TRC Final Report

Volume 4

Chapter 5

Subsection 16

■ THE ALLIED HEALTH PROFESSIONALS

95 The Commission received submissions from other sectors of the profession, including physiotherapists, pharmacists, dentists and complementary practitioners. The submission by physiotherapists pointed again to the hierarchical nature of the health profession and the fact that some professionals were perceived as having a less important status. The submission of the physiotherapy profession complained that:

Certain individuals and institutions had been invited to make submissions [to the Commission]. However, the rehabilitation therapists had not been included in this group, which consisted of doctors (and psychiatrists), nurses and psychologists. This seemed to be a perpetuation of long-standing professional hierarchy/hegemony, which needs to be challenged as part of the health care sector hearings.⁴¹

96 All submissions emphasised the lack of training in ethics as a major area of concern. In addition, the fact that other health professionals felt compelled to make submissions is indicative of the pervasiveness of abuses - either overt or covert - in the health sector and an acknowledgement of the fact that most health workers did not speak out enough, or at all, about these abuses.

■ PROFESSIONAL HEALTH ORGANISATIONS

97 In his testimony, Dr Barry Kistnasamy noted:

The social consequences of apartheid were so gross, so thoroughly destructive and so widely acknowledged and abhorred by the international community that there could be no avoiding the intrusion into the professional lives of the medical men and women of this country.

98 It was surely the task of the statutory and professional organisations to ensure that professionals were able to provide ethical and appropriate health care, regardless of the policies of the government in power. If, as Dr Kistnasamy states, those policies made this impossible, it was for the statutory and professional bodies to speak out against those policies.

The organised medical profession

99 History has shown that the two most powerful bodies with which doctors were associated - the SAMDC and the MASA - failed to speak out or take a stand for most of the period under review.

100 The SAMDC was a statutory body and, during the period under review, was responsible for the registration, education, maintenance and monitoring of professional standards of conduct as well as for disciplinary enquiries into allegations of misconduct of all health professionals except nurses and pharmacists.⁴²

101 The successor body to the SAMDC, the Interim National Medical and Dental Council (INMDC), prepared a submission to the Commission on behalf of the earlier body. The submission made it clear that the SAMDC saw itself as an independent body:

Although created by statute originally in 1928, the SAMDC was not an organ of state. It was totally funded by the health care professionals falling within its jurisdiction. The majority of its membership was persons who were not appointed by the Minister.

102 Yet, the SAMDC was viewed widely as an almost parastatal organisation, lacking in independence. Nothing highlighted this more that its initial failure to launch an investigation into the conduct of the district surgeons, Drs Tucker and Lang, after the death of Steve Biko. The following explanation was given as to why the SAMDC’s first enquiry into the matter in 1980 differed so markedly from the second enquiry in 1985 (undertaken in large part in response to continued public outcry):

When eventually (the second) inquiry was held, that was a completely different body in a different Council. Remember the Council’s terms of office stretch in five-year terms, or used to. So, that was one Council from 1980 to 1985 and then a new Council from 1985 onwards. So that when eventually this inquiry reached the stage where it came before Council, there was a completely new Council with new members, and that Council then came to the conclusion that the practitioners were in fact guilty.

103 One might question this explanation. A body responsible for discipline and the maintenance of professional standards of conduct should display consistency in applying those standards.

104 The SAMDC, in contrast, displayed no hesitation in taking action against another of its members who was guilty - not of negligence in treating patients, but of resisting the apartheid regime. Dr Aubrey Mokhoape was a doctor convicted of terrorism in 1974. During his interrogation, he was put into solitary confinement, beaten and tortured. The Council did nothing to protest about this treatment and proceeded to use the criminal offence (‘terrorism’) as the basis for launching proceedings against him as a medical professional. It eventually dropped its charges against the doctor, but the case demonstrates that the SAMDC could take swift action when it deemed it appropriate.⁴³

105 Another significant problem raised in the hearings was the fact that the SAMDC was only able to respond to complaints or submissions made to it. This inability to be proactive severely hampered its capacity to monitor and maintain professional and ethical conduct.

106 In a letter submitted to the Commission after the hearing, Mr Prinsloo, on behalf of the executive committee of the SAMDC, stated:

The Committee resolved that the [Truth and Reconciliation Commission] be informed … that the Executive Committee wished to state explicitly that it records an apology in respect of any acts of omission or commission on the part of the SAMDC in not taking firmer steps to negate the effects of an unacceptable social system.⁴⁴