In a landmark case, the Cancer Alliance succeeded in a legal action against the Gauteng Department of Health and other related entities for failing to address the urgent need for radiation oncology services for cancer patients in Gauteng. This case highlights the critical issues surrounding healthcare service delivery, the allocation and utilisation of funds, and the constitutional obligations of the state to provide timely medical treatment.
The Cancer Alliance, a coalition of 30 cancer control non-profit organizations, initiated legal proceedings against the Gauteng Health Department and other respondents, including the Member of Executive Council for Health Gauteng Province, the Head of Department: Health Gauteng Province, and the Chief Executive Officers of Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and Steve Biko Academic Hospital (SBAH). The Alliance sought to address a significant backlog of cancer patients awaiting radiation oncology treatment, which had built up primarily at CMJAH.
The backlog of cancer patients in Gauteng had reached alarming levels, with approximately 3000 patients not receiving radiation oncology treatment over the past three years. The Cancer Alliance argued that the Gauteng Department of Health (GDOH) had failed to provide the necessary treatment despite having allocated funds specifically for this purpose. The right to healthcare services, as guaranteed under section 27 of the Constitution, was at the core of the Alliance’s case.
The Cancer Alliance sought urgent relief to ensure the provision of radiation oncology services at CMJAH and SBAH. The application was divided into two parts:
- Part A: Focused on the immediate provision of radiation oncology services.
- Part B: Sought a review of the GDOH’s decision to allocate only R250 million out of the R784 million budget for outsourcing radiation oncology services, arguing that this decision was irrational and arbitrary.
The court found that the GDOH had not acted with the necessary urgency to address the backlog of cancer patients. Despite the allocation of R250 million for outsourcing radiation oncology services, the funds were not utilised effectively, leading to the return of the unspent funds to the Provincial Treasury at the end of the fiscal year. The court highlighted several key issues, including the following:
- Failure to utilize funds: The GDOH’s failure to spend the allocated R250 million on outsourcing radiation oncology services was a significant fact. The funds were intended to provide immediate relief to the backlog of cancer patients but were returned to the Treasury unspent.
- Constitutional obligations: The court emphasised the state’s constitutional duty to provide healthcare services and the need for transparency, accountability, and effective use of resources. The GDOH’s actions were found to be in breach of these obligations.
- Supervisory order: The court issued a supervisory order, requiring the GDOH to file regular reports detailing the steps taken to provide radiation oncology services to the backlog of cancer patients. This order aimed to ensure accountability and transparency in the delivery of healthcare services.
This case underscores the critical importance of timely and effective healthcare service delivery and highlights the challenges that must be met by public healthcare institutions in managing resources and meeting constitutional obligations. The court’s decision serves as a reminder of the need for transparency, accountability, and urgency in addressing healthcare crises. This case sets a precedent for future legal actions aimed at ensuring the right to healthcare services for all citizens from available resources.