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.”
The Directorate of Public Prosecutions (DPP)’s decision to reject and appeal the High Court’s verdict on a case involving High Court Judge, Dr Zein Kebonang has frustrated the Judicial Service Commission (JSC) and Judge Kebonang’s back to work discussions.
JSC and Kebonang have been in constant discussions over the latter’s return to work following a ruling by a High Court panel of judges clearing him of any wrong doing in the National Petroleum Fund criminal case filed by the DPP. However the finalization of the matter has been hanged on whether the DPP will appeal the matter or not – the prosecution body has since appealed.
Botswana Democratic Party (BDP) top brass has declined a request by Umbrella for Democratic Change (UDC) to negotiate the legal fees occasioned by 2019 general elections petition in which the latter disputed in court the outcome of the elections.
This publication is made aware that UDC Vice President Dumelang Saleshando was left with an egg on his face after the BDP big wigs, comprising of party Chairman Slumber Tsogwane and Secretary General Mpho Balopi rejected his plea.
“He was told that this is a legal matter and therefore their (UDC) lawyer should engage ours (BDP) for negotiations because it is way far from our jurisdiction,” BDP Head of Communications, Kagelelo Kentse, told this publication.
This spelt doom for the main opposition party and Saleshando who seems not to have confidence and that the UDC lawyers have the dexterity to negotiate these kind of matters. It is not clear whether Saleshando requested UDC lawyer Boingotlo Toteng to sit at the table with Bogopa Manewe, Tobedza and Co, who are representing the BDP to strike a deal as per the BDP top echelons suggested.
“From my understanding, the matter is dealt with politically as the two parties are negotiating how to resolve it, but by far nothing has come to me on the matter. So I believe they are still substantively engaging each other,” Toteng said briefly in an interview on Thursday.
UDC petitioners saddled with costs after mounting an unprecedented legal suit before the court to try and overturn BDP’s October 2019 victory. The participants in the legal matter involves 15 parliamentary candidates’ and nine councillors. The UDC petitioned the court and contested the outcome of the elections citing “irregularities in some of the constituencies”.
In a brief ruling in January 2020, Judge President Ian Kirby on behalf of a five-member panel said: “We have no jurisdiction to entertain these appeals. These appeals must be struck out each with costs including costs of counsel”. This was a second blow to the UDC in about a month after their 2019 appeals were dismissed by the High Court a day before Christmas Day.
This week BDP attorneys decided to attach UDC petitioners’ property in a bid to settle the debts. UDC President Duma Boko is among those that will see their property being attached with 14 of his party members. “We have attached some and we are on course. So far, Dr. Mpho Pheko (who contested Gaborone Central) and that of Dr, Micus Chimbombi (who contested Kgalagadi South) will have their assets being sold on the 5th of February 2021,” BDP attorney Basimane Bogopa said.
Asked whether they met with UDC lawyers to try solve the matter, Bogopa said no and added. “Remember we are trying to raise the client’s funds, so after these two others will follow. Right now we are just prioritising those from Court of Appeal, as soon as the high court is done with taxation we will attach.”
Saleshando, when contacted about the outcomes of the meeting with the BDP, told WeekendPost that: “It would not be proper and procedural for me to tell you about the meeting outcomes before I share with UDC National Executive Committee (NEC), so I will have to brief them first.”
UDC NEC will meet on the 20th of next month to deal with a number of thorny issues including settling the legal fees. Negotiations with other opposition parties- Alliance for Progressives and Botswana Patriotic Front (BPF) are also on the agenda.
Currently, UDC has raised P44 238 of the P565 000 needed to cover bills from the Court of Appeal (CoA). This is the amount in a UDC trust account which is paltry funds equating 7.8 per cent of the overall required money. In the past despite the petitioners maintaining that there was promise to assist them to settle legal fees, UDC Spokesperson, Moeti Mohwasa then said the party has never agreed in no way to help them.
“We have just been put in debt by someone,” one of the petitioners told this publication in the past. “President’s (Duma Boko) message was clear at the beginning that money has been sourced somewhere to help with the whole process but now we are here there is nothing and we are just running around trying to make ends meet and pay,” added the petitioner in an interview UDC NEC has in December last year directed all the 57 constituencies to each raise a minimum of P10, 000. The funds will be used to settle debts that are currently engulfing the petitioners with Sheriffs, who are already hovering around ready to attach their assets.
The petitioners, despite the party intervention, have every right to worry. “This is so because ‘the deadline for this initiative (P10, 000 per constituency) is the end of the first quarter of this year (2021),” a period in which the sheriffs would have long auctioned the properties.
President of the Umbrella for Democratic Change (UDC) Duma Boko’s alliance with former President Lt Gen Ian Khama continues to unsettle some quarters within the opposition collective, who believe the duo, if not managed, will once again result in an unsuccessful bid for government in 2024.
While Khama has denied that he has undeclared preference to have Boko remaining as leader of UDC, many believe that the two have a common programme, while other opposition leaders remain on the side-lines.