The following describes my experience of medical negligence at Groote Schuur Hospital in Cape Town. Familiar to anyone who has experienced medical negligence, it relates how the profession – doctors, nurses and administrators – react when their self-styled superiority is challenged and the lengths they go to deny mistakes and avoid accepting responsibility irrespective of the effect it has on patients. (Long read.)
1
In September 2001 I presented myself at Groote Schuur’s outpatient Martin Singer Hand Clinic (orthopaedic department) with a five day-old feral cat bite wound to the right index finger metacarpal phalange (knuckle) joint, an emergency referral by my general practitioner. My hand displayed three penetrating bite wounds to the joint, was immensely swollen – it looked like a big, red glove – and extremely painful. Courses of antibiotics and pain killers, including codeine, had failed to mitigate the condition.
Dr Christopher Michael Hobbs, a British orthopaedics registrar and fellow from Southampton University Hospital in England, was an attending hand surgeon. Based on a brief clinical examination and case history – he did not order X-rays as would be expected with an orthopaedic injury – he diagnosed cellulitis, an infection of the skin.
Two days later at my return visit he discharged me over my protestations that something was wrong. My condition – pain, inflammation and stiffness – was still extreme and had not returned to within normal parameters. The nurse said my type of injury was serious – I could lose a finger – so we were confused why I had been discharged.
A week later I was still in distress, and my GP made another appointment. At the hand clinic the nursing staff and Hobbs, whom I approached directly, refused to see me. I left without been attended to.
Bizarrely, later the unit’s head, Dr Mike Solomons, used the clinic's refusal to admit me that day me as a defence. According to him, I should have insisted upon proper medical attention. By his unfathomable reasoning, I was to blame for departmental failures and what subsequently happened.
Over the years there have been numerous reports of patients been "turned away" – refused admission – from clinics and hospitals in the Western Cape health system whether or not their condition was serious, so I was not the first or last this happened to. Some cases resulted in death. This practice is illegal and unconstitutional. The department always downplays these allegations, and typically, following an "investigation", dismisses them outright.
Over the following three weeks, condition worsening, I consulted my GP, a physiotherapist and two other doctors, one of whom was a general surgeon. By this time – the last week of September 2001 – an abscess had developed, and according to the surgeon, my hand was "very bad" and needed immediate surgery. But I could not afford a private hospital, so there was no choice but return to Groote Schuur.
A different hand surgeon, Dr Roger Graham, ordered X-rays, which he said was the minimum that should be done for all orthopaedic injuries. It shockingly revealed infection had eaten away the head of the joint. The diagnosis was bony osteitis and acute septic arthritis, a life-threatening condition if the infection enters the bone or blood stream.
The operation to debride septic tissue and bone was performed 9pm the same day, immediately after a black woman whose husband had slit open her palm with a broken bottle during a drunken argument. Dr Graham was competent and considerate. I was the fourth consecutive patient he had operated on since 1pm without a break. At the end of surgery he told me the joint was permanently damaged, with complete destruction of the cartilage and significant loss of movement. My hand would never be normal. Following the operation I was under outpatient care for 14 months. A concern was that infection had spread to the bone, but fortunately this was not the case.
2
Medical negligence is the variation from standard medical practice. I subjectively knew I had not received proper medical care from Hobbs and the hospital. Later, the hospital’s own specialists (Martin Singer) and private specialists and medical literature I consulted in the period that followed confirmed Hobbs’ initial and follow-up assessments, diagnosis and treatment of a routine orthopaedic injury was wrong and inadequate.
As with all bites to the hand, cat bites is a medical emergency. Hands have no protective fatty tissue on top and cat bites in particular, with their fine, needle-like teeth, are dangerous. Hobbs should have admitted me for intravenous antibiotics and, if required, debridement, especially considering the injury was five days old. He did not.
According to the literature, “hand surgeons must have a high degree of suspicion” for septic arthritis following bites to the hand. Exquisite pain in the joint, especially following a bite or penetrative injury, is the key marker for septic arthritis. Hobbs was unaware of any of this and failed to make a proper diagnosis. He ought to have ordered X-rays as a minimum. He did not order any tests or scans.
The preferred treatment plan for cat bites is clavulanic acid-amoxicillin (trade name Augmentin), intravenously or orally, to overcome the prevalent resistant bacteria in cats’ mouths. He prescribed flucloxicillin, a less effective alternative.
A basic medical procedure for any medical condition is to wait until the overall symptoms have returned to normal baselines before discharging the patient. Hobbs discharged me when the underlying condition (septic arthiritis) had not been diagnosed and symptoms (pain, inflammation and stiffness) had not resolved itself.
He made numerous mistakes – “mistakes at many levels” - hand unit head Mike Solomons later wrote in his report, and ignored protocols from the initial assessment and diagnosis to the treatment plan he prescribed and absence of follow-up care. However, Solomons and the hospital exonerated him and instead blamed me for not diagnosing and treating myself.
3
When I first met Christopher Hobbs that day in September his Oxbridge accent was noticeable (later I learned he was a graduate of Cambridge University medical school and was a lieutenant in a British Army corp based in Yorkshire) among the largely poor and working class African and mixed-race (“coloureds”) clinic patients. When, conversationally, I asked if he was British, he curtly replied, “I’m British but I know hands”.
Including that, I found him to be aloof and uncommunicative unlike his South African colleagues. To be fair, this could be ascribed to an unfamiliarity of local culture – South Africans are friendly with strangers – and race groups. Many patients spoke only Afrikaans and Xhosa. This must explain his defensive and unnecessary reaction to my innocuous comment about his nationality, but not his incompetence.
Hobbs’ poor communication skills are important because he did not ask many questions about my condition and was unfamiliar with the local brands of antibiotics and painkillers I had been taking the previous four days. I saw him first on a Tuesday. On the follow-up visit two days later, he asked no questions and ignored me when I told him my hand was not improving.
Later, I could not understand how a graduate of the prestigious Cambridge University did not know how to spot and diagnose septic arthritis and treat cat bites when it was voluminously covered in the literature. (South African hospitals are favourite locations for visiting, foreign doctors because of the high incident of violent crime and diseases that provide training opportunities absent in their own countries. However, as Britain is an animal-loving nation, cats there are plentiful.)
I dislike bringing up race, but having mentioned the clinic’s patients were almost all African and mixed race – I cannot recall one white patient in the year I attended – would Hobbs have treated me differently had I been white, especially the day I returned and he refused to see me? It’s impossible to say, but from his eyes, as a white person, would I have been worthy of his full attention rather than his outright dismissal?
4
In the first week of October 2001, a couple of days after my surgery, I wrote to the hospital accusing Dr Christopher Hobbs of medical negligence, sending a copy to the health department. The hospital acknowledged receipt and the department’s head of medico-legal services, Dr David Bass, replied he would respond once the hospital completed its investigation. I never heard from him again.
But later I had indirect dealings with this disingenuous and oleaginous bureaucrat. His nefarious influence came up in my dealings with hospital officials about the matter. I should note for clarification that as I had elevated my complaint to the health department, they should as a matter of procedure have sent me a report in the first instance, irrespective of how the hospital responded.
Interestingly, in 2002 or so a tearful Western Cape health department employee alleged on a local talk radio station 567 CapeTalk that a senior departmental official – who, in turns out was Bass who had played a key role in my case – had allegedly pressurised him to drop a criminal complaint against a Red Cross Hospital doctor, a friend of Bass'. Another official confirmed the employee’s account when interviewed. This must be their modus operandi – I was also harassed to drop my complaint against Hobbs.
During October 2001 when I attended the outpatient hand clinic for a routine check-up – at that stage I was attending every week or two – the head nurse, Sr Orrie, told me Hobbs wanted to see me. He is a “good doctor”, she said.
Despite saying I did not want to see him, I was ushered to Hobbs. More loquacious than our first meetings, he pleadingly justified his treatment of me. I told him he had ignored the signs of my condition, but did not want to discuss the matter – I had laid a complaint. Withdrawing his hands from mine, which he had been clutching, in supplication I thought, his expression closed at my words. He turned toward hand clinic head Mike Solomons, who was nearby, and said, “He wrote a letter of complaint.”
I then moved to Solomons to undergo my medical examination. I had never met him before, so to my surprise the first thing he said was I should “put aside your letter [of complaint]”. Other than that he hardly spoke to me, and when he did, was irritable and brusque to the point of rudeness. When he was done, he again told me to put aside the complaint.
I was ambushed the moment I entered the clinic that day – from the nurse, to Hobbs and the recalcitrant Solomons, all of whom, I gathered, were already aware of my negligence complaint. But none had deigned to give me the deserved attention a month before when I begged them to properly examine my injury.
Hobbs’ motives for wanting to speak with me were not altruistic or to mitigate a mistake – if he had made a genuine mistake I would have accepted it – but for selfish, damage control and reputational reasons. His aside to Solomons confirming I would not withdraw my complaint and Solomons’ aggression toward me that day and subsequently was the result of me not giving in to their pressure. I complained of Solomons’ harassment to the hospital’s chief medical director (superintendent) Dr Peter Mitchell.
This was the start of the hospital’s and health department’s aggression, obfuscation, evasion and lies which lasted over the following three years. In his 4 December 2001 report of Hobbs’ treatment of me – I only obtained sight of this report in August 2002 – Solomons libellously attacked my state of mind, of which he had no first- or even second-hand knowledge, and was acerbic about my “intelligence” for lacking the medical knowledge to properly self-treat the infection following the bite, something he exonerated Hobbs for.
5
The director of outpatients, Dr Tunc Numanoglu, was designated to investigate my negligence complaint. During October and November 2001 I asked for progress. First, an assistant told me he was on leave, and when I managed to get hold of him late November, he said he was waiting for Dr Solomons’ – who was allegedly on leave – report. This was strange because during October I saw Solomons on duty in the hand clinic and orthopaedic department.
The reasons for these delays became evident when I received Numanoglu’s carefully worded letter dated December 12 and received the 21st. It was four paragraphs and said:
1. Septic arthritis should have been diagnosed. They regretted my “perception the standard of care” was not as it should be.
2. Dr Hobbs had returned to England. The hospital would cooperate with any investigation of him by the Health Professions Council of South Africa. They had no further comment to make about him.
3. They respected my choice if I wished to obtain treatment elsewhere.
I was astounded. A call to Groote Schuur’s orthopaedic department revealed Hobbs had left the hospital and returned to England on December 1st or 2nd. So it was clear they – Solomons and Numanoglu – had not undertaken any investigation of his professional conduct and had permitted him to continue working as normal until he was allowed to leave with his reputation and record intact. Also, they allowed him, after I had raised the complaint, to have improper contact with me. Note it is hospital and Western Cape Health Department procedure to respond to written complaints within 25 days. This one had taken three months, or it took them that long to reply.
The minimum procedure in such circumstances is to subject the doctor to an internal peer review. This was not done. Only after Hobbs left the hospital forever did they think it was safe to complete their reports and notify me. Numanoglu’s letter was worded – “perception of the standard of care” – as if we had all imagined the misdiagnosis, and they regretted I felt I had not received appropriate care.
I could not understand why the reputation of this incompetent foreigner, who repaid his host country this way, was more important to the hospital than the duty of care and wellbeing of a patient. Also, did they believe with him out of the way I would drop the matter?
Outraged, I fired off a letter to chief director Peter Mitchell rejecting every aspect of the letter. I appealed to the head of the Western Cape health department, Dr Keith (Craig) Househam, and the provincial health minister, Piet Meyer, both of whom refused to review the hospital’s findings and said the matter was closed.
I was naive. I had hoped for a sincere apology for a mistake and to get on with my life. But this arrogant, unrepentant attitude and dishonest manipulation of the truth infuriated me.
In January 2002, replying to my letter of December 5, the Health Professions Council of South Africa (HPCSA) notified me they had no record of a Dr Christopher Hobbs on their register. They asked for his hospital personnel records. They also suggested I contact the British General Medical Council. (I did. The GMC asked me to send all records I had of the case, but a few months later said they had no remit to investigate “mistakes” British doctors made outside the United Kingdom.)
I phoned the hospital’s staff records department, which confirmed Hobbs had been employed there for two years from January 2000 to December 2001. But the clerk said it was “strange” they had no practice number for him. She told me he had come to the hospital from Southampton University Hospital. I wrote to SUH, which confirmed Hobbs had been on staff in the orthopaedics department.
All doctors are required to be registered with the HPCSA before they are allowed to practice, and are issued with a practice number. If Hobbs had no practice number it meant he had not been registered. In other words, he was unlicenced when he treated me.
I sent a copy of the HPCSA’s letter to Mitchell for an explanation who replied that Hobbs was indeed registered from January 2000 to 11 December 2001. The information Mitchell provided – December 11 was a week or so after Hobbs had returned to England – contradicted the HPCSA’s records. I did not believe any of it but forwarded it to the HPCSA anyway.
In April 2002 I received a phone call from a HPCSA legal officer, who confirmed Hobbs had been removed from the register in May 2001, four months before he treated me. He said Hobbs was in “serious trouble” and had committed a criminal offence by continuing to practice after this date. I should lay a charge with the police. He claimed they could not act as they had no jurisdiction.
So, Peter Mitchell, the hospital’s chief director, had fraudulently misrepresented – I assume he checked and discovered the same thing I did – that Hobbs was registered, when, in fact, the latter was not. The matter was quickly turning into a serious criminal and ethical matter.
I raised Hobbs’ registration with Househam. One would have thought the Western Cape health department would be concerned at the highest levels about having allowed an unlicenced doctor practice for seven months. At the very least, allay my concerns. But there was not a peep from them.
This was unusual and telling – legally and procedurally they must respond to formal submissions from patients and public. However, they were in denial, which was evident from Bass’ response to a journalist's questions when I took the matter to the Cape Argus, which published in July 2002 under the title "British Doctor Leaves Furore in Wake".
I was not imaging there was frantic scurrying around in the background. In January 2002 when I phoned the orthopaedics department to request information about Hobbs, a secretary said, “Oh, so you that Mr Johnson. Dr Rossi and Dr Numanoglu were discussing what to do about you.” What to do about me?
Dr Alfredo (Al) Rossi was head of hospital’s medico-legal department.
I could not understand. If Hobbs was becoming an embarrassment and liability, why lie for him? He was not even a citizen, or in the country. Why not just give him up? Did they owe him some perverted sense of loyalty that stretched beyond the bounds of legality and ethics? The truth was they ducked and dived to evade ethical and professional accountability and legal liability for his incompetence and in doing so sullied themselves and became even more dishonourable than they had behaved to then.
It would have been amusing if not sad that these clever, important people – Mike Solomons, Peter Mitchell, Tunc Numanoglu, Al Rossi, David Bass and Craig Househam – who occupied senior management posts and individually and collectively represented a massive investment of taxpayer resources of money, education and training, were running scared of a poor, unemployed person who had no resources, except a deep sense of insult.
I asked the HPCSA to investigate these officers for unethical conduct. They declined except to say it was a “very sensitive matter”. At the time I believed their reluctance was due to the political sensitivity of investigating senior officers of a major hospital and government department, which until recently under Public Protector Thuli Mdonsela was not done in South Africa. Not known for being a fearless champion of medical and ethical standards, the HPCSA was happy to be rid of Hobbs and the mess he left behind.
6
After surgery I began the long process to recover from the physical and emotional trauma of a life-altering event. The physical wound was still raw. At that stage I went to clinic every week (from November it was every month) for a check-up. I did not need or deserve attitude from recalcitrant and aggressive hospital administrators. However, this was exactly what I got. Immediately, for reasons I could not fathom – not until later anyway – the hospital adopted an adversarial approach.
It is a patient’s fundamental right to have access to and copies of his medical records. But even with this basic procedure, the hospital – by which I mean outpatients director Tunc Numanoglu and the hand clinic – was obstructive. This is how they had always done it – dismissive of patients and the public.
In February 2012 the then chief executive of Groote Schuur Hospital, Dr Terence Carter, regarding another matter, told me in an email a “patient-centred approach” was not part of the health service’s ethos. How can patients not be at the centre of what they do? Only recently has the department, though still combative and opaque, become slightly more responsive to public pressure.
Hand clinic staff refused to hand over the X-rays for copies to be made. The clerk handling my application had to search for them at the clinic herself. I could understand why they were reluctant – the X-rays showed in graphic detail the damage to my hand wrought by Hobbs’ flawed diagnosis.
On 11 February 2002 I requested a copy of Mike Solomons’ report, the one Numanoglu told me he had been waiting for. A month later Al Rossi denied my request on the grounds it was “privileged statements by staff members”. However, I knew my right of access was absolute because it was part of my medical records, a patient's fundamental right. I rejected his explanation for the nonsense it was and appealed to chief director Peter Mitchell, without success.
The only basis to decline my request was if the report, as with my other medical records they reluctantly released, formed part of litigation. The Promotion of Access to Information Act of 2000 clearly emphasises this exception, which Rossi and Mitchell would have known. However, at the time no litigation was envisaged and neither had I raised it with the hospital.
On March 14 I complained to the South African Human Rights Commission, which oversees compliance of the act. On May 14 the SAHRC’s Victor Southwell wrote to me that because “appropriate” agencies – Groote Schuur hospital and Western Cape health department – had satisfactorily dealt with the matter, they could not “second guess” them (actually, it's their job to do so). Also, during a phone conversation on May 16, their intern Mondi told me that Dr David Bass, head of medico-legal services of the department, informed them they had not provided me with Solomons’ report because I intended litigating. The SAHRC therefore deemed the matter closed.
This was a lie I intended litigating. Firstly, Rossi never mentioned litigation as grounds for refusal – he said the report was a privileged staff statement. Secondly, there was no litigation – no lawyers or legal papers, not even informal discussions with the hospital, about lawsuits. Bass had no real evidence to give the SAHRC to support their version, so lied.
As early as December 2001 Mitchell had already referred to my “intention to litigate”, which I corrected saying it was his interpretation of my robust exchanges – given what they were putting me through – with the hospital and department. It was part of their agenda to create the unnecessary adversarial and antagonistic situation I mentioned before. To misrepresent a matter when there are especially legal consequences – the failure to abide by access to information precepts – and to a state investigative body, is fraudulent. However, the SAHRC unquestioningly accepted Bass’ dishonest word. I appealed, pointing out the lies and inconsistencies, but never heard from the body again.
The SAHRC, a chapter 9 constitutional body, in my experience, was neither competent nor professional. First, they lost my affidavit of complaint and supporting documents and I had to resubmit it all. Later, when I phoned to ask if the investigation had commenced, I was huffily told staff had gone on a “workshop” at a coastal resort town and it took precedence over any investigation. Over the years the SAHRC has courted controversy with their arguably political rather than technically and legally proficient findings. Some would argue the SAHRC is a tool of the African National Congress, making political statements rather than findings that further human rights.
In 2012, a decade later, I filed an access to information request to the health department for all records pertaining to the case. Unsurprisingly they – Bass and Househam were still the designated officers handling such requests – declined me access to many of the records because of my past, and extinct, legal action instituted between 2003 and 2004. I appealed to Premier Helen Zille. Provincial health minister MEC Theuns Botha – allegedly an “independent” person for the purposes of the appeal – denied it.
Later, I mentioned the difficulties I had obtaining my records to a manager in the health system. He was astounded and said a patient has an absolute right to his records. However, he told me Botha does what Househam tells him to do.
7
Soon after taking office in 2009, with much fanfare, Botha introduced a new complaints process to address the department’s self-acknowledged unsatisfactory response to complaints of poor medical care. He appointed a putatively independent panel of medical and other experts to review patients’ complaints. However, the problem was that only Botha and his head of department Craig Househam would select which complaints were referred to the panel.
Around December I emailed Botha and said the panel was not independent if he and Househam – who from my experience was an unsympathetic, department-biased technocrat who had done nothing with the compelling medical, ethical and criminal evidence against Christopher Hobbs and Groote Schuur Hospital and therefore colluded in the matter – decided which complaint merited the panel’s investigation because they could manipulate the process.
Botha’s private secretary phoned me but was unprepared for my questions. Perhaps he thought I would be so grateful for the call I would accept anything he said. He became defensive and irritable when he was unable to answer my basic objection or questions about why they did not do it properly, merely stating the Western Cape was the only province to institute such a body. I ended the call saying he was unhelpful.
It was obvious Botha, while perhaps well-intentioned but acting under Househam’s recommendations or instructions, lacked the vision to make the proposed mechanism all it could be. More worrying was that it probably was a subterfuge to lull the public into a false sense of confidence. Embarrassing for Botha, he had to disband the panel because it did not meet legal scrutiny. If it was reinstituted, so insignificant was the event because it fell under the radar. Botha, a former member of the apartheid National Party, who after 1994 found refuge in DA leader and Western Cape premier Helen Zille’s increasingly right-of-centre Democratic Alliance provincial cabinet, has underwhelmed in his now – 2014 – second term as health minister. He subsequently resigned allegedly due to ill-health.
Despite claims of improving accountability, the health department under its once-liberal DA rulers proved to be the same conservative, unaccountable and reactionary entity it had always been. In April 2012 the Cape Argus broke the story that the head of Eerste River Hospital’s ER had been fired for publicising appalling conditions at the hospital. The department spokeswoman, Faiza Steyn, wrote to the Cape Argus, published in the letters page on 4 April 2012, and described the conditions at the hospital as “disturbing”. However, instead of offering an explanation, she went on the attack and blamed the dismissed ER head and the hospital’s chief executive, and alleged the paper was conducting a “vendetta”.
In the period that followed, Househam denied the former ER head had been dismissed for speaking out about conditions, but for his alleged irregular appointment to the post. He also asserted there was nothing wrong at the hospital and they had nothing to hide. However, the doctor stood by the reason for his dismissal. The Cape Argus’ investigation, including interviewing other staff who had been warned they would be fired for speaking, confirmed the situation.
I could not understand why the department’s regional manager with oversight of the Eerste River Hospital, Dr Giovanni Perez (back in the day, an anti-apartheid activist), was apparently unfamiliar with the reported conditions. Did Perez not regularly visit and meet with hospital management? Was it not part of his well-paid job to head off problems before they occurred?
I put these and other questions to Steyn in an email. Combative, she insisted he had properly managed the facility. But if that was the case, she could not explain how the situation had escalated to that point. When I rejected her unconvincing reply, she backtracked and conceded they had a long way to go to achieve publically acceptable standards of service.
The relevance of this episode can be summarised by an extract from a letter I wrote to the Cape Argus about the matter, published on April 11, 2012:
“Steyn’s response (of April 4) reminds me it must be a departmental trait to automatically defend and distract questioners’ attention from the real issues. I believe the department lacks management competence. The failures reported now occur too often for it to be anything else. It’s irrelevant to blame a former employee, but not themselves, when the cause may lie in departmental management or a systemic defect of the system. The problem is poor management and a strategy and staff complement that do not focus on patients and their needs. Only a clean sweep of Dorp Street (the department’s head office) deadwood will bring the desired changes.”
In 2013 an arbitration panel was scathingly critical of the department’s reason for dismissing the former ER head – proving they lied to the public – and set it aside. The doctor was awarded a settlement of 12 months’ salary.
The same department executives who played a key role in my complaint against Hobbs and Groote Schuur Hospital in 2001 occupied the same posts in 2012 and had a role in the Eerste River Hospital matter. They – the deadwood I referred to – are still there today in 2014. The clean sweep I had hoped for will never happen because the culture of impunity and unaccountability is too strongly ingrained among South Africa’s incompetent and venal politicians and bureaucracy. (Househam retired after this date.)
8
In August 2002, after a routine check-up at the hand clinic, I confronted Rossi in his office off Groote Schuur’s main mall about the Solomons report and the manner they had conducted themselves. Staff and patients were milling around.
Normally soft-spoken, in a loud voice I accused the hospital of protecting Christopher Hobbs and not cooperating with the police investigation that he had practiced medicine without a licence. Rossi assured me they were and repeated the lie that Solomons’ report was “confidential, doctor-to-doctor”. He must have forgotten that, according to Bass, it was denied me because I had intended litigating because he never mentioned litigation.
However, nothing he said was believable, and he did not try hard to convince me. The detective inspector investigating my complaint had told me the hospital refused to give them Hobbs’ employment records and they had had to obtain a warrant. I did believe Rossi though, when he said he was acting under the “orders of my superiors”. Most likely this was Bass from whom Mitchell would also have taken orders about the case.
Last year a medical director in the health system told me hospitals have leeway in how to resolve patient complaints. Nominally this is departmental procedure – patients must first approach the hospital in question before referring a complaint to the department. However, I suspect this procedure applies to all cases except those of malpractice, as mine was, when the department takes over.
9
On the legal side, in March or April 2002 I laid a charge of failing to practice medicine without a licence, i.e., without registration with the HPCSA. In South Africa this is considered fraud.
Two months later - early June - I called Woodstock Police Station when I heard nothing. They told me the case was transferred to the now defunct Cape Town Fraud Unit (these units were disbanded in 2006, which experts believe undermined policing).
I went to their Foreshore, Cape Town offices a few days later without an appointment. I was shown to the investigator's office, which reeked of smoke. The detective captain had a lighted cigarette in his hand. As I told him why I came, his commander, also smoking, came in and leaned against his desk. he was openly curious. "So you're the person", he said. It appeared he had been forewarned. On entering the unit's offices I had asked a staff member who had my case docket. "This is a nuisance case", he said without preamble or embarrassment.
The investigator said they were waiting for an affidavit from the HPCSA giving Hobbs' registration status, a copy of which I had already given them. I understood they needed an original, though. When I left I got a bad feeling, and directly from the horse's mouth, that they weren't taking the case seriously. (I complained about them to Max. His office sent an "independent" officer purportedly to take my statement. He drank my tea and ate my biscuits, but was more concerned about telling me what fine officers they were. As to be expected, there were cleared of wrongdoing.)
In August when I hadn't heard from them and they were unavailable, I complained to provincial police commissioner Lennit Max. He put a female inspector on the case who called me to introduce herself. Already she could report progress: she had obtained Hobb's personnel file from Groote Schuur. They had had to obtain a warrant because the hospital refused to give it freely. Compare Rossi's lie to me (section 8 above) they had "cooperated" with the police.
A month or two later she notified me the docket was sent to the prosecutor and in eventually, because I had made enquiries about it there, in December to Cape Town's Director of Public Prosecutions (DPP).
In January 2003 the DPP informed me bluntly that they declined to prosecute, and I asked why, because "no crime had been committed". I knew this was legally wrong. This was before the Internet and Google and it took me over two years of badgering a disinterested HPCSA hierarchy, the regulators of health legislation and profession, to get a reply, mainly to get rid of me.
Their reply, which was March 2005, stated Hobbs had contravened the Health Professions Act and, apparently, sounding exasperated, undoubtedly because they had to spell it out, said they couldn't understand why the DPP had made that incorrect determination. The DPP was wrong!
I wrote to the DPP enclosing the HPCSA's letter. Advocate S--- phoned me on receipt. He was , aggressive and unapologetic . "What do you expect us to do", he abruptly asked. "To do your job", I replied. It was clear they didn't know South Africa medical law, so why did he sound as if I had done something wrong?
A week later I received a letter. Sounding slightly more amenable he noted the HPCSA's finding and confirmed Hobbs had broken the law. But because of the lapse of time (that was their fault, which he didn't admit), it would be "unfair" on Hobbs to prosecute, and the offense didn't warrant extradition. However, they could apply for a bench warrant. I thought that was at least something if Hobbs was unwise enough to return to the country, which I knew he wouldn't.
10
Months later when I was near Cape Town Magistrate Court, on the spur of the moment I went in and asked the clerk of the court to check if a bench warrant had been issued against Hobbs. She said one hadn't. I told her the reason for asking was the suspect had fled the country before prosecution, which was not strictly correct.
The truth was that at different levels, different people in positions of power and authority colluded to shield Hobbs and allow him to leave the hospital and country unchallenged and unpunished. The hospital's management by actively protecting him, and police and DPP out of indifference, laziness and incompetence. They were, and still today, are not interested in upholding and maintaining your or my rights, but only the interests of those important and powerful.
In the words of the Constitutional Court judges in the Vodacom "please call me" case, it is not "the kind of conduct to be expected from an ethical corporate entity; it leaves a sour taste in the mouth" and is "disgraceful".
Conclusion
There's a story in Khaled Hosseini's book And the Mountains Echoed.
A family return to their village after the wars. They discover a rich and powerful former warlord has claimed the father’s ancestral land as his own and built a mansion on it. The family has nothing, except the land. The father travels to the capital and submits his ownership documents to a judge.
When he returns to court for the hearing, the judge tells them there was an accident, a fire, and the documents were destroyed. While the judge is telling them there is nothing he can do without the documents, they notice he is wearing a new gold watch he had not worn before.
Apart from the obvious tragedy, to me the story refers to power relations and the alliances that are made between the rich and powerful. The rich and politically and socially influential, which includes politicians and their servant bureaucrats, collaborate and bring their influence to bear on individuals, organisations and institutions to deny supplicants, often victims and the poor, ownership, justice and dignity. They are impervious to and unperturbed by the entreaties of the poor and unconnected.
Dockets and documents disappear or are misfiled; complaints never receive proper attention and investigations are inexplicably delayed or abandoned, often without any work having been done. One incompetent or corrupt institution refers to the findings of another incompetent or corrupt institution as definitive, although neither has the incontestability of a judge’s ruling.
This happens more often than we like.
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First posted on 1/09/2011. Revised 27/07/2014, 30/04/2016 and 26/04/2018.
Omitted from this account for space (it's already long) is my attempt at legal action against the Western Cape Health Department of which David Bass played a significant part. And the ethically questionable role of my attorneys, Millers Inc, who tried to force me to accept a risible settlement, and when I refused to, resigned.
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