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Home » News » General » BHPC rejects Batswana doctors trained in China

BHPC rejects Batswana doctors trained in China

Publishing Date : 06 September, 2017

Author : UTLWANANG GASENNELWE

A semi-autonomous health regulatory body which was established by parliament, Botswana Health Professions Council (BHPC) is currently under heavy scrutiny for applying double standards in registering doctors.


It is understood that, in registering doctors, the organisation favours Chinese expatriates as opposed to local specialists although both having trained in China. This, notwithstanding, the government on one hand continues to send Batswana to China for training as doctors.
The reasons advanced by the BHPC for rejecting Batswana doctors trained in China is said to be that government sends the doctors to “fly by night” institutions in China who are not competent enough to practice as specialists upon their return.


However, the BHPC board is said to be infested with doctors in private practice who protect their monopoly interests. It is understood that they suppress the influx of equally competitive Batswana doctors as they fear competition from their honey pot in the likes of Bokamoso and Gaborone Private Hospitals.


BHPC is composed of members appointed by the Minister of Health and Wellness, Dorcus Makgatho. The council’s composition includes the Director of Health Services; the Dean of the Faculty of Medicine at the University of Botswana; three medical practitioners, one of whom is a specialist; two dentists; two pharmacists; six Allied Health Professionals; one Associated Health Professional; one person form the Public not associated with Health Professionals; and a representative from the Attorney-General Chambers (legal Advisor). The China/Botswana medical training partnership has been in existence for the past 40 years.

What PS Al-Halabi “knows” about BPHC


Meanwhile when appearing before the Public Accounts Committee (PAC) recently, the Accounting Officer at the Ministry of Health and Wellness, Permanent Secretary Shenaaz El-Halabi tried to distance herself from BHPC. She stressed that the Council is semi-autonomous and independent from government but was reminded that it’s directly under her ministry.


Starting to pit the PS against the wall was Selibe Phikwe West maverick legislator who highlighted to Halabi that there is a cartel of self-appointed BHPC council members who are mainly Doctors in the private space, and that this council has decided to not register Batswana specialist Doctors trained in China (and some countries) where the government sends students for training as doctors.


The Accounting officer then responded to Keorapetse by confirming that she “is aware” that the BHPC is mainly made up of private doctors or practitioners in the sector and that there is none from government except the Director of Health Services and the Attorney General representative.


According to Keorapetse, the reasons advanced by the council are that Batswana doctors do not write licensing exams to practice in China or other countries. “It is common knowledge that all Doctors /specialists trained outside our country do not necessarily have to write licensing exams of their country of training as a licensing exam is only required where the candidate intents to practice..in which case only Botswana’s licensing exam is necessary for Batswana…” he informed  Al-Halabi who was on the edge of her chair at the time.


Keorapetse emphasised that it is worth noting that if private practice doctors were to allow an influx of Batswana specialists from any country in large numbers they would risk competition in the private space adding that these people were making millions from Gaborone Private Hospital and Bokamoso hospital and that “they are avoiding competition by denying other Batswana specialists registration.” He asked the accounting officer whether she was aware that Batswana students are sent to China to specialize while on the other hand the BHPC refuses to register them upon their return to practice.


Al-Halabi stated: “yes I am aware of that.” When he asked further why then still they continue to send the student doctors there despite the development, Al-Halabi said “yes we do continue sending them to China to study but with due diligence being followed.” She added that, as a ministry when students doctors are sent to China they make sure that the schools which they attend are accredited.


The local doctors, Keorapetse narrated, have had one of them taking the BPHC to court and the Council lost, but they will not use the precedent to register everyone because they want to keep people out of registration for a while enjoying monopoly in the private space.
“They are fully aware that court cases take a while, they are also aware that in any case every time BHPC loses cases they do not have to personally pay anything, in the end it's the ministry of Health that pays,” he added.


The Selibe Phikwe West law maker also emphasized that this is corruption of the highest order by the elite who are holding the country’s health care at ransom through denying Batswana trained specialists only to protect their private interests. He added that it is sad that their Chinese counterparts are recruited here and registered by the same BHPC but Batswana who trained in the same system are denied that registration out of selfish interests.


The sentiment was also shared by Al-Halabi: “the local doctors’ concern is that Chinese doctors who studied at China come here in our country and they get easily registered and are accredited to practice as specialists while Batswana who likewise studied at China are not when they return back home.” When justifying the move she said, in China they have certain courses for developing countries and so the education system is very different.


On another related matter, Keorapetse said there are some senior doctors who have practiced for a long time as specialists whilst they only hold Member of the Royal Colleges of Physicians of the UK (MRCP or FRCP(Canada)/ Fellowship of the Colleges of Physicians of SA(FCP-SA).


“How many of these doctors have practiced and for how long? Were they hired and paid as specialists? Were they registered by the Health Professional Council? Why? Are some of them now in schools trying to specialize?” he wondered. Al-Halabi pleaded with the committee that she will look into the matter and make sure that the calamity is addressed.


In addition the Ministry of Health and Wellness PS Al-Halabi also told the PAC that she had a meeting with China ambassador and Health professionals to discuss all issues with regard to the professionals’ trainings and will map a way forward. Health Council board chair contradicts PS Al-Halabi


However when speaking to Weekend Post on the matter this week, BHPC Board Chairman Boago Modiitsane dismissed any misdeeds on the part of the Health Council board. In fact, he contradicted her superior, PS Al-Halabi saying that the organ is placed under the Ministry of Health and Wellness. He also said the partnership between government of Botswana through Ministry Of Health and Wellness and The People’s Republic of China also has no bearing on the registration of any applicant.


He broke ranks with the PS while defending BHPC saying they “are not aware” of where the Ministry Of Health and Wellness sends its employees for training when quizzed if this isn’t likely to strain relations between the doctors originating from the two countries. He was quick to clarify that BHPC does indeed recognize any trained specialists who meet registration requirements and that the country of training is never a requirement (in this case China).  


“BHPC does register Batswana trained specialists. We have about 105 Batswana specialists in the register as of February 2017 trained from various parts of the world and we continue to register Batswana specialists. Therefore, the statement that BHPC does not register Batswana specialists is misleading,” Modiitsane said.


He went on to stress that specialists are clinicians who have refined skills in patient care beyond that of a generalist, and therefore on assessing an application for specialist registration BHPC looks for, among other things, whether a training programme has delivered the appropriate clinical competencies to deliver specialized patient care to Batswana in a safe manner.


He also stated that: “training of health professionals follows two different pathways that lead to varied outcomes. Health professionals who intend to sharpen their skills in patient care will follow the clinical pathway that will enhance their clinical competency while those that are interested in research will follow an academic pathway.”  “Consistent with this mandate, BHPC is more concerned with clinical rather than academic programmes. This applies to every applicant regardless of the country of training.”


The BHPC Board Chairman also explained that assessment of applications for registration is an objective exercise that is based on the minimum requirement set by BHPC.  One must meet these minimum standards for them to be registered, he said. According to Modiitsane the BHPC boards are composed of members who are drawn from both the public and private sector, therefore the statement that Batswana Health Professionals are refused registration because of fear of competition is unfounded. Furthermore, he said both Batswana and Foreigners are eligible for private Practice if they meet the required standards. “The alleged fear for competition (real or imagined), therefore, should apply in case of where foreigners are registered.”  

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