One in 10 doctors under investigation by HPCSA contemplated suicide: survey

A new survey of 204 doctors has revealed one in 10 have suicidal thoughts during Health Professions Council of South Africa (HPCSA) investigations into allegations of unprofessional conduct against them.

Conducted by the Medical Protection Society (MPS) — which protects the professional interests of 30,000 healthcare professionals in South Africa — the survey was done among those investigated by the HPCSA between 2018 and 2022.

Eighty-three percent said the investigation caused stress and anxiety, while 61% said it had a detrimental effect on their mental wellbeing.

Nineteen percent considered leaving the medical profession or South Africa to practise in a different country as a result of their investigation.

One in 10 (11%) said they experienced suicidal thoughts during the process.

In addition, 71% of practitioners said the length of the HPCSA investigation affected their mental wellbeing, with some lasting many years, while 81% said the initial, unexpected notification of the investigation affected them most.

Doctors spoke of a “guilty until proven innocent” tone in the initial HPCSA letter.

“The case has been dragging on and I am feeling desperate. I have also thought of leaving the profession as a whole,” said one doctor.

Another said: “It places a strain on one’s mental wellbeing, you feel like a criminal, like you have deliberately set out to injure a patient, which is never the case.”

A doctor said when he received communication from the HPCSA regarding allegations against him, he was already made to feel guilty and that he had to prove his innocence.

“It has had a massive effect on my wellbeing and functioning at work. The complaint came out of nowhere, it was totally unexpected. I had to take a few days off when I learnt of the complaint and after the HPCSA said they needed me to attend a preliminary inquiry,” said another doctor.

This has prompted the MPS to call for “significant changes in how the HPCSA investigates allegations of unprofessional conduct against healthcare practitioners”.

The organisation says the survey results are a stark reminder that while the HPCSA has made improvements to its investigation processes, there is still work to do to ensure cases are resolved quicker and do not impact on the mental wellbeing of those involved.

MPS head of medical services, Africa, Dr Graham Howarth, said: “Through our work supporting members, we see first-hand how a HPCSA investigation takes its toll on the mental wellbeing of those involved, particularly the length of the investigation. We are aware of some complaints taking more than a decade to be resolved, which is unacceptable.

“We know the HPCSA is bound by its regulatory framework and there are statutory obligations which may be causing delays. We also recognise and welcome that the HPCSA has put some measures in place to help speed the process up, but we believe more can be done to expedite investigations by both the HPCSA and the department of health. Justice delayed is justice denied for both the complainant and the healthcare practitioner.

“We would also like to see improvements to the way the HPCSA communicates with registrants during an inquiry and investigation. For example, adopting a more empathetic tone, and making it clear in the initial letter that the practitioner under investigation is innocent until proven guilty, which may limit the impact on mental wellbeing.

“A practitioner under investigation should also be told how long the process should take and when they can expect updates, and the HPCSA should consider introducing an independent 24/7 wellbeing support service.

“The constructive engagement we have had with the HPCSA on this issue and their willingness to consider a number of our recommendations is positive. We hope to continue this dialogue.”

TimesLIVE has reached out to the HPCSA and is awaiting a response.

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