‘They made her life hell’: top breast cancer surgeon quits
The resignation of renowned breast cancer specialist surgeon Professor Carol-Ann Benn from Helen Joseph Hospital has fuelled concerns about the loss of expertise from public health
Professor Carol-Ann Benn’s resignation from Helen Joseph Hospital in Johannesburg has highlighted bad working conditions at the hospital. Insiders call the environment toxic, because of patriarchy and petty hierarchies. This is having a dire impact on staff retention and the quality of patient care.
The surgeon’s last day at the hospital, at the end of September, ended a 17-year relationship with the public health facility. Volunteers from the not-for-profit Breast Health Foundation, of which Benn is a founding director, have also stopped services at the hospital.
“The Breast Health Foundation’s decision to withdraw services in solidarity with Professor Benn comes after months of trying to address barriers to the provision of quality patient care and a lack of support from senior management,” its statement read.
Louise Turner, the foundation’s chief operations officer, says the organisation had five “patient navigators” and three volunteers at Helen Joseph Hospital. Navigators guide patients on their journey from diagnosis to treatment, linking them to services and advancing them on treatment waiting lists.
‘It is only one employee who has resigned’
The Gauteng health department says no patients will be affected negatively by Benn and the foundation leaving.
Department spokesperson Kgomotso Mophulane says: “The Breast Clinic is not closed at Helen Joseph Hospital. It is only one employee who has resigned, but the clinic continues to have other specialists...”
Mophulane says the foundation does not have a formal agreement with the department and “agreements with other facilities such as Charlotte Maxeke Academic Hospital continue”.
Benn has straddled public and private healthcare for over 30 years and remains head of the Netcare Breast Care Centre while lecturing at Wits University’s department of surgery.
If the shoe doesn’t fit
“My patients have taught me so much over the years,” says Benn. “Leaving Helen Joseph after 17 years has been a struggle. There was harassment and an obstructive workplace culture that made our daily working lives impossible. But I can’t spend my time getting into trouble for trying to find solutions. If my patients have to face so much to survive, then I can survive this, too.”
Benn is “stepping outside to find solutions”. She will try to find ways to reform access to cancer treatment on lower-level medical aid schemes without massive co-payments, while her other work continues. She is managing her existing Helen Joseph patients at her practice at Milpark Hospital and has plans to set up a “patient-centred unit for equitable care for public patients within the private sector” in the next few weeks.
“I don’t fit the shoe of government, but I’m leaving to innovate in other ways. No one should be turned away from a specialist unit because they don’t have the money or because they don’t live in a catchment area.”
According to Helen Joseph Hospital CEO Dr Relebohile Ncha, Benn raised issues of “challenges she had with her supervisor, which is one of the clinical managers. Unfortunately, these issues were brought forward at the time of her resignation and therefore there was no time to redress [sic] issues raised...”
According to Turner, the foundation helped to make the clinic a hub of excellence. “Much of what is in the clinic we raised money for – painting the walls, décor, chairs and furniture in the counselling rooms.”
Turner says they have helped about 200,000 patients “navigate” the maze of diagnosis and treatment.
According to Turner, Benn was summoned to meetings constantly to answer for her decisions and was criticised for not following procedure.
“Professor Benn’s approach has always been about putting the patient first. She has used her own money to buy things like surgical drains or surgical gloves so she could do her work. She always made a plan, including squeezing in surgeries, and she did accept patients who do not fall into the Helen Joseph catchment area because of their need to access services. Senior management made her life hell over this,” says Turner. Ouma Mamatela, a patient nav- igator for the Breast Health Foundation, was Benn’s patient in 2016, before she joined the foundation. She says patients at Helen Joseph pay a price for “egos and mismanagement”. “It’s going to be very, very hard for patients who expect to find the navigators there to hold their hand through everything. We built up a family of survivors. I am still waking up very early on Tuesdays and Thursdays because those were the days I knew I was getting up to serve our patients at Helen Joseph,” says Mamatela. She adds that Benn’s out-of-the-box thinking, accessibility to patients, and transparency irked senior male managers and doctors.
“Professor Benn is one person who speaks to everyone. She doesn’t make herself untouchable. I want to say to those managers that they need to put their egos aside because it is the patients that need quality care the most who are suffering,” she says.
Twenty-six-year-old Thandiwe* was one of Benn’s last patients at Helen Joseph. Her mother Thawe* says she and her daughter received professional care and kindness from Benn, but bureaucratic pettiness and outright bullying from senior hospital management.
The name that kept coming up
Thawe describes how Thandiwe found a lump in her breast in July and had a biopsy done at Moses Kotane Hospital in North West, but never received her results. She couldn’t work, so she went to live with her mother in Johannesburg. Thawe’s employer donated R10,000 towards her daughter’s treatment.
“When I asked about help, the name that kept coming up was Professor Benn. We used the money for another biopsy and to see Professor Benn at Milpark.
“When we saw the Prof she was so kind and informative. She explained and gave us some peace even though Thandiwe was cancer-positive. When it came time to pay, she realised we didn’t have medical aid so she told the receptionist not to charge us anything,” says Thawe.
Benn invited them to her clinic day at Helen Joseph to begin surgery steps. She also advised plastic surgery at the same time as Thandiwe’s left breast would be considerably reduced in size.
On the clinic day, they ended up waiting for hours, but: “Everyone from the foundation was friendly and explained in detail what was happening. When it’s like that you accept you have to wait.”
But then Thawe was told her daughter would not be admitted for surgery and her case was being referred to Charlotte Maxeke Hospital. Another doctor took Thandiwe off the surgery list and sent a junior doctor to us with the referral letter, without explanation. At Charlotte Maxeke, Thandiwe was sent from department to department and could not get admitted. Desperate, mother and daughter returned to Helen Joseph to demand an explanation.
“I was taken to see these three men in the clinical manager’s office. They showed no empathy – they just didn’t care. They just kept saying ‘wrong catchment area’, that they could not do plastic surgery at Helen Joseph, and that Benn should never have told us to come to Helen Joseph,” says Thawe.
The mother and daughter kept on fighting and took their complaint to hospital CEO Ncha, who eventually approved the surgery, to be performed by Benn, with a plastic surgeon helping.
“I cannot find the words to thank Professor Benn for all she did to save my daughter’s life,” Thawe says. But since Benn and the foundation left, “it’s been a mess at Helen Joseph”. Thawe’s verdict is backed by dozens of other Helen Joseph patients who have weighed in on social media, declaring support for Benn and the foundation, sharing stories and expressing worries about what comes next for their treatment.
Breast Health Foundation support line:
0860 283 343.