) (22,964,039) Investment income 15 22,547,741 20,729,233 Other non-operating gains (losses) Gains on disposal of assets or settlement of liabilities 1,132,830 - Fair value losses (17,971) (158,535) Deficit for the year (24,180,780) (2,393,341) The supplementary information presented does not form part of the annual 176 HPCSA ANNUAL REPORT 2016/17

178 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 DETAILED INCOME STATEMENT Figures in Rand Note(s) restated Other operating expenses Amortisation 505, ,775 Auditors remuneration - external auditors 311, ,263 Bad debts - increase/(decrease) in provision 926,460 (1,383) Bank charges 3,286,969 3,320,287 Cleaning 650, ,832 Airconditioning Expenses 197, ,941 Consulting and professional fees 844, ,524 Internal Audit Fees 669, ,354 Consulting and professional fees - legal fees 13,944,726 12,611,931 RAF Expenses 12,144,719 6,901,575 Depreciation 1,653,592 1,181,392 Employee costs 153,736, ,904,128 Tender administrative costs 202, ,627 Equipment and furniture less than R ,255 42,650 Strategic projects - Teambuildings and Strategic Sessions 4,734,048 3,735,423 Settlement labour cases - Employees 6,044,287 - Council, professional board and committee meetings 45,503,348 46,516,784 Insurance 778, ,363 IT expenses 7,314,500 5,420,978 Lease rentals on operating lease 1,572, ,338 Municipal expenses 2,158,074 2,045,547 Cash shortages Postage 3,345,773 3,675,366 Printing and stationery 5,216,997 5,310,870 Public relations and promotions 7,260,584 3,157,287 Repairs and maintenance 1,220, ,935 Security 915, ,295 Subscriptions & library costs 205, ,520 Telephone and fax 1,695,552 1,399,586 International conference 2,563, , ,697, ,131,421 The supplementary information presented does not form part of the annual financial statements and is unaudited HPCSA ANNUAL REPORT 2016/17 177

179 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES 178 HPCSA ANNUAL REPORT 2016/17

180 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES HPCSA ANNUAL REPORT 2016/17 179

181 Health Professions Council of South Africa Annual Financial Statements for the year ended 31 March 2017 NOTES 180 HPCSA ANNUAL REPORT 2016/17

182 Contact Details 553 Madiba Street Arcadia Pretoria South Africa P O Box 205 Pretoria 0001 South Africa Tel: (+27) (+27) Fax: (+27) info@hpcsa.co.za RP196/2017 ISBN: Title of Publication: Health Professions Council of South Africa (HPCSA) Annual Report 2016/17