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Doctors in the public sector are fully covered by the state against 'adverse patient events', but those who also do RWOPS are forced to take out insurance just like their private counterparts.
The mere linkage of RWOPS to possible increased maternal deaths in regional hospitals--while the country's horrific overall maternal death rate declines at a pace that will fall way short of the MDG target by the end of next year--is akin to pouring petrol on the coals of a long-simmering controversy in the medical profession.
I will now reflect briefly on the controversial issue of RWOPS. This is my own personal view, and not that of the Exco or our Association.
As has been and is being pointed out, [4-6] RWOPS is a dispensation for all public servants with rare skills, and is aimed within the health profession at improving remuneration for state-employed doctors.
The Public Service Commission (PSC) conducted an enquiry into RWOPS in Gauteng Province, South Africa, in 2004.
Although abuses have been recognised in the past, there is now renewed concern and growing evidence that the privilege of RWOPS has been considerably abused by some (perhaps many) healthcare professionals.
This emerged from Dr Deon Menge, the South African Medical Association (SAMA)'s 'point man' for RWOPS and a key member of the national RWOPS committee advising Dr Aaron Motsoaledi, the National Minister of Health.
Habib promised to crack down mercilessly on both clinicians taking advantage of systemic dysfunction to abuse RWOPS and corrupt outside service providers.
This is how a respected Stellenbosch University medical and legal ethicist and a cutting edge community and primary health care innovator at the University of Pretoria (UP) see the fast-evolving RWOPS abuse saga which took centre stage in public health over the last 3 months.
At its most basic level the SAMA proposal, based on the Free State group practice model, involves eight hours of RWOPS per week in return for a peer-enforced guarantee that all clinics, theatre lists, ward rounds and on-call rosters are fully covered at all times and proper, detailed RWOPS applications are made.
The same SAMA mass e-mail's strident objection to the Free State government's withdrawal of approval for RWOPS (Remuneration for Work Outside the Public Service) during office hours is therefore rather surprising.
State-employed consultants are beginning to resign in numbers at two top Gauteng hospitals--and many of their Free State counterparts may soon follow--as a clumsy and sweeping nationwide crackdown on the Remunerative Work Outside Public Service (RWOPS) and overtime begins.
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