Moonlighting doctors could be a thing of the past if the national Health Department has its way. The department wants the policy that allows doctors who work in the public health service to also work in the private sector to be scrapped.
The proposal is specifically directed at senior doctors because they earn enough, according to the department.
Health Department deputy director-general Dr Percy Mahlathi told the parliamentary oversight committee on health that while the policy allowing doctors to be paid for work outside the public service and the procedures that needed to be followed were contained in the Public Service Act, it was difficult to manage.
“We certainly need to consider scrapping the policy at higher levels of the medical and dental profession, in light of high remuneration packages earned in terms of (the) Occupation Specific Dispensation.”
Mahlathi said very senior doctors were on R1.4 million to R1.5m packages but still did private-sector work, which “is unlimited”.
“It should be addressed both administratively and politically. It’s quite rampant across the country.”
He said the policy had been intended to allow doctors to augment their income. But with the Occupation Specific Dispensation, “the remuneration aspect has been sorted”. The Public Service Act provides for doctors to work outside the public service with written permission from the relevant executive authority, a health MEC, based on the considerations in the act.
The MEC would take into account whether or not the outside work could interfere with the doctor’s functions in the public sector or constitute a contravention of the code of conduct.
“The experience we have is that this is a serious challenge. This is not an easy area to manage,” Mahlathi told MPs. He said the outside work had to be seen in relation to the number of hours clinicians claimed for commuted overtime.
“Some of the senior doctors would come in in the morning, work for an hour and then leave, leaving junior doctors to work.”
He gave an example of how, in Limpopo, five obstetricians had resigned after they had been asked to clock in when they came to work.
“That’s not how you deal with professionals – they just leave en masse.”
He said the matter had been raised with the SA Medical Council “because some of the culprits are its members”.
Committee chairman Bevan Goqwana recommended that the department investigate the “pros and cons” of having the policy, while the DA’s Mike Waters agreed that “a person can’t hold down two jobs indefinitely” because it was “exhausting”, but added that he was worried about how the department would get around the matter in the short term and whether it would have the necessary staff.
All the other MPs were supportive of the idea, claiming that doctors spent most of their working hours in private practice and would proceed to public hospitals when they were tired and ineffective.