|
This past year I had had the privilege of working with a
wonderful executive committee. They have been dedicated in
dealing with the interests of all members, and no query has
been left unanswered.
This year, the 10th year of South Africa’s new democracy,
has seen the introduction of significant legislation affecting
the health sector. There is no facet of practice, private
or public, that is not affected. Attempts by the Medical Association
of SA and others to challenge aspects of some of the legislation
have failed. SA Heart is in no better position than these
other parties to tackle the correctness and application of
these pieces of legislation, and certainly does not have the
financial muscle to do so. It is really now a question of
living with the legislation and adapting to it, rather than
trying to fight against it.
One issue is the prescribed minimum benefits (PMB).
Some aspects of this chronic disease list and the treatment
algorithms associated with it are problematic. SA Heart is
aware of the inappropriate use of certain drugs for some disease
conditions, and in due course will make representation to
the concerned parties regarding these deficiencies. This is
a very complicated process and one has to bear in mind that
the aim of PMBs is to keep essential health care affordable.
However it is our responsibility to point out errors that
can be potentially harmful. If any SA Heart member comes across
problems regarding the legislation and in particular the treatment
algorithms, then they must please contact the executive committee.
I have tried to keep members informed about aspects of the
legislation and how it may affect patient management. This
year, the newsletters have had a section devoted to practical
tips in dealing with treatment protocols and drug formularies,
and members are encouraged to use this information in responding
to funder queries.
SA Heart has been active on the broader political front
regarding our association with other organizations. The
European Society of Cardiology at its past meeting in Munich
changed its statutes to allow non-EU countries to become affiliate
members of the ESC. We have applied and recently received
a communication that shortly we will be officially confirmed
as an affiliate member. This will give us a closer liaison
with our European colleagues, help facilitate exchange of
ideas and information, and will promote joint meetings and
cooperation. We will be able to formally adopt the ESC guidelines
for disease management. This will help us in dealing with
the problem of the selective choosing of guidelines by the
health department and industry and clear the confusion that
exists. We will get our local authorities to write caveats
on the application of those guidelines to South Africa, rather
than attempting to re-write guidelines.
Later in October SA Heart will be sending a delegation
to Accra, Ghana, to attend a meeting of PASCAR (the Pan African
Society of Cardiology). This organization has been largely
inactive for a number of years and need to be re-vitalized.
We hope to take an active roll in that process. It is obviously
important for us to strengthen ties with our African colleagues
and also help promote joint meetings, studies and cooperative
ventures. A further report on the outcome of that meeting
will be given in a future newsletter.
SA Heart has actively promoted and aided research and
researchers in South Africa. Travel and research scholarships
to the value of R48,000.00 have been given. A donation of
R50,000.00 was made to the Circulatory Disorders Research
Fund last year and a further R25,000.00 this year. R25,000.00
was given to promote a local satellite meeting of the International
Society for Heart Research. The executive committee believes
it is important to continue to promote research and researchers
in South Africa and will hopefully be able to continue to
give support where appropriate. Members are again reminded
of these travel and research scholarships/grants and to apply
timeously for them.
This past year has seen the addition of SASCI and LASSA
as special interest groups to SA Heart. While these and
others form part of SA Heart, it has not yet been defined
how the relationship should be effected. Matters of meetings,
congresses, memberships, funding, etc. need to be ironed out.
To this end we will have discussions with the relevant parties
to work out how the relationship should be conducted. It is
important that the interests of all are accommodated where
possible and that uniformity is achieved. We hope to reach
consensus on these issues by early next year.
We also need to re-think the way we hold our annual meetings.
It is a major task to undertake to organize our annual congress
and AGM. Historically the organizers have received only a
big thank you for their effort. There has never been any form
of financial compensation for the time and effort expended.
We work in a new environment, and I believe that we must change
the way we operate. These meetings are conducted professionally
and require professional input. I see no reason why the organizer/s
should not be financially rewarded for their efforts. What
needs to be decided upon is how we measure that compensation,
and what the value of that compensation should be. Approval
from the membership for us to proceed in this direction will
be sought at the AGM.
Also regarding the congress, we need to re-think the need
for an annual ‘general’ meeting. The executive
committee feels that we should alternate the annual ‘big
general’ meeting with a more focused meeting conducted
by one or more of the special interest groups. Again how this
is implemented will be a matter for discussion between the
executive committee and the special interest groups, but approval
of this idea in principle will also be sought at the AGM.
Two projects were implemented this past year, although
the initiation for them arose last year. The “cath lab
registry” was started a few months ago. It is currently
in use in a few pilot centers and once the initial teething
problems have been sorted out, we hope to roll out the project
to as many centers as possible. This is a very important project
as it will enable us to collate data on practice trend and
procedure types and numbers. All information is kept strictly
confidential as regards individual practitioners. Anton Doubell
heads this project and members wishing to find out more or
enroll in the project can contact him directly. The second
project is that of the "script pads". We have
started collecting data on scripting. This is done via a dedicated
script pad. Information regarding the ICD10 code and the drugs
prescribed is gathered and collated. Again the information
is kept strictly confidential, and whilst individual members
can access their own data, the central collation is blinded.
Currently only a few members are involved, but once we have
had an initial feedback, we hope to expand the project to
all willing members. Len Steingo is in charge of this project.
These two projects are important in that they will allow SA
Heart to access information and practice trends. It is likely
that the future will force us to participate in such ‘registries’
and it is important that we drive the process, rather that
have it imposed upon us. With these two systems up and running
we will be well positioned to adapt to potential future legislative
requirements.
Lastly I wish to stress that the Association is there for
its members. What you will get out what you put in. I want
to encourage the newer and younger members to take an active
role in the matters of the Association. We need to have ‘new
blood’ in the committees, giving fresh ideas and impetus
to the Association. Give feedback to the executive committee
on matters that affect your practice, Constructive engagement
and suggestions are always welcome. Let us face the challenges
of the future together.
Dr Colin Schamroth
top of page
|
