Medical whistle-blowers face victimisation, intimidation and assassination, writes MedicalBrief. New information indicates that chief accountant Babita Deokaran flagged potentially fraudulent Tembisa Hospital contracts worth R2.3m just weeks before she was murdered. And paediatrician Dr Tim de Maayer, despite a national outcry over state harassment, continues to be “persecuted”, says the Progressive Health Forum (PHF).
Three weeks before she was murdered, Gauteng Health Department whistle-blower Babita Deokaran raised the alarm over payments from Tembisa Hospital to ANC Ekurhuleni leader Sello Sekhokho, flagging three contracts worth R2.3m as “potentially fraudulent”.
Sekhokho had three companies – even a security firm – supplying medical equipment at vastly inflated prices, reports TimesLIVE.
Health Department CFO Lerato Madyo had instructed the department’s chief accountant, Deokaran, to pay Sekhokho, and told her to keep it secret.
The three contracts providing medical supplies and equipment to Tembisa Hospital were worth R2.3m, and Deokaran flagged these as “potentially fraudulent” just three weeks before her murder.
One of his firms, Kaizen Projects, was among 217 entities she had identified among a flood of transactions out of Tembisa Hospital, her suspicion raised by a buying spree that sharply escalated expenditure in July 2021.
In just one month, goods and services for the tertiary hospital accounted for R239m, 25% more than Charlotte Maxeke Academic Hospital, which is four times its size.
Deokaran reported the expenditure to department CFO Lerato Madyo, calling for an investigation and a stop on payments worth R104m. Ten months after she was executed outside her Johannesburg home, the payments out of the hospital have yet to be probed in their entirety.
Six alleged assassins face murder charges, while the Hawks investigation into their paymaster remains open.
The DA, meanwhile, wants heads to roll, and has called for the immediate suspension of Madyo, after hearing she had authorised "dubious" payments to the politically connected businessman. Gauteng DA health spokesperson Jack Bloom says there needs to be a thorough investigation, and for Madyo to be placed on leave.
“The massive scandal uncovered by the News24 investigation needs to be investigated. This requires the first step of suspending Madyo so that evidence will not be tampered with,” he said.
Deokaran had singled out Kaizen Projects, telling colleagues in internal emails it was dubious that an “events company” was a supplier of medical equipment.
Sekhokho is the sole director of two other companies: Nokokhokho and Bollanoto Security, which also sold medical equipment to Tembisa Hospital and were flagged by Deokaran. Evidence suggests he sold on medical supplies at vastly inflated prices.
He is a well-connected political player who once ran to be the ANC Youth League Gauteng chair and is linked to newly former Ekurhuleni mayor Mzwandile Masina. Sekhokho is now in the office of treasurer general.
In 2019, when Masina was mayor of Ekurhuleni and pushing a R100m per year “poverty alleviation programme”, Sekhokho landed a R1.2m contract to build a science lab at Emmangweni Primary School in Tembisa, amaBhungane reported.
Public funds there too were channelled through Nokokhokho. Last month, the South African National Civic Organisation (Sanco) claimed to have evidence that senior ANC officials in Gauteng were using their influence to swing the award of lucrative contracts out of Tembisa Hospital. Among their allegations were that inflated payments were a ruse, with money intended for vote rigging and bribery.
Suspicion
When Deokaran began investigating massive spending out of the hospital, she flagged thousands of purchase orders valued at under R500,000. Goods or services above that threshold require a public tender process. Below that mark, the hospital’s CEO can sign off.
Sekhokho's Kaizen Projects was one of the first to appear on her radar.
On various price comparisons, Sekhokho and his companies were providing goods easily accessible on the open market at significantly inflated prices. For the purchase of headblocks, for instance, his price was 533% above a fair market rate.
In response to questions from News24, he denied impropriety, insisting that his business dealings with hospitals in three provinces were above board.
He refused to reveal how much he made on state contracts, citing “client confidentiality”.
On his pricing, he said: “Most of the products we supply are imported into the country, while others are sourced locally… We do not buy the majority of our products directly from the manufacturers but from the secondary sources who put mark up prior selling to us.”
He said he places a mark-up of 30% on what he sells on to the hospitals. In essence, his firms then become an intermediary for sourcing and delivering products – with two layers of inflation.
Asked why three separate entities were billing the hospital at the same time, he responded that his administrative staff took care of responding to requests for quotations.
He was adamant that proceeds of his medical supply businesses did not fund his campaign for ANC leadership.
Department of Health spokesperson Motalatale Modiba said that, instead of a forensic investigation that focused on Tembisa Hospital, a randomised compliance audit was undertaken. The findings, he said, identified weaknesses in supply chain management systems and controls, which were being addressed.
Of Tembisa, he said that CEO Dr Ashley Mthunzi had been appointed to act in April 2021, with this made permanent two months later.
“The matters referred to in your inquiry predate his appointment there,” he said.
However, documents suggest that some of the goods supplied by Sekhokho were requested by Mthunzi.
Modiba said: “Given that the issues related to the murder of Ms Babita Deokaran are still under investigation, the Gauteng Department of Health is not in position to provide running commentary.”
On the issue of whistle-blowing paediatrician Dr Tim de Maayer, the Progressive Health Forum (PHF) has raised the alarm over the increasing intimidation of healthcare workers who speak out about conditions, with convener Dr Aslam Dasoo calling it concerning that the health department was continuing with its disciplinary process against De Maayer. This despite his suspension being lifted last month, reports News24.
Dasoo said this was intimidation for healthcare professionals who spoke up about the intolerable conditions under which they worked.
De Maayer, a paediatrician at the Rahima Moosa Mother and Child Hospital, was suspended on 10 June after blowing the whistle on the poor state of the hospital.
He wrote an open letter to the department, saying the “horrendous conditions in our public hospitals” contributed to children's deaths.
His suspension sparked outrage from senior healthcare professionals and academics who are members of the "I Am" movement and a signed letter addressed to Gauteng Premier David Makhura and Health Minister Joe Phaahla in solidarity with De Maayer.
The initial letter had 130 signatures from senior health professionals. An updated follow-up letter seen by News24 this past week (25 July) had garnered more than 10,000 signatories from healthcare workers and public members nationally.
The movement also launched a petition in which they demanded, among other things, the cessation of disciplinary processes against De Maayer and his colleagues.
The 'I Am' movement cannot be ignored. Backed by thousands of health workers, it is calling for concrete changes to systemically fix the falling-apart public healthcare system. Caught in the doldrums of bureaucracy and government inaction, the campaign wrote a follow-up letter respectfully escalating their concerns, writes Daily Maverick.
Instead of delays and platitudes from officialdom, the “I Am” movement is demanding a response from elected representatives. As workers in South Africa’s public healthcare system, they say they need to hear from Makhura and Phaahla, with concrete plans to address concerns raised in their open letter submitted a month ago. The letter calls for an end to the victimisation of whistle-blowers and for systemic changes that will place decision-making power with properly constituted boards and CEOs who are primarily accountable to the hospital, its staff and patients rather than detached head offices.
Dasoo, one of the “I Am” movement’s signatories, emphasised the scale of the crisis faced by public healthcare: “The issues canvassed in the letter are widespread around the country, not just in Gauteng. And so it behoves them to understand that this is a national crisis. Simply meeting with the nation and saying, ‘Okay, we’ll fix up your little hospital over there, or we’ll refurbish that part of the hospital’ is not enough, there needs to be a systemic change.”
The campaign is cautiously optimistic about a meeting that took place on 11 July where some of South Africa’s most senior and respected figures in healthcare advocated for the demands of the open letter.
“The ‘I Am’ delegation, led by Prof Rudo Mathivha, head of ICU at Chris Hani Baragwanath Academic Hospital, comprises a senior clinical head from each of about 20 hospitals across Gauteng, including all the major tertiary academic complexes, as well as the Dean of Wits School of Health Sciences, Prof Shabir Madhi. These senior clinicians collectively represent the fullest spectrum of the public medical professional cohort in Gauteng who make up the core of the ‘I Am’ movement,” said Dasoo
Makhura and Phaahla did not meet these senior clinicians. Instead, they sent functionaries to represent them.
According to Foster Mohale, spokesperson for the National Department of Health, “The first instance of engagement with the group has been initiated through the meeting between the clinicians with the Acting Provincial Government Director-General and new HoD of Provincial Health department.”
These appointed officials lack the kind of decision-making power necessary for the kind of urgent, systemic changes needed in the healthcare system. No substantive decisions were made and no timelines were created at the meeting.
“The premier and minister haven’t as yet met the ‘I Am’ movement, however, they have acknowledged the letter and its contents,” said Mohale.
Vuyo Mhaga, the Gauteng Premier’s spokesperson, told Maverick Citizen that there was an agreement with the healthcare professionals but that further engagement with other stakeholders is necessary.
“There is a conversation and the meeting was quite positive. The two parties will actually work together to resolve some of the issues they are speaking about.
“It’s not an issue we can agree and implement overnight because it does not only affect the clinicians, it affects obviously the workers in those hospitals, it affects the nurses who might not necessarily be part of the group that is complaining… As you will appreciate, there are also other stakeholders like labour that the Gauteng government authorities must also meet.”
Dasoo is wary of endless meetings with no action.
“Even in the previous meetings (around a separate issue of addressing the damage from the Charlotte Maxeke fire in 2021), there’s a lot of acknowledgement. ‘Yes, no, this should be done. We agree with this. We agree with that.’ But then nothing happens after the meeting, because of the arcane kind of arrangements in the government… I think that there’s a national and provincial issue here. Who’s in charge of what? And so everything falls through the cracks.”
Mhaga said that the Gauteng provincial government was already working on some of the issues raised in the letter because they were priorities outlined earlier this year. He said: “If you go and read the State of the Province Address around health and you read (the open letter), you’ll find that there’s a correlation between what the Premier said and what the clinicians are saying.”
Though there are some vaguely shared priorities around issues like hospital maintenance, the 2022 Gauteng State of the Province Address does not make reference to the kind of systemic changes that the open letter is calling for. For example, while the open letter calls for a fundamental restructuring of the process to appoint hospital CEOs to make them more accountable, the State of the Province Address merely expresses satisfaction that most CEO posts in the province have been filled.
Because the movement is still awaiting substantive commitments, Dasoo said: “We wanted to escalate this matter. And not in a confrontational way. You’ll see the letter doesn’t really berate them, it puts the issue clearly, it acknowledges that there was this meeting, but it insists that the campaign requires an escalated response now and from the politicians themselves.”
He added: “When De Maayer was reinstated, we were all happy and thought they had responded to the outcry. But we found out he was still undergoing the disciplinary process, which is when we said ‘no, we had to stop all disciplinary action against him’. So far, nothing has changed.”
Department spokesperson Motalatale Modiba said the disciplinary action against De Maayer had “been mute for almost a month”. He denied accusations of intimidation.
“There are multiple platforms both within and outside government that allow workers to not only raise concerns, but also to suggest solutions to the challenges they identify,” he said.
Mohale and Mhaga said the government was implementing plans to address the challenges raised by the group, including working on a six-month plan to improve the health system in the province. Mohale added that Makhura and Phaahla would regularly engage with health practitioners to address challenges in the sector.
“The Premier and Minister have seen the significance of engaging with clinicians directly and have agreed on a follow-up to the acting director-general’s meeting. This should happen in the near future or sometime in September. There would be numerous follow-ups between the DG and HOD,” he said.
The group has also called for the establishment of an independent inquiry that would investigate the conduct of provincial health officials and the CEO of the hospital.
The government was implementing plans to address the challenges raised by the group, including working on a six-month plan to improve the health system in the province. Mohale added that Makhura and Phaahla would regularly engage with health practitioners to address challenges in the sector.
“The Premier and Minister have seen the significance of engaging with clinicians directly and have agreed on a follow-up to the acting director-general’s meeting. This should happen in the near future or sometime in September. There would be numerous follow-ups between the DG and HOD,” he said.
See more from MedicalBrief archives:
Threat to Presidency DG confirms murder plot – Deokaran family
Deokaran murder: Prosecutor says Zweli Mkhize either ‘potential witness or suspect’
Deokaran murder accused says claims of Mkhize involvement followed ‘night of torture’
Gauteng Health whistleblower’s assassination was meticulously plotted
Health professionals unite in ‘I Am’ movement against state victimisation
Gauteng Cabinet to meet over ‘I am’ letter about dire hospital conditions
Doctors back paediatrician’s account of Rahima Moosa collapse