The ongoing crisis around cancer treatment in Gauteng has again been thrust into the spotlight after the Gauteng High Court delivered a stinging judgment on August 21 in favour of Cancer Alliance, SECTION27 and patients whose lives are hanging in the balance.

Pretoria Rekord reports that the ruling ordered that the earlier March court order, which required the enforcement of the cancer radiology backlog, be enforced immediately, despite appeals by the Gauteng Department of Health.

The March order said the department must:

• Update the backlog list of cancer patients waiting for radiation treatment in Gauteng within 45 days
• Take all necessary steps to treat the patients, whether at public or private facilities
• Give the court progress reports
• Give the court long-term plans to resolve the crisis.

The High Court also found in March that the Department of Health’s failure to provide radiation cancer treatment was unlawful and unconstitutional.

The legal wrangling surrounding the March order has lasted for months.

Instead of complying, the department appealed the ruling in May, and cancer patients continued to wait for treatment during the appeal.

The department argued that its appeal had suspended the original order, but this argument has now been firmly rejected.

In the urgent ruling on August 21, it is stressed in the court order that the backlog has had ‘dire consequences’ and caused ‘irreversible and permanent harm’.

The ruling emphasised that cancer patients must receive treatment within strict timeframes, as any delay undermines the efficacy of radiation therapy.

The ruling has direct implications for Steve Biko Academic Hospital, which, along with Charlotte Maxeke Johannesburg Academic Hospital, is at the centre of Gauteng’s cancer care system.

According to Dr Jack Bloom, DA MPL, both institutions face significant radiology backlogs, with Steve Biko’s somewhat better than Charlotte Maxeke’s, but still dangerously overstretched.

Patients continued to wait months for access to radiation therapy at these hospitals, despite the March court order mandating immediate intervention.

Bloom welcomed the judgment while issuing a scathing call for accountability.

“The DA is again calling on Premier Panyaza Lesufi to fire Gauteng Health MEC Nomantu Nkomo-Ralehoko following the urgent judgment by the Gauteng High Court on August 21 to enforce their earlier ruling on the treatment of cancer patients,” said Bloom.

He further noted that the court’s decision to hold the MEC, the provincial head of department, and the CEOs of Charlotte Maxeke and Steve Biko hospitals personally liable for the legal costs is highly significant.

“Premier Lesufi should not allow this cancer treatment disaster to continue. He should also fire the head of department, Lesiba Malotana, and ensure that competent and caring professionals are put in place to save the lives of cancer patients,” he said.

He feels the court order also touches on the culture of legal stalling that has become commonplace in the Gauteng Department of Health.

“Instead of confronting systemic failings, the department has opted for appeals and technical arguments while patients suffer,” said Bloom.

Bloom also pointed out that the court order stipulated that top officials and hospital CEOs must pay legal costs personally reflects judicial displeasure at these tactics.

According to him, it sends a clear message that the courts will not tolerate state institutions using taxpayer funds to fight losing legal battles while lives are on the line.

Civil society has also hailed the judgment as a landmark moment for accountability.

Salome Meyer, director of the Cancer Alliance, stressed that the ruling was both urgent and necessary.

“This judgment is a critical affirmation of the rights to life, dignity and access to healthcare services. [It] is also a reminder that the state must act with urgency, transparency and accountability when lives are at stake.

“SECTION27 and [the] Cancer Alliance call on the Gauteng Department of Health, the minister of health, and hospital CEOs of Steve Biko Hospital and Charlotte Maxeke Hospital to fully comply with the order. And, to stop using legal processes as delaying tactics, and without further delay, ensure that the patients… receive [the] urgent, life-saving treatment they need,” Meyer said.

She explained that from the outset, Cancer Alliance and SECTION27 maintained that exceptional circumstances existed, and that this is a matter of life and death for thousands of patients.

Despite the damning judgment, the department struck a cautious note in its official response.

“The Gauteng Department of Health acknowledges the judgment delivered by the Gauteng High Court regarding the provision of radiation oncology services to cancer patients.

“The department is in the process of carefully studying the ruling to fully appreciate its contents and implications.

“Once this review has been concluded, the department will determine and communicate the appropriate course of action,” said Motalatale Modiba, the department’s head of communication.

The challenge remains enormous as, according to Bloom, the backlog stands at more than 2 000 patients between the two hospitals, and this cannot be cleared overnight. The court has, however, made it clear that updates and progress reports must now follow.

As Meyer observed: “The order makes it clear that government cannot delay its constitutional duties while patients’ lives hang in the balance.”

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