This week, recently elected Limpopo premier Dr Phophi Ramathuba has to answer for charges of unprofessional conduct brought before the Health Profession Council of South Africa (HPCSA), for a 2022 rant against a Zimbabwean patient.
Ramathuba was the MEC for health in the province when she was recorded confronting a patient in a video that went viral on social media.
In the video, Ramathuba, who is wearing doctor’s scrubs, asks the patient in Sepedi what language she speaks. The patient faintly responds that she speaks Shona. Ramathuba, switching to English, asks how she ended up in Bela Bela when she was “supposed to be with Mnangagwa (Zimbabwe President Emmerson Mnangagwa)”. Ramathuba further complains that Zimbabwe doesn’t give her money to operate on foreigners; that she is operating with a limited budget; and that the patient is killing her health system.
The whole exchange takes place in the ward, in full view of other patients and hospital staff. It’s not clear who filmed the encounter.
It’s not the first time that Ramathuba will have to answer to the HPCSA on this matter.
When the video went viral, a coalition of advocacy organisations lodged a complaint with HPCSA. In January 2023, the Medical and Dentist Professional Boards Committee of the HPCSA resolved that there was evidence of unprofessional conduct on the part of Ramathuba and a caution and reprimand. Ramathuba failed to respond to this resolution and was sanctioned by HPCSA for unprofessional behaviour.
But Ramathuba rejected these charges saying the allegations against her were unfounded and baseless.
She argued that the HPCSA did not have jurisdiction in the matter. She said the conversation between her and the patient did not constitute any form of unprofessional conduct and was relevant to her work as a political head of the provincial Department of Health.
A formal hearing was set for 25-27 July. Ramathuba’s attempt to stop the hearing was rejected by the Pretoria High Court. The disciplinary hearing took place in July last year but Ramathuba was not present as she had to travel for official business to Australia.
Setting a troubling example
At the hearing this week, the HPCSA heard from Nigel Branken, who introduced himself as a registered social worker with 30 years of experience.
Branken spoke on behalf of the coalition of complainants against Ramathuba which includes: Kopanang Africa Against Xenophobia, Lawyers for Human Rights, Neighbours NPO, Treatment Action Campaign, Section 27, Socio-Economic Rights Institute, Health Justice Initiative, Progressive Health Forum and Helen Suzman Foundation.
He argues that, as a public servant, Ramathuba is bound by the South African Constitution. But her action breached six fundamental ethical principles.
“She failed to respect the patient as a person and acknowledge their intrinsic worth, dignity and sense of value. As a provincial healthcare leader, her behaviour sets a troubling example that may signal to other healthcare professionals that such treatment is acceptable,” he says.
He says Ramathuba’s actions imply that healthcare access should depend on nationality. This risks fostering a discriminatory environment, undermining healthcare equity and public trust.
“When healthcare leaders fail to uphold human rights, they foster an environment where healthcare professionals may feel justified in neglecting or discriminating against certain groups, leading to health disparities and eroding ethical standards in healthcare,” says Branken.
Spreading misinformation
Branken says Ramathuba’s statement violated the principle of truthfulness by spreading misleading information about the impact of foreign nationals on South Africa’s healthcare system.
“Dr Ramathuba claimed that foreign nationals and undocumented migrants are included in budget allocations for healthcare services stating that their presence overburdens the system. This claim is misleading. By misrepresenting healthcare funding and migration trends, Dr Ramathuba’s statements stigmatise vulnerable communities, particularly foreign nationals,” he says.
He says such misinformation can lead healthcare practitioners failing to care for foreign nationals and undocumented individuals, further straining an under-resourced healthcare system.
The complainants want the HPCSA to revoke Ramathuba’s registration. They also called on the HPCSA to investigate the other health professionals in the video who failed to intervene to protect the patient.
“Should they be found guilty of unprofessional conduct, we request that appropriate sanctions be applied and a deterrent to similar actions by other healthcare professionals in the future.”
The disciplinary inquiry continues this week and Ramathuba is expected to appear before the committee on Thursday. – Health-e News
Yoliswa Sobuwa
health-e.org.za