Western Cape Health has no jurisdiction over its doctors, senior official claims

On Wednesday June 1, Western Cape Health Department's (WCHD) officer Dr Saadiq Kariem was interviewed on CapeTalk about access to chronic medications for WCHD patients. He spoke of two options: collection at a department facility or delivery to their homes.

He made it sound so easy. He didn't mention, though, that at many community health clinics aka day hospitals there's a wait, often hours, to simply collect medicines even when clinics already have patients' current scripts on file. I myself tried that - the first time and last time I'd been to a clinic for collection - but left after two hours without even being attended to. I buy my meds which fortunately are not the expensive kind.

People cannot take off hours every month merely to collect meds but the poor have no alternative. I gather problems may be clinic specific.

On a related matter, during an after hours phone call that weekend, Groote Schuur Hospital's chief operating officer Dr Belinda Jacobs told me they - hospital and health department - supposedly have no oversight or jurisdiction over medical heads of departments' "medical decisions" ie diagnoses and treatment of patients. This extends to HODs' subordinates too.

This was in response to my complaints in April about a GSH outpatient clinic's doctors, including urology HOD Prof. John Lazarus', who also attended me, confusing, contradictory, tardy, incomplete and inadequate management of my case and one doctor's rudeness and rough examination.

Jacobs and her colleagues would have us believe management only has oversight and control over soft client service issues. Ironically she agreed that under the National Health Act (and Health Professions Act) WCHD is the service provider - not individual doctors - patients have contact with. As such, WCHD must and does bear responsibility for the full patient experience. (In this country, at private hospitals and clinics, doctors are private contractors.)

She was vague and unresponsive when I asked to whom WCHD doctors are accountable then, and for the sections in health laws that support their assertion. If they are correct, though, why doesn't the public know this?

This is especially relevant when the WC's doctors provide inadequate, faulty or negligent care - practitioners and department jointly share responsibility, not the arm's length relationship she insists there is. 

However, it also indicates WCHD's duplicity, lack of patient-centred approach and inadequacies that independent surveys have reported about too. And it disproves the narrative in some quarters, DA especially, that WC's public health is the best in the country.