/ 17 August 2007

The full Manto

In the past seven days there has been a tectonic shift in South Africa’s political landscape. Forces long held in check have started to break loose, and the consequences for President Thabo Mbeki and his legacy are ominous.

At issue is much more than Health Minister Manto Tshabalala-Msimang’s effectiveness and the consequences of her alleged tippling on the job, or the firing of her deputy, Nozizwe Madlala-Routledge. More is at issue than even Frere Hospital, where mothers who have lost their babies to an appallingly high neonatal death toll have shared their grief with the nation.

It is in the gulf between their stark grief and the cold comfort of Mbeki’s online response — that the deaths of their babies were statistically average — that we can see what is happening. That letter, too confident by half in its intellectual posturing, and Mbeki’s actions since he wrote it, typify a political culture that is under serious threat.

The sacking of Madlala-Routledge has made international waves and reopened the battles with civil society. Big business is baffled at the president’s action; and the public health sector is increasingly in open revolt.

Motivating his decision, Mbeki used the principle of collective decision-making. ”I have, during the period you served as deputy minister of defence, consistently drawn your attention to the concerns raised by your colleagues about your inability to work as part of a collective, as the Constitution enjoins us to. For the same reason, I have also discussed this matter with you as deputy minister of health.”

‘Lawless mediocrity’

Writing in Business Day this week, Mervyn Bennun weighs in on Mbeki’s side, saying the issues go far beyond Frere Hospital, right to the heart of our constitutional democracy.

Bennun, an honorary research associate at the University of Cape Town, says South Africa is in the grip of ”lawless mediocrity” and that Madlala-Routledge’s behaviour is part of this trend. Tough political decisions are made in bracing and private political discussion, he argues, but once a position has been taken, it is the executive’s duty to show public unity.

Powers of the president

View a guide to the powers of the president (PDF)

This misses the point. Of course presidents should be able to sack Cabinet ministers that they disagree with or see as delinquent. But in a democracy, they must expect their reasoning to be publicly tested.

The axing of Madlala-Routledge has not withstood that test. Despite a clumsy bid to trap her in allegations of impropriety by leaking details of her abortive Spanish trip ahead of the dismissal announcement, she has drawn enormous support.

The international media (on which the president sets great store) has been fiercely critical and global Aids organisations are aghast. But more importantly, South Africans have had a clear view of Mbeki at his Machiavellian worst, just months before the African National Congress (ANC) policy conference.

The author Ronald Suresh Roberts and lawyer Christine Qunta have tried to justify Mbeki’s actions. Their account is hollow and familiar: Mbeki was right to axe her. Whites who oppose him are liberals — apparently an ideological crime — and the blacks who question his action are ”native assistants”.

Very few people buy this distorted version of events. Those who have opposed Madlala-Routledge’s axing and Mbeki’s stubborn clinging to Tshabalala-Msimang as health minister represent the entire spectrum of opinion and race.

Like Mbeki, the Aids Law Project, which is considering legally contesting the dismissal decision, quotes from the Constitution to back up its case. The project cites section 195, which sets out the values and principles of public administration, including the injunctions that ”people’s needs must be responded to, and the public must be encouraged to participate in policy-making”, and that ”public administration must be accountable”.

Interpretation

Which interpretation of the Constitution are we to accept — the one that envisages an elite clique doing deals in private and then brazening out the consequences, or the one that demands brave, open and responsive government?

It is this debate, about whether decisions should be taken by closed political coteries or in the spirit of accountable and participative government — that must now define the battle for the presidency of the ANC.

The past seven days have seen the country revisit an old and unsolved dilemma: which of the ANC’s political cultures will dominate?

Tshabalala-Msimang represents the authoritarian and Byzantine culture of the ANC in exile. At that time, the movement was infiltrated by spies, making it impossible to consult widely on strategies without letting the apartheid government know.

In these circumstances, cadres were compelled to allow the leadership and a brains trust to take important decisions without canvassing them in broader structures.

Madlala-Routledge represents the culture of the internal wing of the ANC where a genuine effort was made to ensure debates that were exhaustive and inclusive.

The current way of doing things, heavily informed by exile culture, was foreign to her, she told last Friday’s public briefing. Speaking about ”the ANC I grew up in”, she said that she would not have been disciplined for speaking out, but would instead have found ears willing to listen.

The opposite is now happening, at the cost of crucial constitutional values. The suspension of Frere’s superintendent, Nokuzola Ntshona, is a blow to whistle-blowing in the public service and runs contrary to the spirit of open government.

Critical voices

As the Freedom of Expression Institute has pointed out, a trend to shut down critical voices in the public health sector is now firmly established. Charges of ”prejudicing the administration, discipline or efficiency of the department” are levelled against people who speak out are untenable. It is clear that the real imperative in public service is to keep failures of government from public scrutiny.

Faced in the same week with damning allegations in the Sunday Times that Tshabalala-Msimang boozed and behaved atrociously towards staff while in a clinic for a shoulder operation, Mbeki alleged the newspaper had timed its article ”to project these in a caricature of derogation” and ”to demean the person of the minister”.

More attempts to shoot the messenger. The minister’s drinking habits are an open secret in the public service, yet have never been tackled.

Mbeki’s defence of Tshabalala-Msimang, and his inaction on grave and longstanding concerns surrounding her, again highlight his dual culture of blind loyalty and vicious ostracism.

It is pretty safe to wager that Tshabalala-Msimang has been the worst minister in post-apartheid South Africa. She has embarrassed the country on both local and international stages and squandered the support for government from the medical profession and its allied industries.But she will probably stay on in Mbeki’s Cabinet, insulated from the changing political realities outside.

There is no longer any question that the mood in the ruling party and the wider South Africa has changed. Just what it means we will only know once Mbeki has left the Union Buildings.

There is much to admire in Mbeki’s legacy — a growing economy, a more peaceful continent and a more confident black middle class — but he is risking that legacy through a nasty political style that will not outlast him.

What (and who) went down

The row over the sacking of Madlala-Routledge, and the mudslinging involving her, Tshabalala-Msimang and Mbeki, intensified this week. The following is a diary of news events relating to the controversy:

August 13

  • Tshabalala-Msimang announces she will sue the Sunday Times over its report on her alleged drinking and smuggling of liquor into a clinic where she underwent surgery in 2005.
  • August 14

  • Mbeki says he will not act against Tshabalala-Msimang and hints at a smear campaign against her. He defends public hospitals, saying R1,9-billion has been earmarked for hospital upgrades since 2003.

  • Tshabalala-Msimang demands a retraction from the Sunday Times and all documents relating to her hospitalisation. The paper stands by its story and refuses to hand over documents.

  • Former acting health minister Jeff Radebe denies Madlala-Routledge’s claim that he called her to express support after her sacking. Deputy Defence Minister Mluleki George denies inviting her to visit East London’s Frere Hospital.

  • In an unprecedented move, the international medical journal Lancet attacks Madlala-Routledge’s dismissal. 
  • August 15

  • Two senior doctors at the East London Hospital Complex are suspended. Head of clinical services Narad Pandey and Cecilia Makiwane Hospital medical superintendent Nokuzola Ntshona face disciplinary action for publicly criticising hospital conditions.

  • The New York Times attacks the dismissal of Madlala-Routledge in an editorial.
  • August 16

  • Documents are leaked to the media alleging Ntshona was fired from a Polokwane hospital in 2004 for compromising efficiency.

  • MediClinic lays charges with police over the alleged theft of the minister’s medical records.

  • The Treatment Action Campaign calls for worldwide condemnation of Madlala-Routledge’s dismissal.

  • Tshabalala-Msimang files an application in the Johannesburg High Court for the return of her medical records.