The Health Professions Council of South Africa (HPCSA) has cited Limpopo Health MEC Phophi Ramathuba for unprofessional conduct and unbecoming behaviour. 

This comes after Ramathuba’s diatribe against a Zimbabwean patient in a Bela Bela hospital was captured on video in August last year. In the video, Ramathuba accuses undocumented immigrants of draining resources in the country. 

In a report dated 9 February, the HPCSA stated that a caution and reprimand would be imposed on Ramathuba “for unprofessional behaviour and unbecoming [conduct] of a medical professional [for] shouting at a patient’s bedside as the patient was vulnerable at the time”. 

A ‘limp’ sanction

Some have expressed disappointment at the HPCSA for giving Ramathuba what amounts to a slap on the wrist. 

Marlise Richter from the Health Justice Initiative said that while she welcomed the ruling on what she described as the MEC’s xenophobic, hostile and disrespectful behaviour, the sanction was a “limp” one.

“A temporary suspension, removal from the HPCSA register, a fine or compulsory professional service would have been more appropriate in these circumstances, as provided for by the Health Professions Act,” she explained.

Richter added that Ramathuba should not be holding public office and, as a public servant and leader in government, she should also face disciplinary action from her employers.

“I commend the members of the public who lodged the complaint with the HPCSA and encourage everyone who has experienced or seen instances of xenophobia to immediately report it to the relevant authorities or oversight bodies,” she said.

Dale McKinley from Kopanang Africa Against Xenophobia expressed similar sentiments. 

“We welcome the censure; I think it is important that health professionals understand that when they do this kind of thing, they do face some kind of consequence. However, from our side, we would have preferred that there be more sanctions, other than just a simple reprimand,” he said. 

McKinley said Ramathuba’s xenophobic behaviour was unacceptable.

“We are disappointed that the HPCSA didn’t say anything about that, but we hope this sends out a warning to other health professionals or those who have abdicated their professional duties in treating everyone equally,” he added. 

Visit Daily Maverick’s home page for more news, analysis and investigations

Nigel Branken, one of the individuals who filed a complaint with the HPCSA, said the narrative that foreigners are to blame for poor healthcare services and for placing a burden on the healthcare system is factually incorrect.

He said foreign nationals and undocumented migrants are catered for in the MEC’s budget allocation as they are both counted in the distribution of revenue based on population.

“It is factually incorrect that migrants are not being catered for in the National Treasury allocations,” he said.

The MEC’s comments have had a far-reaching effect, with Operation Dudula members reportedly visiting certain areas of Gauteng demanding that South Africans get treated first for healthcare.

“At the very least, she should have been forced to issue an apology in a public statement correcting the misinformation that she shared,” added Branken.

“The only way we can put this right is by holding politicians accountable, to tell the truth, and stop scapegoating foreigners.”

What does the law say?

The Constitution sets out that everyone has the right to health (section 27(1)(a)) and every child has the right to basic healthcare services (section 28(1)(c)). 

This is a right that applies to everyone, according to Sibusiswe Ndlela, an attorney at public interest law organisation SECTION27.

“The National Health Act (NHA) 61 of 2003 is the legislation that is enacted to give effect to the constitutional rights to health. Section 4(3) of the NHA makes provision for the healthcare services that must be offered for free.

“It provides that the State and community health centres and clinics must provide: (1) free healthcare services to pregnant and lactating women and children below the age of six (except those who are on medical aid); free primary healthcare services to all persons (except those who are on medical aid); and free abortion services in terms of the Choice on Termination of Pregnancy Act 92 of 1996,” Ndlela explained. 

Outside of free healthcare services, patients are classified as either fully paying or subsidised in terms of the Uniform Patient Fee Schedule. 

Ndlela said those who are fully paying include some categories of non-South African citizens, such as those who come to South Africa on a medical visa. However, this does not apply to non-South African citizens who are on temporary work or residence permits, or non-South African citizens from SADC states who enter South Africa illegally. 

Therefore, the right to healthcare services applies to everyone – not just citizens. DM/MC