In December 2013, the HPSCA found Basson guilty of unethical conduct for his role in Project Coast, the apartheid government’s perverse biological and chemical warfare programme that turned healers into henchman.

Basson was involved in manufacturing drugs like mandrax that were distributed in townships and for making tear gas more potent. He also provided sedatives to assist the South African Defence Force in cross-border kidnappings.

His sentencing, due to start today has been postponed for the second time due to the unavailability of Basson’s legal counsel, according to a statement released yesterday by the HPSCA.

However, the HPSCA ruling against Basson makes it clear that health professionals can be held responsible for their actions even during times of social unrest, according to University of the Witswatersrand Medical School’s Professor Martin Veller.

But the real legacy of this ruling may be that health workers who are to blame for poor quality – and sometimes deadly – health care in the public sector today can be held accountable, according Dr Kevin Behrens, a senior lecture at Wits University’s Steve Biko Centre for Bioethics.

“If what Project Coast and the doctors did involved did wrong ethically as professionals was to cause harm, what about the many professionals who are now in positions of administration and leadership who are presiding over corrupt tenders, maladministration in hospitals…which lead to deaths and patient suffering?” said Behrens.

“We should look forward to the day when the HPSCA puts the first hospital administrator …in front of them to respond.”

Whistle-blowers still a target

[quote float=”right”]”Your primary duty is to act in the best interest of your patients… not to protect the interests of your employer.”

But the Rural Health Advocacy Project (RHAP), which helps health workers to raise ethical concerns about issues such as drug, equipment or human resource shortages, says many pay a high price for voicing concerns.

“In the past and still today, there have been instances of health workers who stand up for the rights of their patients and get victimised for doing so,” said RHAP Director Marije Versteeg-Mojanaga.

Victimisation can range from suspension to more subtle forms such as being passed up for promotion or forced to work in areas outside their specialities, she added.

Health care workers can lay formal and anonymous complaints with the Public Protector and whistle blowers can also use the Protected Disclosure Act to protect themselves, says Versteeg-Mojanaga. But using the act means proving that victimisation is linked to whistle-blowing.

She advises health workers to document meetings with clinic manager or hospital CEOs to show they attempted to address the problem internally before seeking outside help – and to protect themselves later.

“Health workers deliver a Constitutional right to patients, not a favour,” she told Health-e News. “As a health worker, your primary duty is to act in the best interest of your patients… not to protect the interests of your employer.

“If your employer, the Department of Health, is not listening to and acting on your concerns, you don’t have a choice – you have to look at dealing with it in an alternate way,” she added. – Health-e News Service.