Manto officials unwise (perhaps even stupid)

The Department of Health really knows how to generate bad publicity. Just as the controversy about the Minister alleged alcoholism and liver transplant queue jumping was dying down, its officials takes out a huge advert in daily papers to attack the judgment of the High Court in the case of Tshabalala-Msimang and Another v Makhanya and Others.

If only from a tactical perspective, publishing this advert was spectacularly unwise because it poured oil on a fire that was busy going out. It suggests a stubborn self-righteousness on the part of the Department officials. They really think by slagging off a judge in a paid for advert they will change the parameters of the debate around the Health Minister. Fat chance.

The advert is also problematic for at least two other reasons.

In a constitutional democracy like ours, there is a need to respect the principle of separation of powers. This means that the judiciary should not overstep the mark and intrude on the executive terrain. At the same time the executive should not be seen to interfere with the job of the judiciary.

When officials choose not to appeal a judgment of a lower court but then use tax payers money to criticise that judgment in the most disrespectful terms, stating like Sello Ramasala, the Head of Legal Services in the Department of Health, that the judgement was “a huge disappointment in terms of its internal contradictions and lack of coherence”, it suggest that the officials do not respect the boundary between the executive and the judiciary.

I am in favour of vigorous debate and criticism of court judgments as long as it does not impugn the dignity of an individual judge. It is therefore perfectly acceptable for lawyers and academics to argue that the judge in the Sunday Times case did not present a very good legal argument. But members of the executive have a duty to uphold the Constitution and the law and should not do anything seen as undermining respect for the law. This advert clearly does just that, suggesting that the judgement should not be respected.

Of course the advert is also problematic because the arguments put forward by the Head of Legal Services seem to fundamentally misunderstand the scope of the judgment. Mr Ramasala argues that the judge erred in finding that the Sunday Times had broken the law by possessing and quoting form the medical records – something prohibited by the National health Act – yet allowed the Sunday Times to continue commenting on the Minister’s health issues.

Mr Ramasala seems to think (or pretends to think?) that this means the judge allowed the Sunday Times to continue breaking the law from quoting from the Minister’s health records. But this is not what the judge did at all: he merely said that the Sunday Times could not be prevented from commenting on the unlawfully obtained records. This subtle but rather obvious difference eludes the learned lawyer from the Department of Health.

Of course this argument about the Minister’s health records is a red herring and has been used by the Department and the ANC to divert attention from the real issue which is whether the Minister is fit to continue in public office. Did she jump the queue to get a liver transplant, thereby abusing her power to save her own life and deprive another person from a life-saving operation? If she did jump the queue, she clearly is not fit even to sell second hand cars – let alone be the Minister of Health.

We also should focus on whether the Minister is actually doing her job. Given the difficult circumstances faced by our health care system, has the Minister’s stewardship made things better or has it been a disaster. Available evidence suggests the latter, but sadly this does not matter for those who can decide about the Minister’s fate.

Why would one worry about whether poor people are dying in our hospitals when one has an old friend to support and defend at all cost?

Manto and Mbeki: how far can criticism go?

Are Ministers and the President entitled to a certain amount of respect and deference because of their important positions in our society or should they expect to be subjected to more searing criticism and questioning than the rest of us?

It seems as if the cabinet thinks that members of the Executive are entitled to special treatment and that their credibility may not be questioned . Government spokesperson Themba Maseko said this morning that the Cabinet took a dim view of the "distasteful coverage" of the Minister of Health, particularly the unlawful publication and theft of her medical records from a hospital. "The sacrosanct principle of doctor-patient confidentiality should be respected at all times, and its application could not be dependent on a person's class, position, gender or race."

It is true that public figures do not forfeit their right to privacy just because they run the country - even when they run it very badly like Mbeki and Tshabalala Msimang. Such figures also have a right to expect that what happens between them and their doctors stay private. But the facts in this case seem to suggest that the doctor-patient confidentiality argument is a red-herring.

The Sunday Times on Sunday made very specific allegations that the Minister of Health had been given preferential treatment to enable her to get a liver transplant when she did not qualify for such a transplant because of her alcoholism. In making these allegations, the newspaper did not rely on information that could only have been known by the doctor and his patient.

The newspaper asked questions about the Minister's treatment based on evidence that she was an alcoholic. They also reported that other medical practitioners had questioned whether she had not jumped the queue for the liver transplant. The legitimate question was asked whether her doctors had not broken rules and had not lied to the public when they assured us that everything was above board.

I cannot see how this reporting was in breach of the doctor-patient confidentiality rule unless one interprets this confidentiality rule to be so broad as to prohibit any discussion or speculation about the treatment of a patient by a doctor. Such an interpretation would be absurd because it would preclude the media from ever uncovering any maladministration or abuse of power in cases of medical treatment.

Where this treatment is controversial and perhaps based on abuse of the politicians power, newspapers would have a duty to report on it - as long as they do not report on information that only the doctor and the patient could have shared.

The doctor-patient confidentiality issue mentioned by the cabinet is therefore besides the point. Like the sub judice rule it is being used here to try and shut out any questions about abuse of power and whether the Minsiter really is a drunk and a thief. Interestingly enough, the cabinet did not address the substantive issues, namely whether the Health Minister had jumped the liver transplant queue or not. They therefore never disputed the factual basis of the report but is trying to change the subject - classic tactics if you do not want the public to know what is happening.

The spokesperson for the cabinet also criticised those who suggested that President Thabo Mbeki might have interfered to secure a liver transplant for his Minister of Health and stated that caution had to be exercised when criticising the head of state.

We think it is absolutely essential for South Africans to show a level of respect for the office of the head of state ... If you look at the statement [by the DA], it says the Public Protector must investigate this allegation and the integrity of the office of the president was being called into question ...

This is a complex issue bedeviled by race, but it seems to me also deeply problematic to argue, as Mr Maseko in effect does here, that it is inappropriate ever to question the integrity of the head of state. President Mbeki had denied involvement, but it surely is legitimate to ask the question.

Firstly, we know that heads of state often have little or no integrity - think Richard Nixon or George W Bush. Secondly, we know that President Thabo Mbeki and those in his office has a particularly tortured relationship with reality and "Truth". The President likes to re-interpret it to deny problems and the Minister in his office has on occasion provided answers to questions which turned out to be, well, untrue.

In any case in a democracy where the Rule of Law is upheld, a Head of State cannot expect to get a free pass. I would agree that given our history there might be a need to be sensitive to the tone used when questioning the ethics of the Head of State - calling him a mass murdered might in certain circumstances be inappropriate. But for the President's Spokesperson to suggest that one is not allowed to question the integrity of a Head of State is rather misguided. Is this also part of the attempt to change the topic?

No one is above the law and no one is beyond scrutiny. To suggest that the President is entitled to a free pass because he is our head of state is to question the very basis of our Constitutional democracy - namely that everyone is equal before the law.

Manto and doctors must sue or else....

The Sunday Times is now being attacked from all sides for publishing the sensational allegations that Health Minister Manto Tshabalala Msimang was convicted thief and alcoholic and that the real reasons for her liver transplant (alcoholism) was covered up by medical staff. The National Working Committee (NWC) of the ANC (but not Kgalema Montlante!) issued a statement yesterday attacking the Sunday Times for its "character assassination" of Health Minister Manto Tshabalala Msimang. The statement read in part:

“The national working committee views these reports with grave concern, not merely because [they] violate an individual’s right to privacy, but because [they] affect the right of all South Africans to expect their medical information to remain confidential."

But the privacy of the Minister is not really the issue. Surely the statement from the ANC should have disputed the accuracy of the claims made by the Sunday Times. The "character assassination" by the Sunday Times does not stem from the breach of the Minister's medical privacy, but from seriously defamatory statements about her drinking habits and about the abuse of power and corruption by the Minister and her Doctors.

The only way the Minister, the doctors involved and the Hospital can restore their reputations is by instituting a defamation action against the Sunday Times. If the allegations are untrue, they will be able to sue the pants of the newspaper and probably get a pretty penny out of the deal.

If they fail to sue, the only reasonable conclusion to be drawn would be that the newspaper report was correct and that there was corruption involved in the liver transplant. If this happens, the Minister should be fired and the Doctors scrapped from the medical roll.

The Presidency has asked for evidence of wrongdoing before taking action against the Minister. All the proof it may need will be provided by the absence of a defamation suit. But of course, even then the President will not fire the Minister because he will look weak and disloyal if he does. This means he is now probably stuck with a Minister which may well prove to be a thief and drunk and an abuser of her power.

I give the Minister and her Doctors two weeks to institute defamation proceedings. If they fail to do so, I will assume that the story is true.

A thief and a drunk, or just a sad victim of tabloids?

I feel torn about the explosive story in the Sunday Times this morning that Health Minister Manto Tshabalala Msimang is "a drunkard and a thief". I have to admit (rather shamefully) that on one level it gives me great pleasure to see what was left of the Minister's reputation destroyed by the newspaper.

Tshabalala Msimang's management of HIV/AIDS has been so arrogant, so criminally negligent, so maddeningly wrong, that it is difficult not to lay at least some blame for the unavoidable death of hundreds of thousands of South Africans from AIDS related illnesses at her door. Reading the article in the Sunday Times thus gives as much satisfaction as seeing the baddies in a Nazi movie kicked in the balls.

But of course, our Health Minister is a real person of flesh and blood - not a character in a movie. She has a family whose members have probably suffered greatly because of her alcoholism and tantrums. I therefore wonder whether the newspaper had not gone too far in invading her privacy by revealing that she was an alcoholic and that she had been convicted of theft more than 30 years ago.

Is this not a prime example of a new kind of dangerous tabloid journalism that will make the private lives of public persons fair game - no matter how intimate and personal the information? Do we really need to know these things? Will it make our democracy stronger and better?

One may of course argue that we have defamation laws and if the Minister wants to restore her credibility she should sue the Sunday Times. But it seems pretty certain that the reports are at least partly true, so a defamation action - even if successful - would not restore her credibility. On the contrary, a defamation action will probably be disastrous for her because the newspaper will be able to present witness after witness to tell lurid stories of our drunk as a skunk Minister.

Yet - the sensational headline aside - on balance I think the newspaper was justified to publish the story. The fact that the Minister is an alcoholic and drank like a fish is not relevant on its own, but it does become relevant against the background of her liver transplant and questions about whether she jumped the queue. The fact that she was convicted of theft might also seem besides the point until one realises that it could show a pattern of dishonesty on her part.

This story is relevant and important because at its heart it is about an incompetent and dishonest Minister who abused her power to obtain a new liver that could have saved the live of a more deserving patient. If true, the allegations would show that the Minister had abused her power in a most disturbing and illegal way to save her own life, in the process depriving another person of life-saving medical treatment.

It would also prove that the Minister has a history of dishonesty - stealing items from her very own patients for goodness sake - and that her queue jumping was therefore part of a long standing pattern of breaking rules. Obviously if true, her continued presence in the cabinet has become a national scandal.

The only way to clear her name is through defamation action, but as I pointed out above, she could only afford to do this if the allegations were false. I she thus fails to institute a defamation action, the President would be obliged to fire her. But of course he won't. And that is a national scandal all of its own.