UNION PSYCHOSIS
The Eastern Cape’s impotence in the face of labour disruption at Fort England psychiatric hospital highlights a possibly fatal flaw in the NHI plan
Concern about the viability of a national health insurance (NHI) plan often focuses on SA’S imperilled 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). The hospital is home to about 300 patients with mental disorders, some “extremely disturbed” and in need of constant supervision. It has a maximumsecurity unit that 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. Unauthorised strikes and protests followed, with 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 the management was ignored.
In a meeting chaired by a senior Eastern Cape health department official, a union representative said the hospital would be made “ungovernable” and the administration building was to be set alight. Wards were left without nurses. Police had to help regain access to the kitchen where, in the absence of the striking staff, patients’ food was prepared by the psychiatrists. Fire hydrants were set off. Medicine could not be given to patients. At one stage Walsh wrote to the provincial department, saying unless it acted urgently to stop the unlawful conduct, there was a real danger of violence, escapes and patients relapsing into psychosis.
But while union members agitated for Walsh’s removal, 10 managers of key divisions in the hospital expressed their full support for him, saying union claims were “uninformed, inflammatory”. Two investigations cleared Walsh and his management style, finding no truth to union claims of nonconsultation.
Then, instead of acting to stop the violence, the provincial authorities transferred Walsh to Bhisho as “director: forensic services”.
Walsh challenged this in the labour court: why was he transferred when union officials and hospital employees were involved in unlawful acts — including assaults and threats to staff and property — that infringed court orders? By transferring him, the authorities were capitulating to unlawful demands, he said.
‘Hounded out’
The court held that Walsh’s transfer was not unlawful: it was “not irrational” and he was “consulted”.
However, it said the facts suggested 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 he was entitled to.
In a scathing summation, the judge said the unions operating in the public health-care sector in the Eastern Cape committed “brutal acts of thuggery” to protect their interests. Officials and union members “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”. Instead of stopping unlawful behaviour, the department “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 this background, one has to ask: would the authorities running NHI have more backbone in dealing with “brutal acts of thuggery” by unions? Or would they, too, capitulate, leaving patients at the mercy of the mob?
The health department engaged in ‘craven capitulation to unlawful demands’