Collaborative Efforts in Tackling Fraud and Corruption in the Health Sector

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The Health Sector Anti-Corruption Forum (HSACF) is a group of individuals from civil society, private sector, and public sector that work together to prevent corruption and fraud in the health sector. They aim to enhance prevention, detection, civil litigation, and prosecution of corrupt activities in the health sector. The forum has made progress in investigations, but also expressed concern over increasing fraudulent medico-legal claims. The Special Investigations Unit (SIU) has been granted authority to probe allegations of corruption, fraud, and maladministration in the National Department of Health. The HSACF supports the Legal Practice Council (LPC) in removing fraudulent lawyers from the roll of attorneys.

What is the role of the Health Sector Anti-Corruption Forum in tackling fraud and corruption in the health sector?

The Health Sector Anti-Corruption Forum (HSACF) brings together representatives from civil society, the private sector, and the public sector to enhance prevention, detection, civil litigation, and prosecution of corrupt activities in the health sector. The HSACF aids in the development of measures designed to prevent corruption, fraud, waste, and abuse within the sector.

Health Sector Anti-Corruption Forum’s Role

On September 29, 2023, the Health Sector Anti-Corruption Forum (HSACF) convened a meeting to address anti-corruption strategies within the health sector. The forum, comprised of representatives from civil society, the private sector, and the public sector, aims to foster a collective approach to combat maladministration, malpractice, fraud, and corruption. The primary objectives of the HSACF are to enhance the prevention, detection, civil litigation, and prosecution of corrupt activities in the health sector.

The HSACF brings together members from diverse fields, such as business, law enforcement, regulatory bodies, and government departments, in order to expedite the investigation of corruption and fraud-related cases in healthcare. Moreover, the forum seeks to aid in the development of measures designed to prevent corruption, fraud, waste, and abuse within the sector.

While the HSACF has achieved progress in terms of investigations, resulting in the recovery of millions of rands, convictions, and disciplinary actions, it has also expressed concern over the increasing number of fraudulent medico-legal claims and organized crime. As a result, President Cyril Ramaphosa granted authority to the Special Investigations Unit (SIU) to probe allegations of corruption, fraud, and maladministration in the National Department of Health and provincial Departments pertaining to medico-legal matters under Proclamation R74 of 2022.

Special Investigations Unit’s Actions

The SIU has carried out investigations into medico-legal claims across various provinces and uncovered numerous issues, such as ghost medical billing, unregistered trusts, and fraudulent claims. In some instances, the SIU’s intervention has led to the elimination of fraudulent claims from the Contingent Liability Register, thereby decreasing the contingent liability of the Departments. In other cases, the SIU’s efforts have prevented potential losses amounting to millions of rands and aided in blocking fraudulent medico-legal claim payments.

For instance, in the Western Cape Province, the SIU examined 33 fraudulent birth injury claims worth roughly R409 million submitted by Nonxuba Incorporated Attorneys. The Western Cape High Court issued an order prohibiting Zuko Nonxuba from continuing his practice as an attorney, pending an application to remove him from the roll of legal practitioners. Criminal cases have been filed in several provinces against Nonxuba Inc. and Nonxuba, with the SIU cooperating with the Directorate of Priority Crime Investigations (DPCI).

Continued Commitment and Collaboration

HSACF Chairperson, Adv. Andy Mothibi, praised the forum’s members for their unwavering dedication and effort in addressing and eliminating corruption, maladministration, and malpractice in both private and public health sectors. Adv. Mothibi called for stakeholders to work together in developing preventive measures against corruption and fraudulent medico-legal claims, and urged law enforcement authorities to act promptly in investigating and holding the responsible parties accountable.

Furthermore, the HSACF supports the Legal Practice Council (LPC) in its bid to remove Nonxuba from the roll of attorneys based on the fraudulent claims filed by his firm. The forum’s ongoing dedication, collaborative efforts, and vigilance in the face of escalating corruption and fraud within the health sector highlight its commitment to establishing a corruption-free nation, as outlined by the National Development Plan.

What is the Special Investigations Unit (SIU)?

The Special Investigations Unit (SIU) is an independent statutory body established in terms of the Special Investigating Units and Special Tribunals Act of 1996. The SIU’s mandate is to investigate corruption, fraud, malpractice, and maladministration in public institutions, including the National Department of Health and provincial Departments.

What authority does the SIU have in investigating allegations of corruption and fraud in the health sector?

The SIU has been granted authority by President Cyril Ramaphosa to investigate allegations of corruption, fraud, and maladministration in the National Department of Health and provincial Departments pertaining to medico-legal matters under Proclamation R74 of 2022. The SIU has the power to subpoena witnesses, access information, and seize assets.

What is the concern of the Health Sector Anti-Corruption Forum (HSACF) regarding fraudulent medico-legal claims?

The HSACF has expressed concern over the increasing number of fraudulent medico-legal claims and organized crime in the health sector. This is due to the fact that such claims can lead to significant financial losses for the government and the healthcare system as a whole.

How has the HSACF contributed to the prevention of corruption and fraud in the health sector?

The HSACF brings together representatives from civil society, the private sector, and the public sector to enhance prevention, detection, civil litigation, and prosecution of corrupt activities in the health sector. The forum has aided in the development of measures designed to prevent corruption, fraud, waste, and abuse within the sector.

What progress has the HSACF made in investigations?

The HSACF has made progress in investigations, resulting in the recovery of millions of rands, convictions, and disciplinary actions. However, it has also identified new areas of concern, such as fraudulent medico-legal claims and organized crime.

How has the SIU contributed to tackling fraudulent medico-legal claims?

The SIU has carried out investigations into medico-legal claims across various provinces and uncovered numerous issues, such as ghost medical billing, unregistered trusts, and fraudulent claims. In some instances, the SIU’s intervention has led to the elimination of fraudulent claims from the Contingent Liability Register, thereby decreasing the contingent liability of the Departments.

What action has been taken against fraudulent lawyers by the HSACF?

The HSACF supports the Legal Practice Council (LPC) in removing fraudulent lawyers from the roll of attorneys. For instance, the forum has aided in the filing of criminal cases in several provinces against Nonxuba Inc. and Nonxuba, with the SIU cooperating with the Directorate of Priority Crime Investigations (DPCI).

What is the National Development Plan, and how does it relate to the HSACF’s efforts?

The National Development Plan is a blueprint for South Africa’s development and transformation efforts. It outlines the country’s long-term vision, goals, and targets for achieving a prosperous, inclusive, and sustainable society. The HSACF’s ongoing dedication, collaborative efforts, and vigilance in the face of escalating corruption and fraud within the health sector highlight its commitment to establishing a corruption-free nation, as outlined by the National Development Plan.

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