'Red tape' prevents foreign medics from joining SA's fight against Covid-19

More than 450 foreign-trained medical professionals say red tape is preventing them joining SA's coronavirus fight.

Writing in the South African Medical Journal, two foreign medical graduates said they had heard from 458 counterparts who are "currently in SA, and are either unemployed or working in nonmedical roles. Almost all are willing to serve during the Covid-19 outbreak."

They say the Health Professions Council of SA (HPCSA) can take up to two years to register them, a claim the council has denied.

At the same time, senior medics at the University of Cape Town have raised concerns about the "unethical practice" of First World nations recruiting doctors from poorer nations.

In a letter to the journal, they criticised moves by the UK and US to expedite visa applications so foreign health workers could join the coronavirus workforce.

"We call on governments and professional medical associations in both high-income countries and low-income countries to ensure that as they address the current global need for health workers, their strategies should promote equity and specifically not undermine the already understaffed and fragile health systems," said UCT ear, nose and throat specialist Johan Fagan and four colleagues.

UCT's head of global surgery, Salome Maswime, told the Sunday Times: "Rather than poaching from one another, there is an urgent need to increase training of health workers in all categories."

In their letter about HPCSA red tape, doctors Jehane le Grange and Jacques Jeppe said that "trying to expand SA's health-care capacity while simultaneously contending with a loss of health-care staff due to Covid-19 could pose a significant challenge to a system already under strain".

They added: "SA international medical graduates could potentially assist. The integration of these doctors has long been problematic for the HPCSA and the national department of health. Policy aimed at bridging their integration has yet to be implemented."

Le Grange told the Sunday Times a significant number foreign-trained doctors were registered only with other international medical councils, "therefore they are limited with regards to their ability to practise in any medical capacity in SA".

HPCSA registration could take up to two years, forcing doctors to work in nonmedical roles or as medical sales reps - or to register with medical councils elsewhere that had simpler registration processes, he said.

"Given the current situation, I do think that some compromise would be called for in terms of registration, perhaps a limited or temporary registration, thereby allowing international graduates to play a role."

HPCSA spokesperson Priscilla Sekhonyana said that since the lockdown began the council's turnaround time for registrations had been reduced from 10 working days to 72 hours. She said the regulatory body would, however, "not waive requirements for registration".

But to speed things up, Sekhonyana said, the council no longer insisted on original application forms and accepted applications submitted by e-mail.

"Applicants will be granted a temporary registration for the duration of the lockdown, but will be required to submit originals of documents if they want their registration to be made permanent or continue beyond the period of the lockdown."

Health department spokesperson Popo Maja said allowing unregistered doctors to assist during the Covid-19 outbreak could put lives in jeopardy. "No country in the world takes such a risk," he said.