Doctors, broken chairs and dying patients: Viva Western Cape Health

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 Department (WCHD) issued a statement:

“Upon consideration, the Minister [Nomafrench Mbombo] has set aside the dismissal of Dr De Swardt and dismissal replaced with a final written warning. The suspensions of Drs Morgan and Domingo have also been substituted with final written warnings. The doctors have the right to lodge a dispute with the Public Health and Social Development Sectoral Bargaining Council. Appropriate support will be provided to the doctors to assist them in completing their specialist training”.

Politicsweb columnist William Saunderson-Meyer fumed at the injustice of it (to be fair, so predictably have the excitable media). But WCHD's overreaction contradicts his baseless assertion the “Western Cape reputedly has the best run health department”.  He also said, “One wonders what other disciplinary miscarriages of justice lurk in the WC Health [Department] files. We likely will never know. The ‘open government’ Democratic Alliance administration stalled my request for access to a record of all previous charges, verdicts and sentences”. Good luck with that.

He, public and DA supporters have a false perception the Western Cape is a well-run bubble which without evidence (it's a matter of faith) they attribute to former premier Helen Zille. But the Treatment Action Campaign's 2018 Western Cape: State of Health report stated the WCHD is “failing the people it serves”. The South African Health Review 2018, based on users' perception of services, scored the province's public health 48.3%, the forth lowest in the country (Northwest is lowest at 46.7%).  The national average is 55.1% (2017's figures ex Stats SA.). 

He ought to have researched the WC Government's governance record before making such tendentious statements. There’s no excuse for not knowing, he's a journalist after all. Incidentally, he said Tygerberg Hospital is “one of the finest medical faculties in the world” (sic) and in a comment, the doctors' “training is via UCT” (sic), conflusing UCT's and Stellenbosch University's medical faculties. But to most opinion writers and the media, facts are less important than the points they want to make.

Including under self-styled oracle Helen, whom the conservative/right infinitely admire and who can do no wrong in their eyes, the WCHD is a morass of problems that’s largely not been investigated except for occasional reports. Why wasn't TAC's report given blanket media coverage?  As it is, it got scant, if any. They don't care because it's largely poor people who rely on the service. And who cares about the poor, right?

Instead they report nonsense celebrity and political scandals over what's really important to millions of people. When I raised these issues on Politicsweb, I was trolled for purportedly been anti-Zille and anti-DA. But these same fickle people are outraged about the doctors and critical of WCHD.

The WCHD's patient complaints process at facility and departmental level is compromised and dysfunctional with complaints superficially being attended to but really getting the middle finger and/or massaged to exculpate offending facilities and healthcare workers, which happens each time whatever the merits. They lie, obfuscate and obstruct and deny responsibility on the principle of it, no different to government as a whole. But as Saunderson-Meyer naively complains, the DA claim they're accountable and transparent.  That was under Zille too.

Its Independent Health Complaints Committee is the tame poodle of the head of health and dysfunctional.  In late 2017 the committee ceased functioning for "logistical problems", that is, as I recently found out, its "independent" panel members resigned for unknown reasons, abandoning complaints they still were to hear including ours. (I gave this and related information to the media at the time and since but they weren't interested.)  It's unlikely its integrity has been restored since.  

The abuse and abrogation of patients' rights under the National Health Act and Health Professions Act is real. This goes all the way to the top at WCHD and WC Government including head of health Dr Beth Emgelbrecht, who is the real power in the department, figurehead MEC Nomafrench Mbombo and then premier Zille and present incumbents too (Mbombo is again MEC). Recently my jaw dropped at the lies they and implicated practitioners again told regarding a complaint. This is not a new thing either, but their modus vivendi going back years.

Championing these doctors is admirable – working conditions for staff are not always good – but misplaced, naive, misinformed and opportunistic. This type of disciplinary action, whatever the motives, is rare. We can speculate but WCHD professional disciplinary hearings against medically negligent healthcare workers are non-existent. It's ironic, though, they prosecute doctors for taking dumpster chairs but not for patients dying under their care under suspicious circumstances and medical negligence.

Cape Town NPA and Inquest Magistrate would say, as the latter told me last year in relation to my mother's case before her, Woodstock Police Station's inquest detective is the “busiest detective at the station because of Groote Schuur Hospital”. There's a large backlog of unnatural causes death inquests – health-related and other – of about five years. I guess it's similar for other magistrates' jurisdictions.  Last month the inquests clerk told me in in an email,  “We have grieving families who seek finality in their loved ones matters too. Older than [yours]. Please be patient”.* 

That, and the overall dysfunction of the public service and conduct of its employees as related here, for example, is the real story, not this petty one about broken chairs.

Postscript: Bagraim is paid a lot of money to represent citizens in the National Assembly but he's moonlighting as an attorney. (Do house rules permit it?)  I doubt he's doing it for free.

His firm represented me some years ago.  I was under the impression they were preparing papers on a time sensitive matter but was surprised when they suddenly said they no longer represented me because of alleged other business.  I'm not impressed with him.  Another blowhard opportunist, which I guess is why he's in politics.

*Update 21/09/2019: A Woodstock detective called and said the prosecutor asked for our case number, and had I seen the state pathologist's report! They – SAPS – don't have it either. I don't know why he asked me because the court and NPA have had the docket for two years, and a month ago confirmed it was with them. Or perhaps it wasn't. It appears the prosecutor maybe lost the docket.