Cancer Alliance takes Gauteng health bosses to court over huge backlog

An unemployed mother on chemotherapy and awaiting further CT scans fears for the worst. 

Thato Moncho is one of the cancer patients in Gauteng waiting for a CT scan which will determine whether the cancer is in remission or still spreading. She fears that should the scan return with positive results, meaning the cancer is in remission and there are no longer cancer cells in her lungs, she would be eligible for radiation oncology treatment which she might not receive.

She is one of many patients on the waiting list for radiation oncology services at Charlotte Maxeke Johannesburg Academic Hospital. She was diagnosed with stage 2 inflammatory breast cancer in September 2021. 

Moncho worked as a professional trainer until she was recently employed at a gym company. However, due to work conflicts with colleagues rooted in the amount of sick leave she took, she had to resign.

“I have a 14-year-old daughter, who still needs her mother. It is my dream to live so that I can watch her grow, complete school and pursue her dreams. However, at this point I believe that the hospital is robbing me of that opportunity,” she said in a supporting affidavit as civil society organisations took the department to court.   

Cancer Alliance, represented by the NGO Section 27, filed an application against the MEC for health in Gauteng, the Gauteng department of health and nine others in response to the health department’s failure to use the allocated R784m set aside by the Gauteng treasury in 2023. 

The application was set down for Tuesday at the Johannesburg high court. 

This follows the department's alleged inaction in the provision of urgent radiation oncology services to the 3,000 patients on the backlog list. 

Cancer Alliance wants the failure to devise and implement a plan to provide radiation oncology services at two hospitals to cancer patients on the backlog list by the MEC, the department, the director-general in the department of health, and the CEOs of the Charlotte Maxeke hospital and the Steve Biko Academic Hospital  to be declared “unlawful and unconstitutional”.

The organisation said in the court papers that it wants the department to be directed to update within 45 days of the hearing the list of cancer patients who are awaiting radiation oncology services in Gauteng.

It also seeks to interdict and restrain the Gauteng health department from paying, disbursing, or otherwise dealing with R250m which has been allocated specifically to address the radiation oncology backlog in the province, pending the outcome and finalisation of part B of the application.

Cancer Alliance also wants the department to be directed to file a progress report within three months on the steps taken to provide radiation oncology and a long-term plan to provide radiation oncology services to patients at the two hospitals. 

In part B of the application, which is the review of the head of the department's decision, Cancer Alliance wants the court to review and set aside the decision to allocate R250m of the R784m for outsourcing radiation oncology services.

The organisation said the decision was irrational, arbitrary, unlawful and of no force or effect.

According to the court papers, Cancer Alliance said there were two main issues which brought about the radiation oncology crisis at Charlotte Maxeke. . 

“There is a lack of sufficient radiation equipment (LINAC and brachytherapy machines) and there are barriers preventing Gauteng health from procuring the equipment.” 

The NGO noted three challenges around the lack of radiation equipment, specifically at Charlotte Maxeke.  It said the shortage of machinery was a result of two Cobalt machines being decommissioned and maintenance issues with the remaining machines. 

It said the tender process to replace the two decommissioned machines commenced in 2019, was abandoned in 2021 and started afresh in January 2022. Though it is not known where the process is now, the organisation confirmed the procurement was done. 

“In the meantime, Charlotte Maxeke has had to manage the influx of about 2,000 new patients a year, as well as the about 3,000 backlog patients, with only four machines.” 

According to the application, even if machinery were to be procured it would take almost nine months to have the machines installed and operating. This is because of the high cost of the machines which manufacturers often start manufacturing only when they have received an order.

“In addition, there are insufficient healthcare professionals appointed for radiation oncology at Charlotte Maxeke. There are challenges relating to the appointment and remuneration of additional suitably qualified professionals,” read the court papers. 

Gauteng DA shadow health MEC Jack Bloom said court action to force the department to spend budgeted money to save cancer patients reminded him of the negligence that led to lives lost in the Life Esidimeni tragedy.

“It seems the lessons of the Esidimeni disaster have not been learnt. The DA will continue to pressure the department to provide decent cancer treatment by using questions and motions in the Gauteng provincial legislature (GPL). People should not die because of the department's notorious corruption, incompetence and negligence,” he said. 

Gauteng health department spokesperson Motalatale Modiba said the department was aware of the legal application brought by the Cancer Alliance and other organisations regarding the alleged misallocation of R784m intended for cancer patients. 

“The department wants to state unequivocally that it will be opposing this matter in court. 

“It is important to clarify that the application by the Cancer Alliance is primarily driven by the awarding of a tender in which their preferred service provider failed to participate within the validity period,” he said.

He added that the department “remains committed to providing essential healthcare services for the people of Gauteng and continues to comply with all requirements to ensure that radiation oncology services are delivered to all patients who need them”. 

“The department takes these allegations seriously and is dedicated to maintaining transparency and accountability. We will continue to uphold our responsibilities and ensure that all funds are used appropriately to benefit cancer patients,” he said. 

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