/ 16 August 2013

Dodgy doctor gets back top job

The National Education Health & Allied Workers Union, NEHAWU, has denounced the Limpopo health department's reinstatement of a doctor under investigation for alleged medical misconduct and mismanagement as senior clinical manager at Messina Hospital in Musina. While the provincial department of health assigned a task team to investigate complaints against Dr Allick Dube, as well as potential misconduct of other staff at the hospital, all have been re-instated before the investigation was complete.

In May, the Mail & Guardian reported that hospital staff went on a NEHAWU-lead strike calling for the dimissal of Dube, then the acting clinical manager, and the hospital's chief executive officer, Simon Netshivhambe.

Among other complaints, staff claimed that Dube refused medical care to foreigners, harassed foreign doctors and gave inadequate care to rape survivors, and that Netshivhambe did not respond to several complaints filed by patients and staff. 

In June, the M&G reported that, in 2004, Dube pleaded guilty to involuntary manslaughter in the United States' state of Georgia while practising there as a medical doctor, for irregularly prescribing medication to patients. 

According to Mark Montgomery, an investigator who worked on the case, many of the patients had a history of drug addiction, and two died after taking medication prescribed by Dube. 

After the strike at the Messina Hospital, Dube and Netshivhambe were placed on paid leave. According to the former MEC for health and social development, Norman Mabasa, Netshivhambe was moved to the provincial department. 

Mabasa said that Dube would remain on paid leave until a full investigation was concluded. 

Mabasa was replaced by a former Limpopo sports, arts and culture MEC, Dipuo Letsatsi-Duba, a month ago as part of the provincial government's reshuffle. "I'm hoping the decision [to reinstate Dube] was very sensitive and made with reasoning," said Mabasa.

Dube returned to work
But two weeks ago, with the investigation still ongoing, Dube was back at the hospital, this time giving rabies training to nurses, according to Médecins Sans Frontières (MSF), which gives support to the hospital. 

MSF staff said that the interim hospital chief executive, George Makuya, told them on Tuesday that Dube would be reinstated as senior clinical manager following a directive from the provincial department. 

Makuya refused to comment. 

Adele van de Linde, spokesperson for the Limpopo department of health and social development, confirmed that "Dr Dube has returned to work at the … hospital as the clinical manager/CEO of the hospital, pending the outcome of the task team investigation". 

According to Benoit, the hospital is being downscaled and the position of senior clinical manager will also encompass the position of chief executive. Dube is now holding the hospital's most senior position. 

Van de Linde said the task team appointed to investigate Dube and other staff would submit their findings to the head of department, Sipho Kabane, this week and, "thereafter, further steps may be taken as per the recommendations". 

She said that the report would not be made public "as per the Promotion of Access to Information Act" and would not say if Dube would face a disciplinary hearing. 

Two of the seven staff who were suspended after organising the May strike said all had returned to work but had been told that they would face a disciplinary hearing. It was meant to take place next week but has been postponed. In a press statement released this week by the NEHAWU secretariat, the union called Dube's reinstatement "an unwarranted provocation and a blatant attach on the union and we want to make it clear that this action will provoke an appropriate response from our union."

According to MSF's Avril Benoit, "Dr Dube's reinstatement, despite any clarity on the slew of allegations made against him, is yet another blow against transparency and accountability in Limpopo. It sends a message to ethical employees that exposing the misconduct of hospital managers is futile." 

Following "procedure"
Speaking at a provincial health department public accountability meeting in Musina on Wednesday, the Chair of the Board of the hospital, Hlaulani Mlati, supported the province's actions by saying: "You can't just fire someone from the leadership until the investigations are done about all the allegations. We have to follow procedure." Mlati said Letsatsi-Duba would come to Musina next week to deal with the matter. 

Benoit also said that MSF had not received an update on investigations by the Health Professions Council of South Africa, the body responsible for registering doctors, despite the organisation lodging a complaint about Dube's conduct nearly four months ago. 

Bertha Scheepers, the council's spokesperson, said that they were awaiting a response from Dube before continuing.

She said that the council gave a 40 working day response time and that respondents could ask for an extension. But she could not say if Dube had asked for an extension. 

MSF submitted its complaint on May 2 and, when the M&G asked about its status in late June, the council said that it was awaiting a response from the doctor.

Earlier this year, Minister of Health Aaron Motsoaledi described the Limpopo department of health as the "most corrupt" in the country. 

Dube has been described by hospital staff as "well connected" to senior officials in the provincial department, including Moroamphaga Nkadimeng, the senior general manager for the health branch. 

According to hospital staff, who asked not to be named for fear of retribution, Nkadimeng defended Dube's reinstatement in a letter, stating, "He is bringing him back [because] people are covering their corruption by chasing [Dube] away". 

In addition to allegations of misconduct and mismanagement, staff claim Dube accepted money from patients to skip queues. 

Van de Linde said: "The department is committed to service delivery and rooting out corruption on every level and we will not be distracted from this path." 

Dube refused to comment, saying only that the M&G was "telling lies".

Nkadimeng also refused to comment.

Mara Kardas-Nelson is a journalist at the M&G Centre for Health Journalism. Her stories are produced with the support of the Open Society Foundation but are editorially independent of any sponsorship