Court to settle dispensation saga
Innocent Selatlhwa | Monday October 2, 2023 06:00
In a recent development, BONU, represented by their legal counsel, Busang Manewe, appeared before Justice Modiri Letsididi here on Thursday to seek an urgent interim interdict while preparing for a full review application.
At the heart of the review application is the challenge to the legality of permitting nurses and midwives to dispense medication, as well as the Ministry of Health’s directive issued on September 5, 2023, mandating health facility leaders to ensure that nurses and midwives participate in medication dispensing.
Manewe asserted in court that since July 1 nurses and midwives have refrained from dispensing medication. He argued that this practice is not only unlawful but also contravenes their code of ethics.
BONU contends that its decision to cease medication dispensing was prompted by its commitment to align with the Medicines and Related Substances Act of 2013 and the Nurses and Midwives Act of 1995.
Underpinning BONU’s stance is Section 26 (1) (a-c) of the Medicines and Related Substances Act, which unequivocally states that operating a dispensary without proper authorisation constitutes an offence punishable by imprisonment and/or fines. They emphasise that the responsibility for medication dispensation rests with authorised healthcare professionals, effectively barring nurses and midwives from assuming this role.
Manewe argued that the urgency of the matter compelled them to swiftly approach the court as soon as they became aware of the September 5 directive for nurses to engage in medication dispensing.
He contended that requiring nurses and midwives to carry out this function, which might lead to criminal charges, places them in a precarious ethical and legal position, contradicting the principles they solemnly swore to uphold. Manewe dismissed claims that the unions were adequately informed about the Job Effectiveness Description, which the government cited as the basis for having nurses and midwives participate in dispensing medication. He argued that the government’s reference to an unsigned document amounted to an attempt to legitimise an unlawful practice that flouted established guidelines for nurses and midwives.
In opposition to BONU’s application, the government, represented by Attorney Tebogo Pusoetsile, contested the notion of urgency. Pusoetsile argued that a deadlock had been reached between the parties as early as June 28, making it unnecessary to file an urgent matter. He also pointed out that a more suitable time to approach the court would have been after August 11, following a notice that authorised nurses and midwives to dispense medication.
Additionally, Pusoetsile invoked the BOMRA Act, noting that the Director of Health Services has the authority to authorise individuals to dispense medication. According to him, this authorisation eliminated any concerns that nurses and midwives might be acting criminally when dispensing medication. He further emphasised that nurses had been engaged in this practice for years, making the sudden urgency questionable.
Pusoetsile contended that as essential service providers and per their recognition agreement with BONU, nurses and midwives were prohibited from participating in industrial action. He argued that given their historical involvement in medication dispensaing, abstaining from it now would be a breach of the Trade Dispute Act.
Justice Letsididi is expected to deliver his verdict on the matter on October 6. The outcome of this case holds significant implications for the role of nurses and midwives in dispensing medication in Botswana’s healthcare system.