Cape Town - Nearly six years after a scathing report into the effectiveness of the Health Professions Council of South Africa (HPCSA), the organisation is still plagued with backlogs and complaints of inefficiencies in dealing with professional conduct inquiries.
These concerns were recently made evident when the hearing of a committee set up to probe the conduct of Dr Ganes Anil Ramdhin, accused of practising outside the scope of his profession, collapsed due to procedural issues.
A complaint was lodged with the council in July after a total hysterectomy was conducted on Zoleka Helesi, who was diagnosed with cancer of the womb. Helesi, a performer at the Baxter Theatre, died in December.
Ramdhin, who had been suspended three times by the HPCSA, faced more than 300 counts of fraud relating to medical schemes and government schemes. He even changed his name and is still allowed to practise despite an investigation having found that he was masquerading as a gynaecologist.
During the hearing, lawyers representing Ramdhin ripped into the several procedural errors in how the committee was constituted, claiming that their client was served one day short of the required notice period and, in addition, that the HPCSA had sat on the complaint for months without investigating it.
This is not the first time the HPCSA have come under fire for allegedly dragging their feet on complaints around procedural issues when handling probes into doctors.
Recently, anti-abortion doctor Dr Jacques de Vos announced his intention to sue the council for having been prevented from practising since 2017 without the inquiry into his conduct being completed. Last year the HPCSA withdrew charges against De Vos for a second time on allegations of professional misconduct for allegedly dissuading a pregnant woman from terminating her pregnancy.
In 2018, Dr David Sello also dragged the council to court to set aside their decision to suspend him pending a hearing into allegations against him. Sello’s court bid cited similar complaints to Ramdhin on processes followed in setting up the committee that would hear his matter. However, the court dismissed his case and the following year he was found guilty on 26 counts and his licence revoked.
But acting chief executive and registrar Dr Munyadziwa Kwinda told Weekend Argus the council had acted appropriately when bringing charges against Ramdhin, “Except for the date on which the chairperson of the board appointed the committee being after the date the registrar signed the notice to be served to Dr Ramdhin. The defence used this technical error during the hearing,” he added.
Kwinda could not confirm when the matter would return for a hearing, stating that they would serve Ramdhin with a notice first.
In 2015, the late Professor Bongani Mayosi led a ministerial task team that investigated allegations of poor governance and administrative irregularities at the HPCSA and found a council that was in a state of “multi-system organisational dysfunction”, which resulted in failures to deliver on its functions.
The Special Investigating Unit has also been probing allegations of maladministration since 2019.
While management at the council say they have implemented the report’s recommendations through a “turnaround project”, it is proving to be a long process.
According to the council’s latest annual report from the period April, 2019 to March, 2020, the HPCSA received 2 059 complaints of which 1 239 were referred for preliminary investigation. And of that 1 239 matters investigated, 911 were sent for inquiries and 513 were finalised.
As of April 2019, a backlog in preliminary investigations stood at 683 of which 362 were completed and another 321 are scheduled to be completed in the current year.
Another division which is plagued by backlogs is the office of the ombudsman which deals with transgressions deemed too minor to take before inquiry committees. Of the 1 141 complaints, 656 were dealt with and the remaining 485 rolled over to the current financial year.
“In the year under review, there was a significant improvement in performance compared to the previous three years. The number of matters finalised increased by 60% from 19% in the 2018/2019 financial year to 79%. The turnaround times for finalisation of complaints also decreased from 138 days to 99 days,” read the report.
Kwinda said work was under way to deal with the backlog despite challenges brought on by Covid-19.
“By the end of December 2020, 73% of these backlog matters were cleared amid the challenges posed by the Covid-19 pandemic,” he said.
Dr William Oosthuizen with the South African Medical Association (Sama) said while reports around the Ramdhin matter were concerning, they were not uncommon.
“Many of our members do take a dim view of the functioning of council and the apparent 'unfairness' of some of the processes and decisions. Recurring incidents will lead to a loss of trust by both practitioners and the public – which would be immensely detrimental to the profession,” he said.
“Our members have unfortunately found the council to be less than efficient and effective as a regulatory body – often unable to capably deliver on its primary functions and objectives.
“Although there are signs of improvement under the new registrar, he has inherited a dysfunctional and mismanaged institution, probably confined by a legislative and regulatory structure that doesn't speak to the pressing needs of the profession or public.”
Oosthuizen said addressing the challenges lies in implementing Mayosi’s recommendations.
“The council is an unwieldy beast, consisting of many professional boards and committees. Sama has always, and still does, believed that Professor Mayosi's recommendation of a separate Council for Medical and Dental professionals should be seriously explored. Only then will we start to treat the underlying disease instead of the superficial symptoms, and rebuild trust in the system,” he added.
Kwinda said while concerns around the councils were warranted, it was why they had implemented the turnaround project.
Weekend Argus