Sunday, 16 June, 2024
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Why doctors are fleeing the public service — and SA

DoctorsSometimes small events illuminate big issues. Western Cape Health's bizarre hounding of three registrars explains why doctors are leaving the public service and South Africa, writes Jaundiced Eye columnist William Saunderson-Meyer on Politicsweb.

Saunderson-Meyer writes:

One’s world view is formed not from a spreadsheet — an ordered set of analyses marching to a definitive conclusion. Our concept of what life’s all about is more likely drawn from a loose-leaf folder, messily crammed with vignettes.

But it’s often such ostensibly trifling sketches that best encapsulate a person, a situation, a nation. And it’s often these little things that trigger our delight or dismay.

The storm in a teacup around three young Western Cape doctors, over the past week, is one of those nominally minor matters that turns out to illustrate important realities. It’s certainly a keeper for my loose-leaf folder, to be filed under any of South Africa’s worst public service failings — workplace pettiness and spite, bullying and envy; organisational dysfunction; gutless management; bureaucratic arrogance, and legal over-reach.

The three — Doctors Mathew de Swardt, Kim Morgan and Manie Domingo — all at various stages of anaesthetics specialisation at Tygerberg, had scavenged from the hospital’s outdoor dump of written-off, broken furniture, two weathered chairs.

Their motivation was that with some DIY and TLC, the two rain-rotted items could be resuscitated. The chairs would have a new life in the doctors’ tearoom, which the ringleader of this band of desperadoes, De Swardt, had been sprucing up, out of his own pocket.

Then came the bureaucratic storm. Truly, no good deed goes unpunished.

Although the trio had verbal permission, had checked the chairs through security, and this all took place in full view of hospital CCTV, the gang was charged with theft. Allegedly, union officials had put pressure on the hospital’s management to act against these professional staff with the same alacrity that it dealt with the criminal transgressions of administrative and service employees.

A kangaroo court, masquerading as a disciplinary hearing, was set up. Despite an array of witnesses, from security guards to departmental heads, testifying to the veracity of the doctors’ account, the findings — the Health department, to date, refuses to release the complete record — were harsh.

The gang’s dangerous El Capo, De Swardt, was summarily dismissed. His henchmen, Morgan and Domingo, were respectively sanctioned to periods of a month's and a fortnight’s unpaid leave, as well as given written final warnings.

These aren’t trifling sanctions. As the SA Society of Anaesthesiology pointed out, De Swardt would not be able to complete his training and the public service careers of two senior registrar anaesthetists had been sullied. Although Domingo had by now left the public service, he would not “escape the clear implications of a guilty finding”.

It's tempting simply to skewer Shameem Modack-Robertson, the hearing's presiding chair — a job she carries out regularly for the Health Department, she boasts online — since, on the face of it, she was in this case either unusually incompetent or dancing to a political tune. With a single, foul stroke, a person with a paramedic diploma and assorted credits towards a Unisa undergraduate degree, tarnished the reputations and upended the lives of three doctors who each had undergone more than a decade of rigorous training at one of the finest medical faculties in the world.

Her performance of course deserves criticism, as do her motives, but ultimately the buck must stop with the executives of Tygerberg Hospital and Western Cape Health. That’s where the dimple-arsed managerial drones hum lazily around the honeycomb, sipping their tea from dainty china cups, pinkies cocked, and in cosseted comfort. That’s an entire world away from where their professional employees have to plunder rubbish dumps for sticks of furniture on which to perch their own weary teatime backsides.

It was under the glazed eyes of these zombie functionaries that this ill-considered prosecution for theft was launched, this sentence imposed. What a dereliction of oversight on their part; what a failure of leadership and character.

The public response to the career-wrecking sanctions on the doctors was explosive. After TimesLive broke the story, it rocketed around the social media world to widespread disbelief and anger. A hastily launched petition demanding the doctors' immediate reinstatement garnered 16,000 signatories from within SA and from its global medical diaspora, in a couple of days.

Western Cape Health hastily retreated. On Wednesday, just days after the furore went viral, they backed down. The verdicts were reversed with immediate effect — reduced to written warnings that would be expunged from their records in six months, provided the doctors didn’t indulge in any further impromptu interior decorating.

I guess that will have to do, though a public apology would have been nice. So, too, a kick up one or two of those well padded managerial butts.

One wonders, also, what other disciplinary miscarriages of justice lurk in the Western Cape Health files. We likely will never know. The “open government” Democratic Alliance administration has so far stalled my request for access to a record of all previous Health department's charges, verdicts and sentences.

Western Cape reputedly has the best run provincial health department. If this is best practice, just imagine what bureaucratic mayhem is being wreaked nationwide.

Attorney Michael Bagraim, who acted on behalf of De Swardt and Morgan and who also happens to be the DA’s Shadow Minister of Employment and Labour, said his clients were “overwhelmed by the enormous support from not only the medical profession but the general public”. It was this that “undeniably” drove the department’s internal review. “This change in outcome proves that support in numbers can have an immeasurable effect on people’s futures.”

During a chat, Bagraim takes obvious pleasure in quoting to me the Latin maxim that translates, “the law does not concern itself with trifles”. Meaning, in this case, there was never any credible charge deserving of such a draconian legal response.

Clearly so. But on the positive side, this was a “trifle” that explains, in a snap, why the public service in South Africa is haemorrhaging professional staff and why so many doctors are contemplating emigration.

Follow WSM on Twitter @TheJaundicedEye


The full story can be found on MedicalBrief at:

[link url=""]Doctors’ careers destroyed stealing broken chairs[/link]


[link url=""]Western Cape Health reversal on theft of broken chairs[/link]

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