2nd Memorandum – Minister and Department of Health (South Africa)

Memorandum – Minister and Department of Health

21 September 2020
The Honourable Minister of Health Dr Zwelini Mkhize
Civitas Building
Cnr Thabo Sehume and Struben Streets PRETORIA
0001



Dear Minister Mkhize


On the 10th March 2020, the healthcare professionals wrote to you with regards to the unilateral suspension of healthcare practitioners by facility groups registered under the Department of Health and the subsequent public trial by media and public display and arrest of healthcare professionals.

Since then, there have been no responses to the signatories or comments on this matter by the Ministry. We specifically chose to engage directly with your Ministry, the Ministry of Justice, the National Prosecution Services, the HPCSA and the Facility Groups directly to enable constructive and collaborative solution-finding. We did not believe that engaging the media was the ideal way forward at that time.

We acknowledge that South Africa, and particularly your department and the healthcare workers we represent have been almost exclusively occupied with serving the nation through the Covid-19 pandemic.

However, the lack of response to this request, and the subsequent delay we allowed through the Covid-19 pandemic has had potential and dire consequences. Even if the murder of Dr. Abdulhay Munshi proves completely unrelated to his clinical work, and there is still no evidence of any motive here, there is a public perception being created. His death provokes mass outrage and fear. As healthcare professionals, we now find ourselves operating in a new paradigm of trepidation - uncertain as to what the future may hold for the entire medical profession.

The country simply cannot afford this.

As professionals, we once again engage the Ministry and yourself directly. While we have all been extensively approached by the media, we are doing our best to focus on the facts at hand and address the systemic issues through dialogue and political leadership. We remain extensively under
pressure from the press, however.

For the sake of the state of the healthcare system in South Africa, we are asking for an URGENT meeting with yourself, your senior advisors and senior staff on the issues we raised on the 10th March. We request that this meeting take place before the end of day Tuesday 22 September 2020.

We repeat, for ease of reference, the call to action we included in that memorandum:


Owing to the above, and inclusive of the statements in our Memorandum directed to the HPCSA, we call on the Minister and the Departments of Health to ensure:
1. All complaints (by the public or the professions) that relate to clinical harm to a patient are prioritised over any other complaint dealt with by the HPCSA.

2. All inquiry panels and panels appointed by the Minister to serve within the HPCSA are adequately composed in terms of professional and legal expertise to ensure consistency in HPCSA and legal application as well as professional practice adjudication. We suggest that the Minister review nominations and appoint members of professional boards based on professional expertise and service with such responsibilities in mind.

3. The Medical and Dental Board of the HPCSA should be able to conduct its business free from interference of boards that are currently unreasonably enabled to interfere with regulation and oversight of the Medical and Dental Board. This may be enabled through separation of the Medical and Dental Board from the HPCSA or through other regulatory means.

4. The Minister of Health immediately engages the Minister of Justice and the Director of Public Prosecutions to emphasise the human resource implications and threat of circumventing inquest prior to initiating criminal prosecution of medical professionals as envisaged and addressed in HPCSA regulations and the Inquest Act.

5. The Minister publicly address the threat that the actions of the National Prosecuting Authority, in arresting medical professions, have to the health and wellbeing of the nation.

6. The Departments of Health acknowledge and undertake to ensure facilities in both the public and private sector adhere to the standards of the Departments of Health in terms of facility, equipment, consumables and staff quality and quantity through better oversight, inspections and regulatory policing.

​​We further add to this list a new action item:
1. That the death of Dr. Munshi, as well as the death and assaults on the many other healthcare workers (including the doctors, nurses and emergency medical practitioners) be investigated fully, urgently and with accountability. That through this action, the perpetrators of these vicious crimes be prosecuted and so that healthcare workers may serve this nation with the belief that every possible effort is being made to protect them.

At this time, an attack on healthcare workers is an attack on the state, as health is a national asset.​

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Issued on behalf of:


1. FoSAS (Federation of Surgeons of South Africa) representing:
• APRSSA (The Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa)
• ASSA (Association of Surgeons of South Africa)
• CS of CMSA (The College of Surgeons)
• HPBASA (Hepatopancreaticobiliary Association of South Africa)
• SABS (The South African Burns Society)
• SAAPS (The South African Association of Paediatric Surgeons)
• SACRS (The South African Colorectal Society)
• SAJS (South African Journal of Science)
• SAOA (The South African Orthopaedic Association)
• SASES (South African Society of Endoscopic Surgeons)
• SASOG (The South African Society of Obstetricians and Gynaecologists)
• SASSIT (South Africa Society of Surgeons in Training)
• SAUA (South African Urology Association)
• SCTSSA (Society of Cardiothoracic Surgeons of South Africa)
• SNSA (Society of Neuro Surgeons of South Africa)
• SRSSA (Surgical Research Society of South Africa)
• Surgicom (General Surgeons)
• TSSA (Trauma Society of South Africa)
• VASSA (The Vascular Society of Southern Africa)

2. SAMA (The South African Medical Association)

3. SAPPF (South African Private Practitioners Forum) representing:
• APRASSA (Association of Plastic, Reconstructive and Aesthetic Surgeons of South Africa)
• DSSA (Dermatological Society of South Africa)
• ENT Management Group
• FCPSA (Faculty of Consulting Physicians of South Africa)
• GMG/SASOG (Gynaecology Management Group)
• Iso Leso Optics
• NASA (Neurological Association of South Africa)
• OMG/OSSA (Ophthalmology Management Group)
• PMG (Paediatrician Management Group)
• PsychMg/SASOP (Psychiatry Management Group)
• SARAA (South African Rheumatism Arthritis Association)
• SASMFOS (South African Society of Maxillofacial and Oral Surgeons)
• SASP (South African Society of Physiotherapists)
• SAUA (South African Urological Association)
• SEMDSA (Society for Endocrinology, Metabolism and Diabetes of South Africa)
• Surgicom (General Surgeons)

4. SASA (The South African Society of Anaesthesiologists)

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