Civil society takes Gauteng Department of Health to court over failure to spend allotted R784m on cancer treatment

With the help of SECTION27, the civil society organisation Cancer Alliance is taking the Gauteng Department of Health to court after it failed to utilise the R784-million allocated to it by the Gauteng Treasury in 2023 to provide cancer patients with live-saving treatment and clear the radiation and surgical backlogs in the province.

The organisations filed an application in the Gauteng Division of the High Court in Johannesburg against the MEC for health in Gauteng, Nomantu Nkomo-Ralehoko, nine other officials and the Gauteng Department of Health (GDoH). The application will be heard on Tuesday, 23 July. 

“Following the allocation of the funds, Cancer Alliance and SECTION27 met twice with Gauteng Health officials. At the last meeting on 2 June 2023, the GDoH committed to a plan to use the allocated funding to address the backlog in providing radiation oncology services,” the organisations, together with the Treatment Action Campaign, said in a media statement.  

“A key decision by Gauteng Health was to outsource the provision of radiation oncology services. The agreed-upon plan was for the GDoH to appoint a service provider by early August 2023. However, shortly after our June 2023 meeting, the GDoH abruptly ceased all communication with Cancer Alliance and SECTION27.” 

The department’s lack of communication and action led to a protest march to GDoH headquarters in Johannesburg on 30 April 2023, at which the organisations demanded that the funding be spent in terms of its allocation.

Read more: Gauteng Health’s silence on R784m oncology backlog tender is worrying – Cancer Alliance

Patients failed by the GDoH

At the protest at the GDoH offices, Thato Moncho, who was diagnosed with breast cancer in September 2020 and had since had three recurrences, addressed the gathered crowd, revealing she had been on the waitlist to receive radiation treatment for four years.

“I don’t know how much more I am supposed to fight, and what strength am I supposed to gather to fight going forward? I have pains where I am standing now. All I’m asking from you [the GDoH] is to act, don’t talk. You have done enough talking. We want to see you act. We want to see you do something with cancer patients,” Moncho said.

After receiving the memorandum, GDoH spokesperson Motalatale Modiba said the department acknowledged that there had been delays in providing radiation treatment, which he attributed to the tender process to acquire new equipment, GroundUp reported.

Modiba said that it was in the department’s interest to address the backlog of patients who required treatment and that the department would respond to concerns that the Cancer Alliance, Treatment Action Campaign, SECTION27 and cancer patients had raised, adding that the tender had been awarded. 

Modiba vowed that patients would start treatment in May and some did indeed receive treatment. However, for Moncho, it was too little, too late.

Moncho said that after years of begging for treatment, her cancer had spread, and she would no longer benefit from radiation oncology treatment. 

“I went to the radiation department on one of my check-ups, and the sad news is that they told me … cancer had spread to my lungs. The cancer has moved to other organs in my body, and [that means that] radiation is no longer an option for me.”  

Moncho said her only option now was the hormonal medication that she was currently taking in addition to chemotherapy tablets. In essence, Moncho was told that she must live with the cancer.

“The doctor told me that I could have got radiation at the time that I needed it, and it was a necessity for me, but because of delays for the higher-ups, I could not get it. I simply said to her, ‘You are agreeing with me that they are doing maladministration,’” said Moncho.

“They have simply said to me, wait for your cancer to spread and your time to die. That is what the department did to me.”

Civil society seeks justice

“Despite being allocated R784-million in 2023, specifically for addressing the backlog in radiation oncology and surgery in the province, the GDoH has made no meaningful progress in providing radiation oncology treatment to cancer patients on the backlog list,” read the statement from Cancer Alliance, Treatment Action Campaign and SECTION27.

The organisations said that following the protest and after months of no communication from the GDoH, the department had announced through a media statement that it had apportioned R250-million to procure planning services for the outsourcing of radiation and oncology services for one year.

That left R534-million, which the GDoH claimed was intended for investment in oncology, medical and allied equipment, including the construction of a bunker to house a machine. The civil society groups say the GDoH’s inaction does not bode well for the 3,000 patients awaiting life-saving treatment. 

“Cancer Alliance has been forced to bring an application to interdict the paying, disbursing and otherwise dealing with the R250-million and to ensure that cancer patients on the backlog list urgently receive the radiation and oncology services that they are constitutionally entitled to and for which Gauteng Treasury already made financial provision,” said the organisations. 

The head of SECTION27’s health rights programme, Khanyisa Mapipa, said that in its list of motions, SECTION27 asks the court to declare that the GDoH’s delay in providing radiation oncology treatment to the patients on the backlog list is unlawful and unconstitutional.

Additionally, the civil society groups want the court to mandate the department to provide those services to the patients on the backlog list. They want the court to interdict the department from paying the R250-million that it has set aside to outsource the planning of the radiation oncology services. 

“Basically, we’re saying in our application that it is an unreasonable decision to award this amount of money simply for the planning. At the end of the day, when this is all done, nobody is going to be better off because nobody is going to get the treatment and what we’re after is the treatment,” said Mapipa.  

She said the R534-million earmarked to build bunkers and buy machinery would take years to finalise, to the detriment of cancer patients.

Mapipa revealed that the GDoH had failed to file its answering papers to Cancer Alliance’s application by Tuesday’s filing deadline.

“SECTION27, Cancer Alliance and the Treatment Action Campaign call upon the GDoH to fulfil its constitutional obligation to provide these patients with access to cancer treatment,” the organisations said.

By the time of publication, the GDoH had not responded to Daily Maverick’s request for comment. DM

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