SA health-care workers 'afraid to practise and afraid for their lives', doctors say

05 October 2020 - 06:30
By Belinda Pheto
Professor Peter Beale, right, and the late Dr Abdulhay Munshi after appearing in the Johannesburg magistrate's court in August.
Image: Erin Bates Professor Peter Beale, right, and the late Dr Abdulhay Munshi after appearing in the Johannesburg magistrate's court in August.

A group of health-care professionals have warned of the “destruction” of a functional health system in the country should the persecution of doctors without following due process continue.

This follows the arrest of the two specialists, murdered anaesthetist Dr Abdulhay Munshi and paediatric surgeon Prof Peter Beale, who were charged with culpable homicide after the death of a prominent businessman's 10-year-old son.

Munshi was gunned down in Orange Grove on September 17, two months before he was due to reappear at the Johannesburg magistrate's court on November 16 alongside co-accused Beale.

In March, the doctors wrote letters to the department of justice and director of public prosecutions, the minister and department of health, facility groups through the Hospital Association of SA and Day Hospital Association of SA, and the HPCSA, the statutory controlling body for health-care workers. They copied in the presidency.

Among other things, their letter spoke about their unhappiness with what they described as a lack of due process followed in the arrest of the two specialists.

“The warrants of arrest were issued prior to the initiation of any inquiry or inquest by either the Health Professions Council of SA (HPCSA) or the department of public prosecutions (DPP)," the group said in a statement published last week, in which the letters were attached.

One of the submissions in the letter reads: “The profession of medicine and surgery is unique — it requires an injury to be inflicted to heal. Inquest and inquiry allow for interrogation of complex medical matters to understand the causes. Demanding due process does not place doctors above the law but enables fair treatment for the practice of a unique profession.”

The doctors said laws and mechanisms were already in place for an inquest into any medical complication in an expeditious manner.

“The HPCSA must prioritise clinical patient-related inquiries and come to findings with speed.”

They also pointed out there is a failure of interdepartmental collaboration and communication between the ministries of health, justice, the department of public prosecutions, the HPCSA and the presidency in the matter.

The doctors also alleged the HPCSA was not acting efficiently as a regulator which they say has forced some private or public facilities to act as quasi-regulators.

“This is damaging to clinicians and facilities and serves to undermine quality patient care. Our regulators and prosecuting authorities must fulfil their mandate and expedite inquiry and inquest,” the doctors said in the letter.

They said the majority of functional health-care systems globally have established procedures and mechanisms to ensure no medical professional reaches criminal prosecution without clear evidence of reckless negligence.

They called on the citizens and the media to hold public structures to account by demanding answerability, rapid action and a mandated procedural solution.

“The prosecution of ingenuous health-care workers will have dire consequences for SA’s health-care asset. Without immediate action and intervention to restore the confidence of health-care workers in regulators and the justice system of our country, we will witness the destruction of any semblance of a functional health system — public and private.”

In the statement, the doctors said they were shocked when they heard about Munshi's murder.

“The treatment of SA health-care professionals as common criminals prior to inquiry is untenable. The collective concerns for the national health-care asset include a reticence for young South Africans to choose medicine as a career choice; avoidance of complex and high-risk interventions in providing medical care (that leaves high-risk patients without access to medical care); and an exodus of health-care professionals from the country.

“These are all based on fear of arrest for recognised complications. A failure to address these concerns represents a real and tangible threat to our national health-care asset and therefore a threat to the goal of achieving universal health care.

“Learning of the murder of a much-admired and respected colleague [Munshi] has pushed the health-care workforce to breaking point. It follows on from the assault and attack on a number of health-care workers by the public and families of patients over the past year. The health-care workers are insistent on action and response to the March 18 2020, memoranda,” it reads.