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.”
Lebang Mpotokwane, one of the conveners who presided over the opposition cooperation talks that resulted in the formation of the Umbrella for Democratic Change (UDC), has advised against changing the current umbrella model in favour of a merger as proposed by others.
The Botswana Congress Party (BCP) leader, Dumelang Saleshando recently went public to propose that UDC should consider merging of all opposition parties, including Alliance for Progressives (AP) and Botswana Patriotic Front (BNF).
Saleshando has been vehemently opposed by Botswana National Front (BNF), which is in favour of maintaining the current model. BNF’s position has been favoured by the founding father of UDC, who warned that it will be too early to ditch the current model.
“UDC should be well developed to promote the spirit of togetherness on members and the members should be taught so that the merger is developed gradually. They should approach it cautiously. If they feel they are ready, they can, but it would not be a good idea,” Mpotokwane told WeekendPost this week.
Mpotokwane and Emang Maphanyane are the two men who have since 2003 began a long journey of uniting opposition parties in a bid to dethrone the ruling Botswana Democratic Party (BCP) as they felt it needed a strong opposition to avoid complacency.
Tonota born Mpotokwane is however disappointed on how they have been ejected from participating in the last edition of talks ahead of the 2019 general elections in which BCP was brought on board. However, despite the ejection, Mpotokwane is not resentful to the opposition collective.
He said the vision of opposition unity was to ultimately merge the opposition parties but he believes time has not arrived yet to pursue that path. “The bigger picture was a total merger and we agreed that with three independent parties, members might be against merger eventuality so the current model should be used until a point where they are now together for as long as possible,” he said.
“UDC should gradually perform better in elections and gain confidence. They should not rush the merger. We have been meeting since 2003, but if they rush it might cause endless problems. If they are ready they can anyway,” he advised. For now the constituent parties of the umbrella have been exchanging salvos with others (BCP and BNF).
“There are good reasons for and against merging the parties. Personally, I am in favour of merging the parties (including AP and BPF) into a single formation but I know it’s a complex mission that will have its own challenges,” Saleshando said when he made his position known a week ago.
“Good luck to those advocating for a merger, it will be interesting to observe the tactics they will use to lure the BPF into a merger,” former BNF councillor for Borakalalo Ward and former BNF Youth League Secretary General, Arafat Khan, opined in relation to BCP’s proposed position.
Mpotokwane, who is currently out in the cold from the UDC since he was ejected from the party’s NEC in 2017, said the current bickering and the expected negotiations with other parties need the presence of conveners.
“We did not belong to any party as conveners so we were objective in our submissions. If party propose any progressive idea we will support, if it is not we will not, so I would agree that even now conveners might be key for neutrality to avoid biasness,” he observed. Despite being abandoned, Mpotokwane said he will always be around to assist if at all he is needed.
“If they want help I will be there, I have always been clear about it, but surely I will ask few questions before accepting that role,” he said. UDC is expected to begin cooperation talks with both AP and BPF either this week or next weekend for both upcoming bye-elections (halted by Covid-19) and 2024 general elections and it is revealed that there will be no conveners this time around.
The Botswana Democratic Party (BDP) moved through its lawyers to attach the property of Umbrella for Democratic (UDC) President Duma Boko and other former parliamentary contestants who failed in their court bid to overturn the 2019 general elections in 14 constituencies.
WeekendPost has established that this week, Deputy Sheriffs were commissioned by Bogopa Manewe Tobedza and Company who represented the BDP, to attach the properties of UDC elections contents in a bid to recover costs. High Court has issued a writ of execution against all petitioners, a process that has set in motion the cost recovery measures.
Botswana Sectors of Teachers Union (BOSETU) says COVID-19 as a pandemic has negatively affected the education sector by deeply disrupting the education system. The intermittent lockdowns have resulted in the halting of teaching and learning in schools.
The union indicated that the education system was caught napping and badly exposed when it came to the use of Information System (IT), technological platforms and issues of digitalisation.
“COVID-19 exposed glaring inefficiencies and deficiencies when it came to the use of ITC in schools. In view of the foregoing, we challenge government as BOSETU to invest in school ITC, technology and digitalization,” says BOSETU President Kinston Radikolo during a press conference on Tuesday.
As a consequence, the union is calling on government to prioritise education in her budgeting to provide technological infrastructure and equipment including provision of tablets to students and teachers.
“Government should invest vigorously in internet connectivity in schools and teacher’s residences if the concept of flexi-hours and virtual learning were to be achieved and have desired results,” Radikolo said.
Radikolo told journalists that COVID-19 is likely to negatively affect final year results saying that the students would sit for the final examinations having not covered enough ground in terms of curriculum coverage.
“This is so because there wasn’t any catch up plan that was put in place to recover the lost time by students. We warn that this year’s final examination results would dwindle,” he said.
The Union, which is an affiliate of Botswana Federation of Public, Private and Parastatal Union (BOFEPUSU), also indicated that COVID-19’s presence as a pandemic has complicated the role of a teacher in a school environment, saying a teacher’s role has not only transcended beyond just facilitating teaching and learning, but rather, a teacher in this COVID-19 era, is also called upon to enforce the COVID-19 preventative protocols in the school environment.
“This is an additional role in the duty of a teacher that needs to be recognized by the employers. Teachers by virtue of working in a congested school environment have become highly exposed and vulnerable to COVID-19, hence the reason why BOSETU would like teachers to be regarded as the frontline workers with respect to COVID-19,” says Radikolo.
BOSETU noted that the pandemic has in large scales found its way into most of the school environments, as in thus far more than 50 schools have been affected by COVID-19. The Union says this is quite a worrying phenomenon.
“As we indicated before when we queried that schools were not ready for re-opening, it has now come to pass that our fears were not far-fetched. This goes out to tell that there is deficiency in our schools when it comes to putting in place preventative protocols. In our schools, hygiene is compromised by mere absence of sanitizers, few hand-washing stations, absence of social distancing in classes,” the Union leader said.
Furthermore, Radikolo stressed that the shifting system drastically increased the workload for teachers especially in secondary schools. He says teachers in these schools experience very high loads to an extent that some of them end up teaching up to sixty four periods per week, adding that this has not only fatigued teachers, but has also negatively affected their performance and the quality of teaching.
In what the Union sees as failure to uphold and honour collective agreements by government, owing to the shift system introduced at primary schools, government is still in some instances refusing to honour an agreement with the Unions to hire more teachers to take up the extra classes.
“BOSETU notes with disgruntlement the use of pre-school teachers to teach in the mainstream schools with due regard for their specific areas of training and their job descriptions. This in our view is a variation of the terms of employment of the said teachers,” says Radikolo.
The Union has called on government to forthwith remedy this situation and hire more teachers to alleviate this otherwise unhealthy situation. BOSETU also expressed concerns of some school administrators who continuously run institutions with iron fists and in a totalitarian way.
“We have a few such hot spot schools which the Union has brought to attention the Ministry officials such as Maoka JSS, Artesia JSS, and Dukwi JSS. We are worried that the Ministry becomes sluggish in taking action against such errant school administration. In instances where action is taken, such school administrators are transferred and rotated around schools.”