*** LATE UPDATE:

The charges relate to department tenders and contracts signed off between January 2011 and December 2015. Motau joined as head of department in 2013. He resigned in 2021 and took up the post of registrar of the HPCSA towards the end of June.

On Monday, 2 August, Motau and 10 others appeared in the Bloemfontein Magistrates’ Court on 304 counts ranging from contravention of the Public Finance Management Act, forgery and uttering, to fraud, corruption and money laundering. Motau himself is charged on 45 counts.

Before he was ordered to appear in court, Motau spoke to Spotlight about his plans to reform the HPCSA. On Tuesday, after being charged, he responded to follow-up questions.

He maintained that he inherited many of the problems relating to the contracts and tenders, which the state alleges were corrupt deals, when he joined the department. He was “not aware of the alleged commission of such offences”.

Motau also said he is “solely being charged for being in contravention of sections in the Public Finance Management Act” and intends pleading not guilty when he and his co-accused appear in court again on 22 September.

Spokesperson for the Director of Public Prosecutions in the Free State, Phaladi Shuping, said Motau faces 44 counts of contravention of the act and one count of “accepting gratification”.

Motau said he has written to the president of the HPCSA since being charged and the charges “should not follow him to his new role”.

HPCSA spokesperson Christopher Tsatsawane did not respond to questions about any action the council intends to take in light of Motau’s court case or his future at the HPCSA.

The controversial Buthelezi EMS ambulance base in Bloemfontein. The Special Investigating Unit is investigating the ambulance contract. (Photo: Spotlight)

The other accused in the case are Motsumi Polori and Kenosi Legobate, who are still employees of the provincial health department, and retired employees Mietjies Johns, John Chakane, Maria Mabitle, and Lebohang Beqeze. Tsietsi Polori, Thabo Moeti, Mavuso Kwababa, Simon Njonga and Charity Moloi, who were directors of the implicated companies, make up the remainder. The companies are Tsa Rona Consultancy, Azrago, Land Breeze Trading, Amakholwa Consultancy Training and Zen Communications.

According to the Director of Public Prosecutions, it is alleged “that between January 2011 and December 2015 the officials facilitated and approved payments of claims for services that were not rendered by these companies. The companies were used by department officials as vehicles to commit the offences because they never rendered any service to the department.”

Motau and the other accused were released on bail ranging from R2,000 to R5,000.

History of controversy

The Free State health department was considered one of the country’s worst performing for years. It was placed under administration by the provincial treasury in years largely overlapping with Motau’s time in the key position. The department previously told Spotlight it was under administration from 2014 to 2018 – although it was taken out of administration for five days in February 2017, a period in which Motau signed off questionable price increases for a private ambulance company contracted by the department.

Issues in the province that Spotlight has reported on include the controversial contracts with the ambulance company (currently being investigated by the Special Investigating Unit), the purchase of inferior or inappropriate medical equipment, and the charging of 94 community health workers who held peaceful protests outside the department’s head office, Bophelo House, in Bloemfontein in 2014.

Speaking to Spotlight before his court appearance, Motau would not go into specifics on any of these issues. He only said it “was a complex environment where it was like drilling into a stone to get water” when trying to deliver healthcare to 2.9 million people with budgets that “you shout for till you are blue in the face”.

Unfinished business

Motau also said there was unfinished business he would have liked to have seen come to fruition in the Free State, including shifting the priority of maternal mortality in the province. The Free State registers one of the highest death rates among pregnant women and new mothers in the country. By getting a political principal to chair meetings on maternal mortality, he had hoped to expedite decision making and free up budgets. He had also been in the process of deepening collaboration with universities to introduce new health-related systems, and working to reach alternate agreements with the courts in liability cases.

His plan, Motau said, was to offer victims court-approved packages of care and services, not payouts. The province’s contingent liability bill was skyrocketing. It stood at about R5-billion by the time he exited his post earlier in 2021.

“It will be difficult to turn that corner in the province because of the failures in the lower levels of care,” he said.

A brand eroded

Motau also has big plans for the HPCSA, although that future now seems uncertain in light of his court appearance.

Before this week’s events, and before Spotlight was aware of the charges, Motau, in an interview, reflected on his new role at the council.

He acknowledged that “the HPCSA’s brand has been eroded” and that the council has become removed from its members and the public. He called out the “lack of urgency and agility” that has come to define the council’s working culture and which has made it sluggish, clunky and ineffective.

It has become so removed from its members and the public that at one point the council simply chose to disable its social media platforms because of all the negative comments it was receiving, Motau added. 

The battered image of the Health Professions Council of South Africa has suffered another blow with its registrar, Dr David Motau, appearing in court this week in connection with allegedly corrupt payments amounting to R8.7-million in public funds. (Photo: Spotlight)

Formed in 1974 as a statutory body, the council brings together 12 professional boards. It is meant to protect the public by setting and upholding standards, ethics and a code of conduct for the education, training and registration of practising health professionals. It is also supposed to protect and advocate for its members who have to pay subscriptions to the council to be licensed to work. The HPCSA is funded by these subscriptions. Currently it is described as a going concern and in 2020 collected annual fees of R223,174,168, but its financial statements also reflect growing deficits that more than doubled between 2019 and 2020.

For years the HPCSA has been dogged by poor governance, mismanagement and administrative irregularities. Conflicts of interest keep arising, as do the unsettled issues of possibly unbundling boards from the council, and the need for a clearer delineation of functions between its internal structures.

As far back as the end of 2015, a ministerial task team investigation found senior staff at the HPCSA unfit to hold their positions and highlighted widespread misconduct, irregular expenditure and failure to efficiently manage operations. Drawn-out Special Investigating Unit probes from 2019 finally led to the precautionary suspension, in April 2021, of 16 employees implicated in bribery and corruption in registration processes.  

Planning to turn things around

Suspensions are part of the consequence management Motau spoke about as part of how he intends to get the HPCSA’s house in order, while working to improve the relationship with labour – the council’s 265 staff. “It’s your staff who has to implement your strategies and programmes and you can’t do that effectively if you’re standing outside the whole time receiving memorandums,” he said.

Motau said a different relationship means a balance between incentivising and tracking performance and not carrying dead wood in the organisation. “Your staff should feel like there’s a reason why they should get up and come to work each day, but you also have to have signed performance agreements in place for deliverables they must meet. They should feel each day that they have earned their salaries, otherwise they must look in the mirror and ask themselves what they are doing wrong,” he said.

Six weeks into the job, he said he has revived the HPCSA social media platforms – even at the risk of negative comments coming in fast and furious. He said he is working on digitising more of their registration processes and listings to improve the user interface for members and the public.

He had also introduced quarterly staff assessments, hoping to catch problems before they became crises at an annual review. “But if there is a question of clear dereliction of duty and you get to a point where you have to fire someone, then you must not be afraid to do that.”

‘Tough love, silent compassion’

His presence in the office at a time when Covid-19 infection rates are still high is important for visible leadership, Motau said. It also meant he had personally dealt with some routine complaints from members, including resolving issues for doctors waiting for months to receive their licence cards even as paid-up members.

Motau described his management style as “transactional and transformational”. Transactional in looking for performance and results and transformational in leadership that gets more buy-in.

“I’m not a command-and-control kind of leader. I would say I try to implement tough love and silent compassion,” he said. DM/MC

This article was produced by Spotlight – health journalism in the public interest.