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Hospital official suspended for speaking to media; "free speech in the public health system needs intensive care," says FXI

(FXI/IFEX) - The following is an FXI media release:

Media Release: Free speech in the public health system needs intensive care

The Freedom of Expression Institute (FXI) feels that recent reports strongly suggest free speech in the public health system needs intensive care. The most recent case of Eastern Cape's Dr Nokuzola Ntshona, the Medical Superintendent at the Frere Hospital who was suspended this week, raises serious questions about the state of free speech in the public sector.

The suspension also comes in the wake of controversies about the Daily Dispatch's groundbreaking investigation into baby deaths at Frere hospital, which led to a deeply disturbing verbal attack on the newspaper by President Thabo Mbeki. This investigation prompted a visit by the then-Deputy Minister of Health, Nozizwe Madlala-Routledge, who described the situation at the hospital as a "national emergency". Ntshona backed up her statements in a letter to President Mbeki. Madlala-Routledge has since been dismissed for, in part, being incapable of functioning in a collective, and now Ntshona has been suspended. These events strongly suggest the existence of a witchhunt to stop further embarrassment to the Eastern Cape Health Department.

Attempts to shut down dissent in the public health system are not new. The FXI has in the past dealt with an attempt by the Western Cape health department to gag doctors from speaking to the media, as well as National Department gags on provincial health officials from commenting in the media about HIV/ Aids, during the visit of United Nations Special Envoy on HIV/ Aids, Steven Lewis. Last year, the longstanding battle between Eastern Cape-based Doctor Costa Gazidis came to an end, when he was reinstated after being fired from the Department of Health for a media statement in which he criticised the Minister of Health. Also last year, Western Cape-based doctors were instructed to desist from protesting against budget cuts, even in their lunchtimes, and on their leave days. The FXI has also been reliably informed that a number of doctors have been told that they cannot speak to the media, even in their individual capacities.

When taken together, these incidents point to a climate of increasing intolerance of critical debate in the public health system; in these conditions it is small wonder that action is being taken against those who are most vocal within this system. The people who stand to lose the most from this clampdown on freedom of expression are ordinary health workers who are far more vulnerable to victimisation than more high profile figures like Gazidis, Ntshona and Madlala-Routledge. More and more public sector health workers will be reluctant to speak to the media on the record, which will force them to go off the record, or to stop speaking to the media entirely. In the process, the sorts of investigative journalism that we have seen coming out of the Daily Dispatch will become impossible, leading to the media having to rely on the official, and not necessarily always accurate, "spin" of government spokespeople.

Dr Ntshona was suspended for what she was told was a breach of conduct. She is accused by the Chief Executive Officer (CEO) of the East London Hospital Complex, Luvuyo Mosana, of "prejudicing the administration, discipline or efficiency of the department, concerning unauthorised publication and supplying inaccurate information to the Daily Dispatch . . . as well as the Cape Argus." Essentially, the superintendent is being punished for talking to the media. Her letter of suspension also warns her to avoid speaking to the media.

It is unclear which of the statements that Ntshona has made to the media can be regarded as "inaccurate information". Indeed, we suspect that she is being victimised precisely for supplying the media with accurate information about the state of health in the Eastern Cape. Further, some of the media quotes from her were obtained not from interviews that she gave to the media but from a presentation she made on behalf of the Department when former Deputy Health Minister Madlala-Routledge visited the Frere Hospital. Yet another interview she gave to the Daily Dispatch concerned allegations about fraud committed by her in the past, which required her to defend her credibility as a whistleblower.

We are also concerned that the idea that a senior civil servant can be suspended with a charge of "prejudicing the administration, discipline or efficiency of the department" is actually an attempt to chill the free expression of civil servants and prevent them from exposing to the public what is clearly in the public interest - the state of the country's health system in this case.

Civil servants have a constitutionally guaranteed right to freedom of expression. The Constitutional Court affirmed in 1999 that they have a right to express themselves even if they use this right in the workplace to criticise their employer. Criticism of the public health sector all too often crosses over into the terrain of political speech, which should receive the highest levels of protection under s.16 of the Constitution. That right cannot be undermined or violated because a particular civil servant uses it to expose unsavoury conditions in the service that her department provides to the public. Further, when such exposure is clearly in the public interest - as in the current case where the exposure relates to the health and lives of thousands of people, then it is a right that must be protected by all levels of society. If the information given to the media by the civil servant turns out to be untrue, then s/he should still escape disciplinary action if s/he can prove that the statements were not malicious.

Ntshona's suspension also brings into question the media policy of the Health Department. We question whether such a policy exists - relating who should speak to the media and on which issues, whether it is in conformity with Section 16 of the South African Constitution and whether it is implemented uniformly across the country. It sometimes seems as if the health departments of individual provinces or even the CEOs of individual hospitals make up their own rules which are often in contradiction to their employees' constitutional rights.

We call for the immediate lifting of the suspension of Dr Ntshona. Further, we call on the Department of Health to make clear what its media policy is and to ensure that this policy is consistent with constitutional provisions on free expression.

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