President’s Report 2022
PRESIDENT’S REPORT 2022:
JAMES LOOCK: 18/10/2022 – INDABA HOTEL, JOHANNESBURG
Thank you to all of you for this good attendance turnout. I regard it as a great honour to have been chosen to be the president of your Society, and to stand here today – albeit a daunting one in the light of the excellence of our previous leadership.
I will certainly do my best in this position – although I must to start with a disclaimer: I spent my career almost entirely in the academic / public sector, and am only now beginning tounderstand the complexities of the politico-financial landscape of private practice. I have gained new respect for my predecessors and our stalwart colleagues who have striven over the years on our behalf in this minefield!
I propose in this address the following:
• To keep it very short
• Not to dwell too long on what your EXCO and other representatives have achieved
• To sketch briefly what I see to be the problems we face in ENT in 2022
• To suggest some ideas as to what we might do to improve our situation
CHALLENGING TIMES:
It is not an overstatement to say that we live in challenging times. We are dealing in an economy hammered by state capture, endemic corruption, rampant crime, job losses, unemployment, the erosion of our already small tax-paying base, COVID and Vladimir Putin.
It is inevitable that this will make the environments of practice, private and public, hard. There is simply less money to go around, and there are pressures on all role players.
We face a number of challenges in private practice.
As such we are fortunate to have the co-operation and support of not only Healthman, but also our colleagues in SAPPF (the SA Private Practice Forum) and FoSAS (the Federation of SA Surgical Societies)
The challenges include:
The threat of a certificate of need to practice: SAPPF to whom we are affiliated, supported
Solidarity in opposing this in the Courts
NHI (National Health Insurance): We know this would be disastrous. SAPPF is opposing it, and we must support them in this.
HPCSA: Is dysfunctional. Efforts are being made to have the Medical and Dental Councils split off from the others.
HPCSA excessive fee increases: We supported the FoSAS and SAPPF in getting this year’s fees reduced to CPIX levels. BHF attempts to dictate fees (“medical aid rates”): We are part of an application to the Competition Commission for right to draw up tariff guidelines.
Battles around coding and remuneration: These continue. We know that our surgical remuneration is grossly inadequate, but the role players – medical aids, hospitals and other disciplines – block correction.
Medical aids rating hospitals (and doctors):
Hospital groups intrusion on doctors’ independence:
Enforcement of adherence to their electronic medical records
Signing of contracts/agreements
Medical aids’ intrusion on doctors’ independence: The hospital groups’ practice of having “preferred providers” interferes with the doctor-patient relationship and certainly seems anti-competitive.
CHALLENGES IN ACADEMIC MEDICINE AND PUBLIC HEALTH:
In a way, because the public purse is less affected by the economy, these have perhaps been somewhat shielded from the recent problems. This is not to say that the number of posts are adequate, funding sufficient, service delivery meeting demand, surgical lists adequate, or nursing in a good way. All this impacts on morale, training and public health care. The situation is worse in the smaller centres.
I have been concerned in particular about the future of the Academic Subcommittee (ASC). There appears to have been for a while now a lack of morale, lack of cohesion, and a questioning of what purpose the ASC serves. However the meeting before this congress re-energised the Committee, and it is my hope that it will be strengthened under the leadership of Andile Sibiya and Shivesh Maharaj. At times like these, I believe that we need mutual support and sharing of ideas and synergy – especially support of those units that are less-well staffed and resourced.
ON THE POSITIVE SIDE:
Financial situation:
Your ENT Society manages its financial situation prudently, but with generosity and compassion, as was demonstrated in its fee reduction to members during the COVID pandemic, and the financial situation is good. Academic meetings, journal clubs and workshops are thriving, and better than ever. We continue to deliver great Congresses:
SO WHAT DO WE NEED TO DO TO MAKE THE FUTURE BETTER?:
1. INCLUSIVITY and CO-OPERATION
Yuval Noah Harrari: in his book Homo Deus makes the point that the success of the human species is due to its ability to communicate and co-operate We must all be involved and work together
It is time to involve and prepare a new generation of young people with futures ahead of them. Energy and new ideas – less tired and programmed.
These people should represent all races, genders and groupings. I ask our young people please to stand up, not to feel excluded, to contribute, and to be counted.
I know many of you feel excluded, and that the EXCO is some sort of an “old boy’s club” from which you feel alienated. I used to feel that way. I can only assure you that it is not, and that it really wants YOU to be involved and part of it. The fact that I, of all people, stand here in front of you, is testimony to its lack of prejudice, open-mindedness, and willingness to be inclusive.
2. PASSAGE OF WISDOM, INSIGHT AND EXPERIENCE TO A NEW GENERATION
We have for many years relied, as a Society, on the dedication and institutional knowledge of an handful of people who are no longer young – people like Chris Joseph and Stefaan Bouwer. We have literally sailed on their coat-tails for as long as I can remember.
We need to equip a new generation. I have already spoken to the members of our coding committee about how we might achieve this – perhaps starting with a Workshop of the experienced and the new, where our experienced members equip new colleagues with the knowledge of the system and wisdom of their experience.
3. A NEW APPROACH TO OUR COMPETITORS/”THE ENEMY”?
I wonder whether there is not room to work with the entities that we see as denying us decent remuneration, and;
Suggest alternative ways to work more cost-effectively while paying us better?
Break the established processes/structures?
Build relationships of confidence and trust?
4. TO MEET YOUR NEEDS
I will be sending out an Email/Survey inviting your criticisms, suggestions, and priorities
for your Society and your EXCO. Please respond to it!
Thank you for your attention and attendance, and enjoy the Banquet this evening