The Eastern Cape’s impotence in the face of “brutal” and “thuggish” union disruption at Fort England psychiatric hospital highlights a possible fatal flaw in the NHI plan.

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Concern about the viability of a national health insurance (NHI) plan often focuses on SA’s imperiled finances. But a recent labour court decision highlights another problem with wrecking potential.

It concerns Dr Roger Walsh, former CEO of Fort England psychiatric hospital in Makhanda, previously known as Grahamstown. Home to about 300 patients with mental disorders, some “extremely disturbed” and needing constant supervision, the hospital’s national maximum-security unit also manages SA’s most dangerous state patients.

Walsh found the hospital in crisis, with administrative chaos, rampant absenteeism, “financial interactions” between staff and patients and a level of clinical care that was cause for great concern.

But his vigorous cleanup ran into trouble with union members. Unauthorized strikes and protests followed, with increasingly serious consequences for the hospital, staff and patients. Shop stewards led mob disruption at the hospital, targeting certain staff for intimidation and assault. A court interdict obtained by management was ignored.

In a meeting chaired by a senior Eastern Cape provincial health department official, a union representative said the hospital would be made “ungovernable” and that the administration building was to be set alight. Wards were left without nurses. Access to the kitchen was blocked and police had to help regain access to the kitchen where, in the absence of striking staff, patients’ food had to be prepared by the psychiatrists. Fire hydrants were set off. Medicine could not be given to the patients. At one stage Walsh wrote to the provincial health authorities saying that unless the department acted urgently to stop the unions’ unlawful conduct, there was a real danger of violence, escapes and relapsing of psychosis among patients.

But while union members agitated for his removal, 10 managers of key divisions in the hospital expressed their full support for Walsh and his leadership, saying union claims were “uninformed, inflammatory”. Two independent investigations cleared Walsh and his management style, finding there was no truth in union claims of non-consultation.

Instead of acting to stop the violence, however, the provincial authorities transferred Walsh to Bhisho as “director: forensic services”.

Walsh challenged his “transfer” in the labour court: why was he transferred when union officials and hospital employees were involved in serious, unlawful acts that infringed court orders, including assaults and threats to staff and property? By transferring him, the provincial authorities were capitulating to unlawful demands, he said.

The court held that the transfer was not unlawful: it was “not irrational” and he was “consulted”. However, the facts disclosed a “relentless campaign” to oust him. He was “hounded out of his position” by a campaign of vilification, harassment, intimidation and assault, and he did not get the departmental support to which he was entitled.

Scathing about the illegal activities at the hospital, the judge said the trade unions operating the public health care sector in the Eastern Cape committed “brutal acts of thuggery” to protect their interests. Officials and members of the unions “engaged in serious misconduct”, some of which, on the face of it, warranted “summary dismissal”.

As to the department’s response, “employment policy at the hospital … appears to have been dictated by the unions” and instead of stopping this unlawful behaviour, the department “ultimately engaged in what can only be described as appeasement and acquiescence and ultimately, craven capitulation to unlawful demands.” The employer was held hostage “to a concerted campaign of violence and intimidation conducted by power-hungry union officials” and in this anarchic situation, health services could be seriously compromised.

Against the background of this case one has to ask: would the authorities running NHI have any more backbone in dealing with “brutal acts of thuggery” by unions? Or would they, too, completely capitulate to intimidation and violence, leaving patients to the mercy of the mob?

  • Financial Mail, 28 February 2019