Fresh criticism of 'dysfunctional' HPCSA after Ramdhin debacle

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Yet another collapsed Health Professions Council of SA disciplinary hearing has brought new criticism of an organisation that a ministerial task ream six years go declared to be organisationally dysfunctional, writes MedicalBrief. It follows the HPCSA having to abandon a hearing into the suspension of allegedly serial offending Cape Town obstetrician and gynaecologist Dr Ganes Anil Ramdhin because of an administrative bungle.

Ramdhin faced charges related to fraud, incompetence and practising beyond the scope of profession. The latest complaints against him related to allegations that two cancer patients in their 40s — Zoleka Helesi of Khayelitsha and Beauty Mama of Port Elizabeth — died after he botched gynaecological surgery, report Sipokazi Fokazi and Tanya Farber on TimesLIVE.

On Febraury 21, the precautionary suspension hearing before an ad hoc committee set up by the HPCSA was abandoned when Ramdhin successfully challenged HPCSA procedures in the setting up of the hearing. The matter referred back to the HPCSA for a way forward.

“On a technicality, Dr Anil Ramdhin is now allowed to continue practising despite his long history of misconduct,” Dr Caro Nel, a gynaecologist who attended the hearing, was quoted as saying.

Ramdhin was suspended from the South African medical roll twice, and was struck off the British roll in 2006 after the General Medical Council said he had shown “a flagrant disregard for his responsibilities”.

HPCSA acting registrar Dr Munyadziwa Kwinda confirmed to TimesLIVE that Ramdhin had been suspended three times and fined twice:

In 1991 he was suspended following a criminal conviction of assault;
In 2000 and 2002 he was suspended for unprofessional conduct;
In 2011 he was fined R15,000 for misrepresenting himself as a gynaecologist; and
In 2014 he was fined R30,000 for diverting patients from the public sector to his private practice.

TimesLIVE quotes Prof Errol Holland, former dean of health sciences at Limpopo University (now Sefako Makgatho Health Science University) saying that the council is incompetent and inconsistent in its handling of complaints against doctors. Holland, who was involved in a 2009 decision to withhold a gynaecology degree from Ramdhin, said it was an indictment that a regulator which is “supposed to be the guardian of the health profession and protect the public had been so slack in handling cases of unethical conduct by doctors”.

“How they handled this matter demonstrates the lack of due diligence. It is unbelievable that someone who is facing such serious charges can be allowed to continue to practise even after he had been suspended several times by the very same council and struck off the roll by the UK’s General Medical Council.

“It’s a hard pill for me to swallow when I look at the inconsistencies … that a doctor who clearly has a history of being unethical and committing gross misconduct is allowed to simply walk away while those with integrity are hunted down like criminals,” said Holland.

Holland referred specifically to the case of Johannesburg paediatric surgeon Dr Peter Beale, writes TimesLIVE, who with anaesthetist Dr Abdulhay Munshi were charged with murder after 10-year-old Zayyaan Sayed died after a routine laparoscopic operation in 2019. The council suspended Beale within two months of the surgery.

Munshi was later shot dead in an apparently carefully planned murder. Beale went into hiding and is still awaiting trial.

Dr Angelique Coetzee, chair of the SA Medical Association, told TimesLIVE that despite the HPCSA inquiry task team’s recommendations, many doctors continued to find the HPCSA “to be less than efficient and effective as a regulatory body, and often unable to capably deliver on its primary functions and objectives”.

“The reports around the (Ramdhin) case are concerning and, unfortunately, not uncommon. Many of our members do take a dim view of the functioning of the HPCSA and the apparent 'unfairness' of some of the processes and decisions,” Coetzee said.

Special Investigating Unit spokesperson Kaizer Kganyago told TimesLIVE that allegations of maladministration at the HPCSA remain under investigation.

The SIU probe began after a ministerial task team appointed by then-health minister Aaron Motsoaledi filed its report in 2015.

The task team, led by the late University of Cape Town dean of health sciences Prof essor Bongani Mayosi, had found that the HPCSA was riddled with corruption, its executives incompetent, and its administration a shambles. It concluded that the HPCSA was structurally unsuited to carrying out its core functions — which include the examination and recognition of foreign qualifications and the registration of medical practitioners — and sacked its top executives. It found that HPCSA employed more lawyers than health professionals and in the section that dealt with professional conduct matters, there was not a single medical practitioner or person with a medical background.

HPCSA spokesperson Kwinda told TimesLIVE that based on ministerial task-team recommendations, the HPCSA had embarked on a turnaround strategy in December 2017.

The HPCSA's critics, however, point to a continued string of legal failures, writes MedicalBrief:

  • In October 2020, the botched prosecution of Dr Jaques de Vos, which his lawyer had described as a “personal vendetta” because of his outspoken anti-abortion views, ended with the HPCSA abruptly dropping all charges. De Vos, in the meanwhile, had been in professional limbo for three years, prevented from completing his training.
  • The three-year prosecution of Professor Tim Noakes, over his championing of the Banting diet in a tweet, similarly collapsed in tatters. In one embarrassing incident, the HPCSA issued contradictory statements hours apart, the first declaring Noakes guilty of unprofessional conduct, the second declaring him not guilty.
  • A five-year prosecution of Dr Wouter Basson over his role in the apartheid government’s secret medical programmes was similarly ham-fisted. Eventually, the Constitutional Court in February this year put the HPCSA out if its self-flagellating misery when it refused to hear its appeal against a High Court judgment that had described the prosecution of Basson as a “comedy of errors”. In January 2021, the HPCSA announced that it intended to reinstitute disciplinary proceedings against Basson.

 

 

Full report in The Times (Open access)

 

 

See also MedicalBrief archives:

Gynae with ‘history of misconduct’ benefits from HPCSA ‘bungle’

 

HPCSA will take yet another try at a disciplinary hearing into Basson

 

HPCSA rapped over 7-year delay in accepting top Swiss surgeon’s qualifications

 

HPCSA’s 3-year disciplinary action against anti-abortion doctor collapses

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