At least 101 state doctors raked in R22 million from one medical aid, claimed while moonlighting when they should have been attending to patients at public hospitals. Investigators have called for criminal charges to be brought against the medical practitioners.
The medical scandal is part of a report presented to KZN’s Department of Health. It exposes the widespread neglect of patients in state care.
According to the report, seen by the Sunday Tribune, the full-time state doctors were openly working in private surgeries, but also claiming millions in overtime from state hospitals for hours not worked.
In some cases, particularly in rural areas, more than one-third of full-time doctors in state facilities were guilty of the practice, leaving their patients in hospitals either waiting or unattended for days.
State doctors in KZN are not allowed to do paid work outside their official duties, or to use state resources for such work, yet the report found 354 state doctors had private practice licences, which they obtained by submitting bogus or residential addresses when applying to the Board of Healthcare Funders.
Among those implicated is one of the country’s leading cancer specialists (known to the Sunday Tribune), who claimed more than R3m from one medical aid in one year for his private practice when he was meant to be treating cancer patients at the state hospital where he was in full-time employment.
The report, for the period from June 2011 to June last year, also found that:
l Patients in public hospitals were being neglected by doctors working privately.
l Considering the amounts claimed from medical aids, it was impossible for those doctors to work a 40-hour week with overtime, yet they continued to claim for this.
l There was a lack of proper monitoring and supervision of the attendance of medical practitioners in state health facilities.
The amount of R22 068 716.07 in medical claims from those implicated reflects just one medical aid provider, and this figure is expected to be substantially higher when claims from other medical aids and cash payments are considered.
Speaking to the Sunday Tribune, a former state health specialist now working in the private sector said the report was not surprising.
“Everyone working in public health knows it happens. We have specialists, surgeons and senior doctors who come in, work less than half their time, and leave for their private practices. We would never have the long queues in public hospitals if every one of them actually worked their hours.
“There are no checks and balances because they feel they are not accountable. They don’t care because they feel they won’t be fired due to the demand for their skills.
“I know of cases where a surgeon would rush through his operations because he had patients waiting at his private practice, while others would leave their patients in the care of junior doctors.
“It’s no wonder we have so many claims of negligence in state hospitals,” said the specialist.
Approached for comment, KZN Health HOD Dr Sibongile Zungu confirmed the report’s findings and said the department would be taking legal action to recover the monies claimed from medical aids by those implicated in the report.
Asked whether the lack of management allowed moonlighting without being detected to take place, Zungu said for many years they had tried to implement a policy of compliance in all departments, but this had not worked.
She said each department head was responsible for monitoring rosters, but this had unfortunately not been done. Doctors also needed to be guided by their own consciences.
Unable to specify when the doctors would be charged, Zungu said a full consultative process would be undertaken.
“We will be presenting the report to the legislature ahead of our legal action, but I can say we are not going to sit back and allow taxpayers and patients to be held to ransom.”
“The moral fibre of our health profession has disintegrated, and it’s a huge challenge, because we have some dedicated professionals in the public sector, but unfortunately it’s the abuse of trust by others for their own greed which creates the crisis we have.
“When we tried to enforce systems of control like time sheets and physical security checks of every employee, including doctors and specialists, there was a level of arrogance and resistance from those who felt we were being too bureaucratic, and they then turn to the media with half-baked allegations, or threatened us with resignations, knowing their skills were desperately needed.
“We are facing medical claims in the amount of R1.1 billion, and some include negligence, because of those doctors who neglect their patients for their private practice responsibilities, so we will use the monies recovered to settle some of the claims against the department,” explained Zungu, adding that the department would also look at the report’s recommendation of implementing time sheets and attendance registers.
DA KZN health spokeswoman Makhosazana Mdla-lose said the buck stopped with hospital management.
“There is a lack of control in public hospitals, and their chief executives need to be held accountable,” she said.