Health professionals groups have called for specialised medical courts or alternative processes to deal with criminal charges against medical professionals, saying such allegations should be investigated by medical experts, reports MedicalBrief.
The call from the South African Medical Association (Sama) and Dr Angelique Coetzee, chair of the health committee of the South African United Business Confederation comes as well-known Johannesburg paediatric surgeon and Wits University professor Dr Peter Beale faces more criminal charges.
Beale (75), who has been charged with three counts of murder and two counts of fraud after three children died following surgery, appeared in the Gauteng HIgh Court this week where he was told about the additional charges.
In a statement in the South African Medical Journal, Sama condemned the charges, saying medical doctors pledge to first do no harm – and no doctor intentionally plans to commit murder, and that Beale’s murder charges had created a dangerous precedent.
“His trial has dragged on unacceptably long, despite a previous ruling that no further postponements would be tolerated,” it wrote.
“This treatment of Professor Beale by the National Prosecuting Authority (NPA) is nothing but a case of ongoing victimisation. It will likely be four years before this case is finally heard. The association cannot remain silent as doctors are subjected to trial by media, while simultaneously being denied the chance to defend themselves in court due to endless delays in the justice system.”
Similarly, Coetzee said what was happening to Beale was astonishing. Salaamedia reports that in conjunction with Sama, Coetzee’s organisation condemns the charges brought against Beale by the NPA. “You cannot criminalise the medical field as it is currently being seen, especially from the NPA, which is actively driving this. It’s unacceptable … the accusations against Professor Beale, it’s only one-sided. It’s based on two or three observations, according to what we have seen in the media.”
She said before doctors operate on anyone, they discuss the risks involved in operations and only go ahead once approval is given. Doctors and medical professionals do not intentionally look to harm their patients, and to say Beale murdered them “doesn’t make any sense”, she added.
Specialised operating procedures
Coetzee said “it is insufficient to follow the pathology reports of these cases as they do not provide a clear understanding of what truly happened on those days”. She stressed the importance of having specialised courts for medical-related cases – a court “which consists of medical experts, judges and people”.
“And if there is evidence of malpractice, they should be referred to ordinary law courts. It’s also very important to understand all reasonable and necessary steps to ensure that any medical decision-making does not become a violation of state and or criminal law. We need to oppose any legislation which gives the government responsibility to define appropriate medical practice and regulate such practice through criminal penalties.”
Coetzee said the Health Professions Council of SA (HPCSA) has experts who look into such cases. However, their turnaround time in dissolving their cases leaves much to be desired, she added.
Sama questioned the appropriateness of a murder charge in any instance of alleged medical negligence and, particularly, in complex treatment situations where multiple causal factors come into play.
“This is all too frequently the situation in specialist medicine and it is precisely due to this reason that inquests and HPCSA hearings call upon panels of experts to determine if any negligence exists,” its statement said.
“Doctors should not be victimised due to failure of those systems. Our fears are that the current scenario will encourage the avoidance of any potentially high-risk patient management, exposing those patients to a possible treatment void. It will also discourage young people from entering medical practice, especially any of the high-risk specialties. This can further compound the severe shortage of medical doctors in South Africa.
“Sama believes in a mediated solution to the issues of medical errors. Doctors are human and the association supports an alternative dispute resolution mechanism. Sama recommends that a specialised medical court be established in which trained medical practitioners would be called to scrutinise decisions made by doctors.”
Beale appeared in the Gauteng High Court (Johannesburg) on 31 January where prosecutor Advocate Elize le Roux told Judge Dario Dosio more charges could be added. he trial was postponed to 22 January 2024.
In 2019, Beale and anaesthetist Abdulhey Munshi were arrested and charged with culpable homicide after the death of a 10-year-old boy. Munshi was killed the next year. Three years before their arrest, Beale was allegedly involved in the death of a 21-month-old baby in 2016, after what was supposedly a routine surgery.
In late 2019, the charge in the case of the 10-year-old boy was changed to murder, along with the case of the 21-month-old baby. In addition, in 2012, Beale was charged for the death of a three-year-old boy.
The Health Professional Council of South Africa (HPCSA) subsequently apparently removed Beale from its register.
However, Coetzee said this was because Beale had asked to be removed from the register.
In a separate medical negligence case in the Eastern Cape, the provincial Health Department, already swamped in debt, has been granted a reprieve after Judge Robert Griffiths of the Eastern Cape High Court (Bhisho) ruled it no longer had to make upfront lump sum payments in medical negligence claims.
Slapped with a R35.4m lawsuit by the parents of a baby who developed cerebral palsy because of negligence at the Cecilia Makiwane Hospital in 2018, the department had approached the court.
The child, now 11, was born after a prolonged labour, suffering major brain damage as a result. He has spastic quadriplegic cerebral palsy and intellectual impairment, and suffers from epilepsy, reports News24.
"He is visually impaired and has a percutaneous endoscopic gastrostomy tube for feeding and has poor head control, is unable to sit, roll, crawl or stand on his own. He cannot speak," read the court papers.
Provincial Health spokesperson Mkhululi Ndamase said the court ruling would save the government millions of rands, which it would pay in instalments.
The department had approached the court and argued that paying huge amounts of money to one person crippled its service delivery programmes, the judge agreeing that it should provide care through rehabilitation centres of excellence and provide the necessary medical care instead of paying for future medical costs.
On the drawing board are plans by the department for rehabilitation centres in each district to support 43 clinics, where rehab teams would be available.
The department had been given R5m by provincial Treasury to establish a fully fledged legal service unit that would be led by a qualified chief director.
Salaamedia article – SAMA Condemns Charges Brought Against 75-year-old Surgeon (Open access)
See more from MedicalBrief archives:
Call for SA Law Reform Commission review on criminal charges against doctors
Accused paediatric surgeon Dr Peter Beale struck from HPCSA register
SAMA calls for specialised courts to handle medico-legal cases
Culpable homicide charge added to surgeon Peter Beale’s murder/fraud case
HPCSA probes ‘magnitude’ of negligence claims against paediatric surgeon
Petition to drop ‘premature’ criminal charges against Beale and Munshi
Eastern Cape’s plan to turn tidal wave of negligence claims
Court blocks Eastern Cape’s attempt to stop medical negligence payments
Court furore over Eastern Cape attempt to stop medical negligence writs