Doctors battle red tape

Staff shortages due to immigration red tape could put services at hospitals such as Victoria Hospital under pressure.

Complying with immigration regulations is a nightmare experience for foreign medical staff.

Victoria Hospital hit a staffing crisis in May that led to the cancellation, for at least one day, of all emergency surgery and threatened patients’ lives, says a senior anaesthetist at the district hospital.

The reason, says Dr Sampath Weerakkody, is that his work visa had expired and he was waiting for it to be renewed.

Dr Weerakkody was born in Sri Lanka and has spent most of his life in Britain. A member of the Royal College of Anaesthetists, specialising in anaesthesia and critical care, he came to South Africa in 2012, on a general work visa, one of many doctors who come to the country to gain experience in emergency medicine – things like gunshot wounds and stabbings.

But his intention to practise medicine here, he says, set in motion cumbersome bureaucratic machinery.

His first stop on the paper trail came in 2011, before coming out here he had to register with Foreign Workforce Management (FWM), which is part of the Department of Health, as well as with the Health Professions Council of South Africa (HPCSA), the statutory body that regulates health workers, registers doctors and disciplines them if they do something wrong. That all took nine months.

He then applied to the Department of Home Affairs for a temporary residence visa and a general work permit.

Dr Weerakkody then worked in hospitals in KwaZulu-Natal, but moved to Cape Town in 2014, where he landed a five-year contract at Victoria Hospital in April of that year.

Because he had changed provinces and was upgrading his visa from general to critical skills he applied for a new FWM endorsement.

Then in January this year, on one of many visits to Home Affairs he was charged with being an illegal immigrant and taken to Cape Town police station and formally charged. It took almost two hours to be processed. “My only way to continue with my application for a critical skills visa was to admit guilt, which I did,” he said.

Then on another day he had to go to court to have his case processed and pay a fine of R400 so that he could proceed with getting his critical skills visa.

Then one evening in May, Victoria Hospital told him he couldn’t come into work – he had had been suspended because of his visa status.

Dr Weerakkody’s said his most recent application for a critical skills visa had been erroneously rejected by Home Affairs which had led to him not being paid for 13 days by the provincial Department of Health.

He said the critical skills visa lasted for three years after which you had to reapply. “This should take three months but in practice it can take up to a year,” said Dr Weerakkody.

Home Affairs spokesman Mayihlome Tshwete said a critical skills visa is issued to applicants who had skills the country needed. “We prioritise these people and fast-track their applications. We’ve processed thousands each year and our turnaround time has improved drastically,” he said.

Another doctor has had similar problems but did not want to be named because his visa is up for renewal.

He came to South African in 2010 on a general work visa and also worked inKwaZulu-Natal hospitals.

In 2014, he applied for permanent residency, citing his critical skills. Ten months later, he was refused by Home Affairs: he had not included a British police clearance certificate.

With the help of an immigration agency, he appealed. He was turned down again: he had not included an FWM programme endorsement, even though this requirement, he says, is not featured in the Home Affairs check-list for submissions.

He continued struggling with Home Affairs until mid-September when he sent a tweet to Home Affairs Minister Malusi Gigaba and the acting chief of permits.

In less than two weeks his certificate for permanent residency was ready for collection.

Dr Afke Robroch wasn’t so lucky. She was forced to leave South Africa in August after her application for a critical skills permit was granted three days before her work permit expired. She had applied in June 2014.

Dr Robroch recently appeared in a Carte Blanche segment “Visa Vitriol”. She was a Fellow Paediatric Intensive Care doctor at University Medical Centres in Amsterdam and Groningen.

In 2013, after a two year wait for registration with HPCSA she quit her job and moved to Pietermaritzburg to work at Grey’s Hospital. She was one of four paediatric specialists in KwaZulu-Natal.

When she first applied for a critical skills visa her application was rejected. She later discovered that she had received the wrong paperwork. Reapplying numerous times, thinking she had the correct paperwork, it was rejected again in September 2015.

She was told that one document was missing – a document she had with her when she applied but was told it was not needed.

Appealing the case she was informed there was an 11-month backlog and the appeal would only be looked at in October 2016.

She then tried to extend her work permit which expired on July 1, 2016. The new permit was processed on June 28, after she had booked tickets back to Holland and accepted a job at a hospital there.

Department of Health spokeswoman Monique Johnstone said Victoria Hospital’s human resources department had gone to great lengths to help Dr Weerakkody.

The hospital had been legally bound to terminate his contract until Home Affairs approved his documents.

“The doctor was informed by the hospital that he will be taken off their system from Sunday 1 May 2016 and asked to take his remaining leave days including unpaid leave until his working visa was renewed by Home Affairs and then placed back on the system on Friday 13 May 2016 after he could legally work at the hospital again,” said Ms Johnstone.

At no time, she insisted, had surgeries been cancelled, and the hospital had used other on-duty doctors to help with the extra workload.

“The hospital has sufficient doctors on duty but undue pressures are felt if unforeseen incidents occur where other doctors cannot perform their duties.”

The Bulletin contacted Joe Maila of FWM but they did not respond to our questions about the three doctors’ visa applications. And the

SA Medical Association and the HPCSA declined to comment about the medical skills shortage.

Asked why registration takes so long, HPCSA spokeswoman Priscilla Sekhonyana did not reply, instead sending a list of requirements for foreign doctors.

Meanwhile, with much support from Victoria’s human resource department, Dr Weerakkody’s critical skills visa was granted and he returned to work there three weeks later.

He is frustrated by the visa process saying what should have taken three months took 11 and also led to him suffering the indignity of being arrested prevented from working. “Foreign doctors bring their knowledge and expertise to this country, often buying property and also contributing to the economy. But instead of being welcomed they run the gauntlet of applying for work visas – a lengthy and expensive journey,” said Dr Weerakkody.