Equipamiento adecuado para trabajo de oficinas

In contrast with the 57% of research participants who expressed positive views, a total fifteen (or 43%) of the sample made statements that showed their dissatisfaction with the HPCSA and questioned its effectiveness in fostering the profession of EH. Unlike the previous situation where 60% of EHP managers have positively commented about the HPCSA, in this case 73% (12 of the 15 research participants) were EHPs and 27% (4) were EHP managers. This

132

difference of opinion43 could be interpreted as signifying that the EHPs as people on the ground were eager to see the HPCSA being active and engaging EHPs on issues they face at their workplaces.

The statements made suggest that the EHPs in the study had expectations that remain unfulfilled pertaining to the role the HPCSA plays in the environmental health professional practice. The views were centred on the following three issues: being unaware about what the HPCSA does for EHPs; being unable to separate the role of the HPCSA professional board and the professional association; as well as a concern regarding registration fees and lack of communication thereof.

Concern 1: Ignorance about the Role of the HPCSA

As pointed out in the previous paragraph, research participants expressed concern that some EHPs did not understand what the HPCSA was doing for the environmental health profession. They acknowledged being aware that HPCSA was a professional body that all EHPs needed to be registered with to practice environmental health. However, the exact role the HPCSA plays in handling EHPs affairs other than registration and expulsion for failure to pay annual professional fees, was unclear from the EHPs’ perspective on the ground. It would seem that some EHPs needed clarity about the exact roles of the HPCSA in relation to the EH profession; hence they raised concerns that the HPCSA was, in their view, not available when required to act on matters affecting the practice of EHPs. One research participant made a broad comment that contrasted the ideal role with the reality on the ground, pointing to the fact that the two were not the same, for example:

“What I understand to be the role and what happens are two different things. I feel that HPCSA are not playing enough role and there is not enough information advocating for environmental health which they should be doing. I feel they are there, more as a body that we should be affiliated to and pay our annual fees to and only use them or approach them in rare occasion. Other than that, it’s sad that they don’t play enough big role. We had cases where we call on HPCSA, but there was no response at all” (NDM04).

Other research participants echoed similar sentiments of concern about not knowing the role of the HPCSA in regard to their affairs as can be seen on the following statements:

43 _{The difference of opinion happens to be a discovery which was not the main focus of this study. This study} aimed at determining the awareness EHPs have of the role of the HPCSA towards addressing EH professional activities.

133

“Honestly, I don’t know the role of the HPCSA and I’m not sure what it does for us as EHPs except for paying money every year and being expelled if you have not paid” (WDM01). “The only thing I know is that, it is a body by which as an EHP, you need to be registered with, other than that, I don’t understand clearly” (NDEHP02). “HPCSA should be looking after the profession but I’m not quite sure in what extent it is doing that” (WDEHP01). These responses highlight the importance of clarity of roles and communication of those roles to the affected parties. It would seem that even if the HPCSA might be working hard with the aim of serving EHPs, they are unlikely to appreciate the service, if they do not understand the role HPCSA plays in meeting their interests. Lacking understanding of the role played by the HPCSA could have serious implications in assuring that EHPs rely on it for their professional identity. It is therefore imperative that the HPCSA takes steps to determine what works and not just assume that everything is working well and that people are compliant, not realising that they are not pleased with the way things are done.

Concern 2: Serving both on the HPCSA Professional Board and the Professional Association Research participants also raised a concern over the dual role of serving on the HPCSA Professional Board of EHPs, which is a statutory regulating board and the South African Institute of Environmental Health (SAIEH), which is a professional association. Linked to this concern was the notion that some members belong to both these two bodies that seem to be serving the same roles as far as they are concerned. This anomalous situation raised the question:

“How can a member serve dual roles by playing a prominent role in the Professional Board and simultaneously in the Professional Association?”

Research participants believed that belonging to the Professional Board, the HPCSA and simultaneously being an executive member of the Professional Association (SAIEH) is likely to cause a conflict of interest. This concern is comprehensively captured in the following paragraph as expressed by one of the research participants:

“Currently, some of us as EHPs, are very much confused because we are paying so much for HPCSA to take care of our professional growth, and to be aware of the trends and be guided. HPCSA should make sure that EHPs are always updated about developments in the profession – this is why they renew their subscriptions every year. HPCSA is supposed to take care of the continuous development of EHPs. Presently, there is a great confusion about the role of the HPCSA, compared to that of SAIEH. What I have seen so far is that there is

134

a conflict as to who sits on the HPCSA, and who sits on SAIEH? If they sit on both sides, is that not a conflict of interest? And what are their common interests? Are their interests common with me as an EHP? Who actually represents me as a professional? Whose interests are served? If HPCSA is no longer interested to take care of my continuous development, what are the agreements between these two bodies? I acknowledge that SAIEH talks my issues – the issues that are handled within SAIEH are much relevant to my profession and even to my daily life – I appreciate that. I just need to understand what is going on between these two and this dual membership – how far it will go? Who controls who? Who is the executor and who is the regulator?”(CDM03).

It could be deduced from this expression that clarity is needed on how one becomes a member and the role one plays in being a member of either a professional body or a professional association. The Professional Board as pointed out in section 5.2 is established through the provisions of the Health Professions Act no. 56 of 1974 with a mandate to regulate the affairs of the profession concerned. EHPs elected or appointed to serve on a professional body do so by own freewill44. In this regard, they have a choice to accept or refuse to sign nominations and appointment forms to serve on the Professional Board (Health Professions Council of South Africa, 2008e).

Contrary to a professional body whose role is to guide relevant profession and to protect the public, a professional association, for example the SAIEH, provides an alternative platform for voluntary professional association of EHPs in South Africa. It appears per the concern in this section that a confusion has been created on the ground which needs clarification of roles of members who are appointed to serve on the Professional Board – HPCSA [which is a statutory body] but still actively serve in the executive of the Professional Association – SAIEH [which is a voluntary body]. It appears that the confusion is related to how the member would separate the role of being a regulator when serving on the Professional Board and the advocacy role when he or she is a member of the Professional Association.

A professional association by its very nature has the primary interests of serving its members, unlike the statutory professional body whose scope of service is meant to cover the interests of the profession that affect all professional members within its control. The reality is that even with the ideals of having regulated processes of appointing members of the Professional Board,

44 _{The HPCSA regulations governing the nominations and appointments of members of a professional board} clearly articulate the processes to be followed in nominating, selecting and appointing candidates for a professional board. The transparency of the processes which involve the gazetting of names afford prospective candidates a choice to agree or disagree to serve as members.

135

simultaneously serving on both the HPCSA, the statutory professional body and the SAIEH as pointed out by the research participants appears to have sent confusing messages to some practising EHPs, particularly those who were not members of the SAIEH. They might have fears that members of the Professional Board are likely to have a bias towards the interests of their association.

The perceived conflict of interest is difficult to resolve in that as long as it exists, it has the potential to tarnish the image of the Professional Board and its integrity might be questionable to the EHPs who are not pleased with this kind of arrangement, hence raising it as a concern. It would therefore seem prudent for the HPCSA and SAIEH to clarify their modus operandi pertaining to dual role practice that allows members to concurrently serve on both the Professional Board of EHPs and the Professional Association, the SAIEH.

Concern 3: Paying Annual Fees and Lack of Communication

A total of fifteen (43%) of the sampled research participants raised the issue of the paying of annual professional fees by EHPs, which was of a great concern. Apparently, research participants questioned the payment because they felt that the HPCSA only contacts EHPs once a year when they are required to pay or are being reminded to pay. This situation made them associate the payment with the contact the HPCSA arranges to consult with EHPs and the public through roadshows. The concern is encapsulated in the following statement:

“I think the HPCSA basically needs money from us and I don’t know the role they are playing. The money we pay as EHPs is too high. You come to hear about HPCSA only when you are expected to register. To me, they are not active throughout the year and nothing happens until the next registration. There is no communication or anything else” (NDEHP01).

The above statement indicates unhappiness about the annual fees paid by the professionals. Apparently, participants needed to know why they pay such fees when they are not aware of the service the HPCSA provides for them. They seem to expect some communication and engagement with the HPCSA (which seems to be lacking) so as to be given reasons for the payment of fees. Research participants to some extent acknowledged the role of the HPCSA, but seemingly would prefer better engagement and exchange of information. The Professional Board of Environmental Health Practitioners has an annual newsletter intended to be distributed to all EHPs in both hard copies and electronic formats. Such a bulletin highlights important Environmental Health Practitioners professional related issues (Health Professions Council of South Africa, 2017). The bulletin is an important communication tool between the Professional

136

Board and EHPs. The distribution and communication of this newsletter, however still requires attention to better the engagement of EHPs and the Professional Board. Encouraging EHPs to submit articles and sharing their ideas could probably increase EHPs’ value attachment to the bulletin.

The participants did not seem to question the legality of the fees, but rather the returns from the fee payments. The truth of the matter is that paying annual professional fees is inevitable given that Section 19 of the Health Professions Act, no. 56 of 1974 read with Section 62(1) prescribes the payment of professional fees by all professionally registered health practitioners in South Africa. Failure to pay leads to removal of the professional’s name from the register, meaning that one loses the licence to practise as an independent practitioner (Republic of South Africa, 2007a). Section 61(2)(3) of this Act, further stipulates that if one fails or refuses to pay the prescribed annual fees, the HPCSA is entitled to recover the fees through a competent court and the affected person’s name would be removed from the register within three months from the due date.

According to the HPCSA, the rationale for the fees, which seems to be unclear to the EHPs, is to cover the costs of running the professional boards and other administrative duties of the HPCSA (Health Professions Council of South Africa, 2015f).