Despite several civic organisations expressing concern about some pregnant and lactating migrants being denied access to certain public health facilities, the spokesman of the Office of the Health Ombud (Health Ombud), Ricardo Mahlakanya, has confirmed that the Office has not received nor had complaints related to such a matter. 

The matter in question was the subject of the ruling by the Gauteng high court in April, which “upheld the right of all pregnant and lactating women, and children under 6, irrespective of nationality and documentation status, to access free health services at all public health establishments, including hospitals,” as noted in a statement from Section27.

The very same statement — released on 4 July, 2023 – called on the Health Ombud to “initiate an inquiry into systemic health xenophobia in South Africa and to hold institutions and their management accountable”. 

For any institution and management to be held accountable by the Health Ombud, a complaint needs to be filed with the respective health establishment. If not resolved, a submission should then be made to the Ombud within two years of the alleged misconduct. 

After the submission, the regulatory body goes about “considering, investigating and disposing of complaints in the national health system (private and public health establishments) relating to non-compliance with prescribed norms and standards,” according to the Ombud’s website. It does so to “protect and promote the health and safety of users of health services”.

The investigation of each claim is followed by a recommendation for action, which the chief executive officer of the Office of Health Standards Compliance (OHSC) ensures is implemented promptly. This is an important aspect to safeguard public health facilities and render quality services to users of health services as there is immediate change being enforced upon the situation at hand.

A health worker pulls out a stretcher beds at Chris Hani Baragwanath Academic Hospital. (Photo: Felix Dlangamandla / Daily Maverick)

Health xenophobia

Court rulings — pertaining to access to free health services at all public health establishments — do not necessarily change anything on the ground, however — a reality noticed by Dale McKinley of  Kopanang Africa Against Xenophobia (Kaax), a coalition of organisations campaigning against xenophobia.

In particular, he speaks of the inappropriate treatment and care that migrant women have received from some healthcare professionals in several public health facilities in central Johannesburg. Those two categories of misconduct have been well documented by GroundUp and fall within the parameters of the Health Ombud.

The other categories are “inappropriate behaviour by a healthcare facility”, as explained on the Health Ombud’s website, “poor quality healthcare service provided by a healthcare establishment”, and “unsatisfactory management of a complaint by a healthcare establishment”.

Any of these acts of misconduct can be filed by “all members of the public, healthcare users and anyone on behalf of a relative, a minor or any other person,” the website further notes.

Marlise Richter — a steering committee member of the Collective Voices for Health Access and researcher at the Health Justice Initiative — said the Coalition and its partners plan to lodge a formal complaint about health xenophobia with the office of the Health Ombud.  They are currently gathering evidence from affected patients to submit a comprehensive complaint.

In an earlier open letter to the minister of health about health xenophobia, the Collective — which was previously named Collective Voices against Health Xenophobia — is described as “a coalition of civil society organisations, activists, healthcare workers and researchers who work on furthering social justice and challenging xenophobia within the healthcare sector.”

Patients waiting outside a clinic in Aliwal North. Its normally a long wait for most patients to get assistance in the clinics as a results of stuff shortages. (Photo:Felix Dlangamandla/Daily Maverick)

A complaint, however, was submitted by Kaax and Lawyers for Human Rights to the Health Professions Council of South Africa (HPCSA) in January about the misconduct of Limpopo Health MEC Dr Phophi Ramathuba. It received support from seven other civil society organisations such as the Treatment Action Campaign, Section27 and the Helen Suzman Foundation.

Dr Ramathuba was captured on video stating to a female Zimbabwean national that she and other Zimbabwean health users are draining the resources of the Limpopo province’s health system.

Read more in Daily Maverick: Court dismisses Limpopo MEC for Health’s attempt to quash inquiry into her ‘killing my health system’ remark

In January, the HPCSA’s Medical and Dental Professions Board announced its findings about the complaint’s inquiry and sanctioned her, as she was in violation of regulations in the Health Professions Act and imposed a penalty of “caution and reprimand”. 

Dr Ramathuba rejected both the January findings and sanction and is due to appear for another inquiry before the Medical and Dental Board’s Professional Conduct Committee in Pretoria from 25 to 27 July. DM