‘I’ve been sitting at home dependent on my mother, who is a cleaner. She is the only breadwinner and I have other siblings so it is not an easy situation. I thought by now I’d be able to help my mother by supporting my siblings but I can’t… I am back at home, hopeless, not knowing what I am going to do and trying not to fall into depression.”

These were the words of a devastated 24-year-old student from Queenstown who asked not to be named for fear of reprisals.

The student was part of the first cohort that enrolled for the four-year Bachelor of Science in Speech & Language Therapy introduced by the University of Fort Hare (UFH) in 2018.

However, students who completed their studies in 2022 and 2023 are yet to graduate because the Health Professions Council of South Africa (HPCSA) does not recognise the qualification.

Concerns raised in 2019

Another 24-year-old student from Nqamakwe in the Eastern Cape, who also asked not to be named, said students had voiced concerns about the teaching methods.

“In 2019 – our second year – we started questioning how we were being taught. We were being taught in blocks… we would have a guest lecturer come for maybe a week or two and teach us an entire module,” she said.

“We raised our concerns with the head of department and staff and they showed us papers of accreditation from HPCSA and higher education.” 

Another student said she didn’t know much about the degree when she registered since it was new, but university staff assured her it was accredited and a viable career option.

“We started noticing issues when it was time to do our practicals… Most of those issues were during our final year when it was time to do our OSCE [Objective Structured Clinical Examination].

“The HPCSA was meant to sit in during that, but they never did. We were told that the HPCSA had said they were unable to come because they were informed about our exam too late,” she said.

In 2022, students were told they had insufficient clinical hours.

“Even though we did our hours and submitted, we had to go and redo those hours. They [HPCSA] then came back and said that we didn’t qualify to register for community service because they were not there to monitor our OSCE and were not happy with the standards,” she said.

The student said the HPCSA took a long time to respond to queries from the university and that students had spent almost all of 2022 at home. 

“The HPCSA said we must redo the OSCE for the second time. We did the OSCE and they complained again, saying the questions that were asked were not appropriate for an exit-level exam,” she said.

According to the student, the questions were sent to the HPCSA for approval and they had been approved.

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The Nqamakwe student said she learnt of the accreditation issues in 2022, the year she was supposed to graduate.

“We were not given the entire truth about what was happening. It was said that we were still lacking clinical hours. So some students did go back and do their hours, but there was no response,” she said.

The students were then informed that the HPCSA wanted them to repeat their final oral examination as the HPCSA had not been present the first time.

“We did it, but the results did not come. We were then informed that the type of examination we were given did not meet exit-level outcomes,” she said.

The university implemented a six-month special intervention programme in 2023 to enable the students of 2018 and 2019 to register with the HPCSA. According to some students, they are still awaiting the results of this programme.

No communication

Many students said there had been little to no communication from the university or the HPCSA. 

“Right now we are not getting any information directly from the university or the HPCSA… we just hear on news outlets what the HPCSA is saying about the degree,” said one student.

“We have no idea what is happening – all we got from the institution was that they are still waiting for communication from the HPCSA. But what we’re seeing in the news is a different story to what the institution is telling us,” said another student.

Daily Maverick sent questions to university spokesperson JP Roodt on 16 January and a follow-up email on 19 January. At the time of publication, Roodt had not replied.

When Daily Maverick approached Christopher Tsatsawane, head of corporate affairs at the HPCSA, he said: “We are no longer responding to issues relating to this matter. Thanks.”

According to DispatchLive, Tsatsawane said the university needed to “wholly implement the improvement plan to remediate and address to satisfaction the recommendations made by the HPCSA speech, language, and hearing board (SLH). 

Tsatsawane said the programme had been evaluated on-site on 22 and 23 June 2021 and in a virtual interview on 6 July 2021.

“The UFH’s report on the evaluation of the SLT (speech, language and therapy) programme highlighted several challenges noted with concern by the SLH board: staffing, curriculum, assessments, resources, clinical education, quality assurance, governance, student recruitment and final year students [2018 and 2019 cohorts].”

The report of the reviewed programme and the challenges in the review report indicated that students graduating from this programme would not meet the HPCSA criteria to register as speech-language therapists. 

He said that in November, the University of Fort Hare submitted a progress report on the improvement of the programme, which the board reviewed and found that there were still aspects of the improvement plan on which the board needed more clarity, including staffing, curriculum and governance. 

Spokesperson Roodt said the university was in good standing for the programme regarding accreditation and standards, as outlined by the SA Qualifications Authority and HPCSA.

“Accreditation of our programme has always been there and remains in place.

“In line with the requests and recommendations by HPCSA, the university responded with a six-month supplementary support initiative for our students which concluded in December.”

Students in limbo

A 24-year-old student from Lusikisiki said she was “disappointed, angry and emotionally drained” by the ordeal. 

“I received my academic record from Fort Hare, but it is incomplete. It just states that I stopped attending, which I don’t understand because I finished all my modules, so I’m stuck here… I cannot go anywhere,” she said.

Another student expressed similar sentiments.

“We are without hope at this point. We’re not sure if we’re going to be registered or not and no one wants to say what is the way forward. The HPCSA is not giving any clear answers – they say that they are waiting to hear back from the university, and the university is also saying that they are waiting for the HPCSA,” she said.

The student from Nqamakwe said the uncertainty was affecting not only her mental health but also that of her family. 

“My mother is a very old lady… 2021 was supposed to be my final year and she was supposed to retire that year, but she insisted that she will continue until everything with my studies is clear. She is still working and she is suffering. Her health is deteriorating day by day and I can’t help out with anything,” she said.

“We are just sitting in despair right now. We don’t know what is going on. Our future is being tossed around. We did our part and yet they are still not giving us anything.

“They should tell us the truth and see how they can compensate us.” DM