This is a graphic that is trending on social media to describe how witnesses gets admitted to hospital to avoid the Madlanga Commission.
Image: Social media / X
Professional bodies of medical practitioners have expressed serious concerns about the questionable medical certificates presented to the Madlanga Commission of Inquiry.
This comes after the medical certificate submitted by Investigative Directorate Against Corruption (IDAC) head Andrea Johnson was scrutinised when she did not make a scheduled appearance on Monday after she was reportedly rushed to hospital, prompting the postponement of her hearing.
The commission also heard that businessman Suliman Carrim, who was meant to appear this week, was reportedly seen at a Western Cape shopping mall despite submitting medical certificates.
Other witnesses who submitted medical certificates when they were due to appear included alleged political fixer Brown Mogotsi and Crime Intelligence’s Feroz Khan, among others.
The commission’s Chairperson, Mbuyiseli Madlanga, expressed concern that the medical certificates provided no meaningful details.
“I notice that this is one of those medical certificates, the nature of which, I previously said, is useless in the sense that they give no information whatsoever,” he said this week when commenting on Johnson’s.
The commission has previously indicated that it may subpoena doctors to come and explain whether a witness was ill.
The Health Professions Council of South Africa (HPCSA) spokesperson, Priscilla Sekhonyana, said on Saturday that they noted the public discourse around medical certificates.
Sekhonyana said concerns around dubious medical certificates were not new, as about 2% of all complaints lodged against medical practitioners arise from allegations of fraudulent or insufficiently detailed medical certificates.
“However, the conduct of most registered practitioners is overwhelmingly professional and ethical, and consistent with the professional practice guidelines and ethical standards approved by council in terms of its mandate to protect the public and guide the professions,” she said.
The HPCSA’s annual report for 2024/25 shows that out of 2,255 complaints received in the year under review, only 31 (1.4%) related to medical certificates.
South African Medical Association Chairperson, Mvuyisi Mzukwa, said they were not happy to see incidents where their profession was dragged down because of certain individuals in the profession.
“It is a serious matter we don't take lightly. We also recognise there might be isolated incidents where you find that there are abuses of medical certificates, which is unfortunate.
“We know that a majority of doctors in South Africa do their work professionally and do their work ethically,” he added.
HPCSA head of Core Operations, David Mametja, said practitioners registered with the council were meant to conduct themselves ethically and professionally with a level of satisfactory integrity.
Mametja stated that before a certificate was issued, there must be consultation, diagnosis, and determination of the health condition of the patient, whether he or she was unfit to go to work.
“That certificate has to reflect important information about the practitioner himself or herself, not just the names but the registration number with the council that confirms they are legitimate practitioners and assist in weeding out bogus practitioners,” he said.
Mametja also said a recipient of a medical certificate has the right to reject it, but the rejection has to be based on justifiable reasons.
“We believe that there is no harm in the employer or recipient requesting the patient to indicate to the practitioner that that kind of information should be provided, although it is always subject to the patient's consent.”
Mzukwa said they respected the concerns raised by the Madlanga Commission and that they supported accountability across sectors, including the medical profession.
“SAMA is a voluntary medical association and is not a regulatory body. Our responsibility as SAMA is really to promote ethics and professionalism within our members,” he said.
Sekhonyela said the HPCSA has a well-established process for investigating and adjudicating all complaints alleging unethical conduct.
“It also has a framework for disciplining practitioners found guilty of contravening the applicable professional and ethical guidelines.”
She also said they noted public discussion regarding the potential issuance of subpoenas to registered health practitioners, requiring them to give evidence in legal proceedings and commissions of inquiry concerning medical certificates they have issued to patients.
“Registered practitioners are expected to comply with lawful subpoenas and other legal processes,” she said, adding that practitioners may be legally required to confirm authenticity without necessarily requiring disclosure of that clinical information.
“However, where disclosure of clinical information is lawfully required, it should be limited to what is necessary and relevant to the proceedings, with the patient's dignity and privacy preserved. In the absence of informed consent, practitioners may only disclose confidential patient information when directed to do so by a court order or pursuant to a lawful order issued by a competent authority,” said Sekhonyela.
The South African Medical Association Trade Union (SAMATU) said patient confidentiality is a cornerstone of good medical practice.
SAMATU President Tshilidzi Sadiki said the correct approach was to respect the legal process while ensuring that patient privacy was protected as far as the law permits.
“That balance is very important or is essential to maintaining both the public confidence in the justice system and in our belief, the important factor, the trust in the doctor-patient relationship,” Tshilidzi said.