NPOs ask court to force Gauteng to treat cancer sufferers

SA’s leading cancer advocacy group, the Cancer Alliance, has launched legal action against the Gauteng health department to try to compel it to spend more than three-quarters of a billion rand set aside by the provincial treasury last year to tackle its radiation oncology and surgical backlog.

The Gauteng health department was allocated an extra R784m in the 2023/24 fiscal year, but has yet to provide backlog patients with the care they need.

The Cancer Alliance, which represents 30 nonprofit cancer organisations, has asked the Johannesburg high court to declare the department’s failure to implement a plan to provide radiation therapy to cancer patients at Charlotte Maxeke and Steve Biko hospitals as unlawful and unconstitutional.

It asked the court to direct the department to take “all necessary steps” to provide these services to the patients on its backlog list within 45 days at either public or private facilities.

Cancer Alliance also asked the court to interdict the department from paying R250m it had set aside for outsourcing radiation oncology services. This included a treatment planning service contract awarded to Varian Medical Systems which Cancer Alliance said was irrational because no service providers had been appointed to provide medical treatment.

The contract with Varian was potentially worth R17.48m, but this value was not guaranteed as the service would be billed per plan, said Andreas Roedder, head of media for Siemens Healthineers and Varian Medical Systems for Africa and the Middle East.

There are about 3,000 cancer patients on the provincial department’s backlog list for radiation therapy, which uses high energy X-rays, protons or other particles to destroy cancer cells. Patients undergo radiation therapy planning before treatment, a process that provides doctors, radiologists and therapy staff with a detailed picture of the area that needs radiation, in order to minimise damage to healthy tissue.

“If patients do not receive radiation treatment within the recommended time frame of three months, they often suffer recurrences which necessitate further medical assessment, cancer staging and sometimes further surgery and chemotherapy before they qualify for radiation treatment again,” said public interest law organisation Section 27, which is representing the Cancer Alliance.

Many of the patients on the backlog list have been waiting for radiation treatment for years, said Cancer Alliance director Salome Meyer. “With each passing month, if not week, the backlog list continues to grow and patients ... face the very real possibility that they may not survive. The pain and suffering endured by cancer patients go unnoticed because they are at home trying their best to manage their illness,” Meyer said in court papers.

The department said that it would oppose the Cancer Alliance in court.

“It is important to clarify that the application by the Cancer Alliance is primarily driven by the awarding of a tender in which their preferred service provider failed to participate within the validity period,” it said in a statement. “We continue to comply with all requirements to ensure that radiation oncology services are delivered to all patients who need them,” it said.

The DA’s health spokesperson, Jack Bloom, said the fact that patient advocates had resorted to the courts to force the Gauteng health department to spend budgeted money on cancer treatment reminded him of the negligence that led to the deaths of state mental patients in the Life Esidimeni scandal.

The delays in providing radiation treatment to the thousands of patients on the backlog list were effectively a death sentence, he said.

“It seems the lessons of the Esidimeni disaster have not been learnt. People should not die because of the department’s notorious corruption, incompetence and negligence,” he said.

Update: July 22 2024
This story was updated to clarify that Varian Medical Systems’ contract amounts to only R17.84m of the R250m set aside by the Gauteng Health Department for outsourcing radiation oncology services.

kahnt@businesslive.co.za