Press Release The People’s Health Movement response to the South African Medical Association planned demonstration and march on February 6th 2004: The Peoples Health Movement (PHM) South Africa, is part of a large global civil society network of health activists supportive of the WHO policy of Health for All and organised to combat the economic and political causes of deepening inequalities in health worldwide and revitalise the implementation of WHO’s strategy of Primary Health Care. The PHM South Africa draws on the support of over 200 health and allied personnel, including public hospital medical specialists, medical practitioners, nurses and other health professionals, senior academics, representatives of health and related NGOs, Trade Unions and community-based health workers. · PHM notes the demands raised by SAMA and its call for a protest by health workers and the concerned public tomorrow, Friday 6 February. · PHM believes that health is a fundamental human right and that improved health results from improved access to resources (income, improved diets, basic services, etc.) as well as improved access to basic health care. In this regard we strongly support SAMA’s demand that government increase its allocation of funding to the public health sector to upgrade facilities, infrastructure and improve retention and conditions of service of health personnel. Here, the announcement this week of allowances for retention of scarce skills in rural and underserved areas are welcomed as an initial measure to redress the imbalances in health between rural and poor urban areas and metropolitan centres. PHM believes that these allowances should be extended to include all personnel working in these areas. · One of SAMA’s key demands, and one which clearly is mobilising the support of private medical practitioners, is its opposition to the Certificate of Need (CON). PHM’s understanding is that the CON is an instrument to redistribute private medical practitioners to less-well-served areas and halt their increasing concentration in already well-served urban areas. The CON was included as a component of the new National Health Bill, which Bill went through many drafts and which was subject to extensive formal public consultation, in which SAMA and other organisations participated. PHM supports this intervention by government, as it represents an attempt to address the greatest inequity in S.A.’s health system, namely the widening gap between the public and private health sectors, the latter accounting for over 60% of South Africa’s doctors. While government’s actions are being portrayed as an infringement of the rights of doctors and the public, PHM contends that the rights of poor people, who have little choice in the health care they can use, need to be considered alongside those of private practitioners. PHM’s view is that the implementation of the CON is, on balance, likely to be protective of more people than it disadvantages. Because of the conflicting nature of SAMA’s demands, PHM will not be participating in this protest but will continue to press for a larger and more equitable allocation of health resources in S.A. Doctors’ Protest March in Cape Town on February 6, 2004 Article: An estimated 2000 doctors other health care professionals and patients participated in SAMA’s Health Care Survival march in Cape Town on February 6, 2004. With this public campaign, SAMA succeeded in highlighting the profession’s concern regarding shortcomings in public health care delivery and legislative issues that impact negatively on the private sector. It also focused on SAMA’s role in influencing policies that regulate the delivery of health care in both the private and public health sectors. The publicity around the march brought about unprecedented political pressure on SAMA not to proceed with the march. The President’s office approached the national organizers of the march on Thursday evening, February 5, and requested that the route be reviewed as a compromise, and to allow the parliamentary opening to proceed uninterrupted. As a gesture of goodwill the SAMA leadership agreed to change the route, thereby making a concession in the spirit of facilitating future discussions with the Department of Health and other decision-makers in government. The march ended at the Grand Parade where the acting Director-General of Health, Dr Kami Chetty, received the memorandum on behalf of the Minister. For many it was a great disappointment that the Minister did not make herself available to receive it in person. SAMA’s decision to publicly express its views in such a manner was not taken lightly, and followed on meticulous evaluation of the merits of pending and current legislation and regulation. This march was not a single day event. It was the beginning of a process. The Association is committed to constructive engagement with the Department of Health and will pursue opportunities to meet with government with a view to building strong and meaningful partnerships with government on issues that affect all levels and aspects of health care delivery. SAMA is the only authentic body that is in a position to fully represent doctors in South Africa. It will proceed with its mission to unite all doctor groupings into one unified profession, acting and working as one body to look after the needs of doctors and their patients. Your support of the march, whether it was financial, in principle or being present at the march, assisted in affirming SAMA as a professional body, which cares and puts patient care first. The SAMA leadership fully acknowledges and appreciates the commitment and support that contributed to the success of this event. The Association has a critical role to play in shaping the future of health care in South Africa, and ensuring medicine as a viable profession. All the role-players in health care delivery must stand together, influence legislation and be part of the implementation process. SAMA has a wealth of knowledge and expertise to make this happen. Make sure that you are part of that process. Kgosi Letlape Chairperson SA Medical Association Date: 18 February 2004