/ 3 July 2014

Editorial: MEC’s sickening abuse of power

Patients waiting to be seen by a doctor in a state-run health service.
Patients waiting to be seen by a doctor in a state-run health service.

A woman has to push her disabled son in a wheelchair, on a journey of about an hour and a half, to get to the clinic where she and the boy are supposed to get their HIV medication – except it’s not always available. And, she says, when she gets to the clinic she is victimised by a nasty nurse.

A man who is HIV positive and suffering from a psychiatric condition has to wait six hours for the doctor – only to discover that, without explanation, the doctor won’t be in that day.

The man has lost his disability grant, his only source of income, because of the absence of a doctor to endorse his claim.

A woman who gave birth was unable to wash herself afterwards because the hospital had no water – and her blood-drenched linen were not replaced by hospital staff for the week she was there.

These appalling stories, told in the Mail & Guardian this week, all happened in the Free State, where state-run health services are falling apart. This is the province in which about a quarter of people between 15 and 49 are HIV positive, yet more than half of its medical facilities, according to one survey, suffer medication shortages.

At the same time, the precious few available resources are seized to benefit the politically connected, at the expense of ordinary patients. The other Free State healthcare story the M&G tells this week is about how the province’s health MEC “personally intervened” to get a bed in an intensive care unit (ICU) for a patient who would not ordinarily get such a bed because his chances of survival were so low.

But, on orders from above, an ICU bed was “created” for him – and this after the relevant hospital had cut its allocation of five ICU beds to three because of cash problems. Meanwhile patients who really should get such ICU beds – for medical, rather than political, reasons – are dying in the same hospital.

What this reveals is not just the heartbreaking suffering caused by the province’s inability to run its medical services properly. It reveals a sickening abuse of power on the part of provincial office bearers, plus sheer disregard for our fundamental constitutional principles of equality and a state based on the rule of law.

The tragic irony is that most of the political ruling class, whose incompetence and lack of leadership have led to the dire state of public primary healthcare, shun public hospitals – but then they can afford private healthcare.

When they can’t, or they want to do favours for those who can’t afford private care, they use their political power to provide state healthcare for those they choose to help (doubtless, too, for political reasons).

As we report in this edition, Benny Malakoane – the Free State health MEC who ordered the hospital to prepare an ICU bed for his favoured patient – was reappointed to that position by premier Ace Magashule despite the fact that he, with five others, face charges of corruption, due to be heard in court next month.

We are not suggesting that the politically connected patient didn’t deserve decent medical care.

But the provision of such care should not have been at the expense of other patients – or at the behest of politicians. It should have been a clinical call made by qualified medical practitioners. That clinical call, however, was dismissed by the politicians. They, it seems, are the ones to get to decide who lives and who dies.

This chain of events shows the ugly consequences of the behaviour of an uncaring political elite that equates political office with absolute power and the capacity to act with impunity. Ironically, in February Malakoane made site visits to hospitals in the Free State and promised to deal with the poor quality of services there.

Are these just more empty promises? Is there any comeback if he doesn’t fulfil them?

Looking at the bigger picture, we have to ask: Has dependence on political connections led to ordinary South Africans’ lives being sacrificed to ensure comfort and care for the connected?

What happened to ubuntu and compassion? What of the governing party’s repeatedly stated commitment to improve the lives of the poorest and most vulnerable in our society?

Acts such as Malakoane’s go beyond nepotism. They are simply the crudest and cruellest form of political arrogance and corruption. In this case, unlike many others, the consequences are immediately apparent: the suffering and death of ordinary people.

When he was appointed to his job, Malakoane took an oath in which he undertook “to hold my office as a member of the executive council of the province with honour and dignity; to be a true and faithful counsellor”.

He has violated this oath. He doesn’t deserve to hold office. He should pay for abusing his power. He is supposed to discharge his duties without fear or favour – and with a sense of justice and compassion. He has very obviously failed to do so.

We hope the public protector and other constitutional watchdog bodies will investigate this matter. All of South Africa should – in the words of one of the neglected patients mentioned above – be very, very angry.