Long awaited regulations for Nursing training gazetted: Now what?

Regulations gazetted last week relating to the accreditation of postgraduate qualifications for nursing and the designated nursing colleges that will offer the new qualification, was widely welcomed.

The regulations come in the context of public concern over the fate of prospective nursing students for the 2020 academic year. From next year the old curriculum will be completely phased out in line with the new qualifications sub-framework of the Department of Higher Education, Science and Technology that is due to take effect from January 2020. The change over process started in 2015. The public now has a month to comment on the proposed regulations.

Until last week there was much confusion over the postgraduate curriculum and regarding which nurse training institutions are accredited to offer this new curriculum.

MPs in the Portfolio Committee on Health pressed the Minister of Health Zweli Mkhize and his department for answers on the delays when they were in parliament last week to brief MPs on its annual report and budget.

“We are extremely concerned,” ANC MP Dr Kenneth Jacobs told Mkhize. Freedom Front Plus MP Phillip van Staden asked for certainty and DA MP Siviwe Gwarube warned- “If we don’t rectify these issues around nursing training it will undermine your whole primary healthcare strategy.”

Mkhize and his department’s answer? “The regulations will address these concerns.”

But did it?

On Friday after the regulations were gazetted some opposition parties were not happy with how the process was managed. DA MP Siviwe Gwarube warned the regulations “are merely a stop-gap measure for the greater issues around full accreditation of nursing colleges as institutions of higher learning”. “That is why we will be holding the Department of Health accountable for this process with their Department of Higher Education and Training counterparts. We need a permanent solution,” Gwarube said. “Nurses are the backbone of any health system especially one that requires greater focus on primary healthcare. We cannot play Russian Roulette with nursing training in South Africa.

Chief operating officer in the National Department of Health Dr Gail Andrews, said ten colleges will be offering the postgraduate qualification and three universities have been accredited to offer it. “Seven more universities have been submitted to the South African Nursing Council (SANC) but are still being assessed for accreditation.”

According to the notice in Gazette the ten designated nursing colleges will offer Certificates, Diplomas and Bachelor degrees in nursing which are accredited and registered on the Higher Education Qualifications Sub-Framework from January 2020 until they are declared as one of the institutions as provided for in the Higher Education Act.

The ten public colleges include – Lilitha College of Nursing with five campuses, Free State School of Nursing with three campuses, Gauteng College of Nursing with six campuses. Free State School of Nursing, Gauteng College of Nursing with 6 campuses, KZN College of Nursing with 11 campuses, Limpopo College of Nursing with 5 campuses, Mpumalanga College of Nursing with 4 campuses, Henrietta Stockdale Nursing College in the Northern Cape, North West with 2 campuses, South African military health service nursing college with 3 campuses and Western Cape Nursing College with 4 campuses. In provinces the nursing colleges were amalgamated into one provincial nursing college with sub-campuses at the different health institutions.

 

Overall readiness

Mkhize earlier in response to a written parliamentary question on nursing numbers said there are 285 704 nurses registered with the South African Nursing Council in the public and private sector at present.

Chief Nursing Officer in the Department of Health Nonhlanhla Makhanya during the last committee meeting in December last year, told MPs  3 535 nurses had qualified in 2018 and 3 417 had been placed. She also told MPs the department was busy with a report on the “state of readiness of nursing colleges, which included the accommodation, human resources and infrastructure”.

Makhanya and the department did not respond to Spotlight’s questions on this report and the overall readiness of the colleges for next year’s intake.

When Spotlight approached the provincial nursing colleges for comment on their readiness, responses were limited to one province.

Western Cape spokesperson for Health Mark van den Heever said the WC College of Nursing is ready for the 2020 intake. “We are just awaiting accreditation of the new programmes by the South African Council for Nurses (SANC).”

Van den Heever said the province was impacted by the delay with the regulations. “Without the regulations we could not offer the new postgraduate diplomas in nursing that is expected to start in January 2020. We could also not finalise the development of the new curriculum in respect to those speciality nursing qualifications.” He said despite this the department took the opportunity granted by SANC for a second intake of students enrolled in legacy qualifications to close the gap.

It is unclear what the situation is in other provinces.

A World Health Organization Report in 2017 found that in January that year there were 401 543 nurses and midwives eligible to practise nursing in South Africa. SANC statistics show the present ratio is one nurse for about 202 people.

*Comments on the Proposed Regulations can be submitted to the Director-General of Health, Private Bag X828, Pretoria, 0001 or emailed to mihloti.mushwana@health.gov.za for attention Director Public Entities Governance.