A preliminary investigative system to disciplinary inquiries of the Health Professions Council of South Africa, with specific reference to Maxillo-Facial and Oral Surgery

Abstract

The purpose of this study was to evaluate the effectiveness of the committee of preliminary inquiry (in the context of professional conduct committees) of the Health Professions Council of South Africa, with specific reference to maxillo-facial and oral surgery. An evaluation was done of cases that were referred by the committee for preliminary inquiry to this specific professional conduct committee of the Medical and Dental Professions Board. Where necessary, these cases were supplemented by relevant cases from other professional conduct committees. In order to achieve this goal, a comprehensive literature study was conducted on the broad concept of medical and dental misconduct and negligence. Specific attention was paid to the issues of expert testimony and witnesses and consent. Furthermore, a study was conducted to determine the legal framework in which these committees are supposed to function. In the cases where inquiries into the complaints against the registered practitioners followed, a detailed evaluation of the so-called legal process was done, as well as the findings in each case (in the context of the professional conduct committees). The results of this study have shown that the investigative system of the committee for preliminary inquiry preceding professional conduct inquiries into complaints against registered practitioners has certain shortcomings, especially in the more complex cases. The following proposals have been made (in order of most importance): 1. Both the committee for preliminary inquiry and professional conduct committee must abide by the rules of natural justice, as pertained in the Constitution of the Republic of South Africa. 2. Establishment of a Forum of Expert Witnesses that will evaluate all cases of alleged professional misconduct and negligence pertaining to the field of maxillo-facial and oral surgery, after it was evaluated and referred by the Ombudsman. 3. Appointment of a maxillo-facial and oral surgeon as Ombudsman to evaluate all cases brought before the committee for preliminary inquiry pertaining to the field of maxillo-facial and oral surgery. 4. Acceptance of the proposed test of medical negligence, i.e. the ‘reasonable person’s test’, subjected to that of the ‘reasonable specialist’ as standard for evaluation of cases of alleged negligence in maxillo-facial and oral surgery. 5. The proposed patient’s consent form serves as an example of a legitimate patient consent form. It follows that the legal requirements, especially in cases of extensions and deviations of medical interventions, must be adhered to. 6. It is advisable to belong to an organisation providing indemnity cover (such as Medical/Dental Protection Society) in order to receive proper assistance in the handling of these cases of alleged unprofessional/disgraceful conduct. The recommendations consequential to this study would provide a more streamlined, cost- and time effective investigative system to investigate claims of unprofessional conduct for possible further disciplinary action.