Thomas Johnson - Medical Blog

Catholic weekly newspaper The Southern Cross columnist Sarah-Leah Pimentel (“Lesson in humanity from a cat", 20-26 November 2019) writes it's an untenable moral problem to spend money on expensive medical care for animals, as recommended for her friends' ill cat Sparky (an MRI) she cared for while they were away, when many people don't have access to basic medical care. I appreciate she loves Sparky and would do what’s “financially and morally” feasible for him, and I acknowledge that from her writing she’s a compassionate person. But her argument which she couches as a moral dilemma of “how can we justify cutting-edge medical care for animals while thousands of people do not have access to basic care” is specious because it lacks equivalence. As she wonders, “it is not right I have access to the best medical care but the majority battle in the hope they will receive the help they require”. In South Africa 17% of the population with access to private health acco...

I sent Dr Beth Engelbrecht, the head of the Western Cape Health Department (WCHD), Premier Alan Winde and Wendy Philander, DA chair of the WC Parliament Health Committee a report of my assessment of the WCHD's service. This followed an exchange of emails with Engelbrecht last week in which I told her about my experience at Abdurahman Community Health Clinic last month. In my email I referred to Daily Maverick's uncritical interview of her about the department's first clean audit and her giving themselves top marks for performance managing a "burning platform" (see here ). I contradicted their good news story with known problems about and my and users' poor assessment of facilities. She replied, "Thank you for your mail. Please accept my unreserved apology for your negative experience of our services. We strive to be as best we can and what you have experienced is very unfortunate. I fully agree that a clean audit reflects good governance, yet the pa...

The Cape Town office of the National Prosecutions Authority (NPA), aka the director of public prosecutions, is reluctant to open a corruption case against the Health Professions Council (HPCSA) and medical committee member Prof. Elmin Steyn after last month directing me to lay a charge with the police. In this blog (see here and here ) I relate how this came about. In May the HPCSA's Third Committee of Preliminary Inquiry cleared six doctors and their superiors implicated in my mother's death in 2017 at Groote Schuur Hospital (GSH) and for covering it up. The decision was irrational: they ignored the law and their own precedent for similar cases, and the inquiry was procedurally flawed having violated inquiry regulations. There was proven bias and conflict of interest. Committee member Steyn[1] of Stellenbosch University and Tygerberg Hospital, had a prior and ongoing personal-professional relationship with one of the accused, Prof. Andrew Nicol of UCT and GSH. On Augus...

This is a response to Daily Maverick section editor Mark Heywood's article about the Western Cape Health Department's (WCHD) first clean audit . In it he interviews head of department Dr Beth Engelbrecht. The pedant in me corrects Heywood where he mentions "superintendent-general" Beth Engelbrecht.   The correct title is "head of department". (Hospital "CEO" replaces "superintendent".) Many people, especially politicians, bureaucrats and media, make too much of clean audits . There's ignorance and misinformation about financial year-end audits. The objective of an audit is to express an opinion on the financial statements. It's not to express an opinion on management's decision-making prerogatives, service delivery or any other aspect, as Engelbrecht and Heywood believe. I assume the WCHD previously received "[financially] unqualified audits with findings on "reporting on material [significant] performan...

Rot in the woodpile   On 1 October 2019 President Cyril Ramaphosa launched the Health Sector Anti-Corruption Forum (HSACF).  The noble objectives are to “fight against fraud and corruption in the health sector who will together prevent, detect and prosecute fraud and corruption”.  Among its members are the National Prosecutions Authority, SA Police Service, Special Investigations Unit and Health Professions Council (HPCSA). However, already there’s rot in the anti-corruption woodpile.   Putting aside that the NPA is in a continual state of paralysis, what Sunday Times columnist Barney Mthombothi called “chaos and incompetence” among his severe criticism of Ramaphosa (18/08/2019).   Ditto for SAPS and HPCSA, which itself is touched by the stink of corruption. In 2015 the minister of health said the HPCSA is “in a state of dysfunction”.  The Special Investigations Unit (SIU) is investigating bribes for medical registrations and exam passes t...

In 2015 the minister of health found the Health Professions Council (HPCSA) is “in a state of dysfunction”. The Special Investigations Unit (SIU) is investigating staff who allegedly took bribes for medical registrations and exam passes. Whistleblowers reported it. Dr Wouter Basson won related cases against the HPCSA’s disciplinary committees in the Gauteng High Court and Supreme Court of Appeal for bias and conflict of interest.   Two members of the committee of the inquiry into complaints about his apartheid-era work were among those who had brought charges against him for.   Recently I laid charges against the HPCSA and members of its Third Preliminary Committee of Inquiry.   A member of the committee had a prior and ongoing business relationship with one of the respondents at the time the case was heard in November and May 2019.   That was a significant factor in the miscarriage of justice (see in this blog).   The committee was biased in favo...

TimesLive broke the story of three Tygerberg Hospital doctors, anaesthetics registrars Mathew de Swardt, Kim Morgan and Manie Domingo, who faced charges of theft at a disciplinary hearing for, with permission, taking two broken chairs from the hospital’s outside dump to repair and put them in the staff tea room (see here and here ).   As a result of presiding officer Shameem Modack-Robertson’s findings, De Swardt was fired and Morgan and Domingo respectively received a month's and two week’s unpaid leave. Domingo had already completed his training and left the hospital by the time of the sanction.   De Swardt and Morgan have appealed at the Commission for Conciliation Mediation and Arbitration (CCMA) and are being represented by Michael Bagraim, the DA’s shadow minister of employment and labour. After the story broke, the sanctions drew attention and an online petition with 16 000 signatures demanding their reinstatement.  The Western Cape Health Dep...

"What do you want? What is this? Who are you" the police colonel aggressively asked me. South Africans justifiably have a low opinion and expectations of the country's public service and employees  –  health, education, police, NPA ... They're mediocre, corrupt, incompetent and negligent. Public sector employees are very well paid , a third or more than their private sector peers for similar jobs having received above-inflation increases since 1994. The sector is overstaffed, around 2.7 million people, with many unqualified for their posts. Too many people earn too much but quality of service remains poor. That's not a perception either but proven by Auditor-General and Public Service Commission reports . In my posts about our experiences with Groote Schuur Hospital and Western Cape Health Department and our complaints to various agencies including South African Police Services (SAPS), National Prosecutions Authority (NPA) and Health Professions Council of...

The Health Professions Council of South Africa (HPCSA) has doubled down to protect Groote Schuur Hospital doctors accused of the unauthorised removal of a patient's life support that resulted in death (euthanasia) and hospital and Western Cape Health Department administrators who covered it up.  As I related in a previous  post , on 31 May 2019 the HPCSA's Third Medical Committee of Preliminary Inquiry (committee) exonerated doctors Ahmed Al Sayari, Marcelle Crowther and Mikhail Botha and Trauma Centre head Prof. Andrew Nicol, CEO Bhavna Patel and WCHD head Dr Beth Engelbrecht.  I requested the committee's rationale and doctors' responses but despite promising to do so, they only sent the responses excluding Nicol's second statement (2019) which they refuse to.   The committee and CEO/registrar Dr Raymond Billa, who nominally investigates the public's complaints and assured me they're an "advocate for the public", cleared the doctors based ...

This is an update to my previous posts (most recent here ) of the Health Professions Council of South Africa's (HPCSA) investigation into Groote Schuur Hospital (GSH) and Western Cape Health Department (WCHD) doctors who removed my late mother's life supporting breathing tube on 7 July 2017 that resulted in her death by respiratory and heart failure. GSH's Trauma Centre doctors who removed the tube didn't inform us of her deteriorating condition nor sought our consent as is required by national health law. The hospital only called us after she died. My mother was critically ill and couldn't breathe without it. She had been intubated  that day, the doctors allegedly puncturing her lung in the process according to a nurse. The previous evening she had been awake and lucid. The following morning, the day she died, she was breathing on her own, and unconscious from pain medication. Later that evening she was still unconscious, with a breathing tube having been in...

This is an update on the Office of Health Standards Compliance’s investigation into Groote Schuur Hospital and Western Cape Health Department (see here ). On May 9 I wrote to Monnatau Tlholoe and Phumzile Phiri, director and assistant director of OHSC's complaints centre, asking for progress as I had heard nothing from their Stella Hartzenberg who had promised to report back.  I cited the HPCSA's lack of communication too. Phiri replied they "do not conduct investigation parallel with other regulatory bodies" and I must follow-up with the Health Professions Council of South Africa (HPCSA).  I replied the HPCSA only conducts disciplinary investigations of medical practitioners as individuals and not healthcare providers/institutions like hospitals and health departments, and the public has no recourse when parts of the system itself are at fault. I told her I shall not waste more time on them. Apparently, OHSC hadn't conducted a proper ...