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Show cause letters for doctors


Ntsoaki Motaung

The Ministry of Health has issued letters to several District Medical Officers (DMOs), requesting them to explain why disciplinary action should not be taken against them for insubordination.

The letters, copies of which Newsday has seen, were sent by Dr. Lucy Mapota Masoabi, the ministry’s Director of Clinical Services, who emphasised the ministry’s mandate to provide high-quality healthcare services to the nation.

Masoabi said the ministry’s commitment was towards promoting, preventing, curing, rehabilitating, and controlling diseases to improve status and quality of life.

“This commitment draws heavily from the MoH’s goal: to reduce morbidity and mortality and contribute to the attainment of improved health status among the people,” she said.

She said the constitution of Lesotho highlights health as one of the fundamental human rights. She warned that the ministry would not be able to achieve its mandate without accountability at all levels by those designated and given managerial authority and responsibility.

“It is in line with this information that it has come to the attention of the MoH, Director General (DG) office that under your leadership and supervision, less is done to push toward the commitment of the MoH.

“You have been requested to submit to the office of the DG, the schedule/duty roster of your doctors through a memo dated April 3, 2023, but to date, no schedule has been submitted,” she said.

She indicated that this had led to a compromise in the provision of health services and was considered insubordination.

“A follow-up on this matter was through a call and email, but you still failed to submit it. furthermore, you did not submit the doctors’ call schedule for June as requested.

As a result, you are requested to respond within five working days upon receipt of this letter, on why disciplinary action should not be instituted against you for insubordination,” Masoabi wrote.

The Lesotho Medical Association (LMA) has expressed its concern regarding the letters and has threatened a full-blown strike if the ministry proceeds with legal proceedings against the DMOs.

The LMA has demanded payment of call allowances for its members before they resume their duties.

Dr. Mojakisane Ramafikeng, the President of the LMA, confirmed to this publication that some members had received the letters and that the association’s stance was clear: they would not take any calls until their call allowances were paid.

“I know of two doctors who got the letters but I know that there are more than two who received such letters. I do not have the exact number because some of them panicked and responded to the letter secretly without letting the association know,” Ramafikeng said.

He criticised the ministry for instructing doctors to perform unpaid work while disregarding a court order to pay their night shift allowances.

“Instead of paying doctors, they instruct them to do the work they are not paid to do and when they do not comply they write letters threatening them. The ministry now needs to comply with the court order which says they should pay us, then we will go work and serve Basotho as they deserve,” Ramafikeng said.

Earlier this year, the LMA threatened to sue Dr. Masoabi, accusing her of intimidating the association’s members.

The association’s lawyer, Advocate Fusi Sehapi, warned that legal action would be pursued if the ministry continued to ignore the court’s judgment.

“Client inform us that a judgment was issued by the High Court sitting as a Constitutional Court in LMA v. Minister of Health and Others, Constitutional Case no.19/2019 on the 24th June 2020 directing the Ministry of Health to pay night shift work done by LMA members,” Sehapi said in a letter.

He stated that the ministry had knowingly or intentionally and negligently ignored, failed, or refused to abide by the judgment.

He said that as a legitimate outside court remedy, members of LMA opted to refrain from preparing call rosters and attending unpaid calls but the ministry continued to force them to do unpaid calls despite the judgement.

“On the other hand, you Dr Lucy Mapota are busy posing illegal threats of immediate dismissals to members of LMA for their justified refusal to prepare call rosters and attend unpaid calls.

“Kindly note that the principle of no work no pay has a corresponding principle of no pay no work which perfectly permits LMA members from withdrawing from performing unpaid work,” Sehapi said.

He explained that Dr Masoabi’s threats to expel the doctors for refusal to do unpaid work were beyond her legitimate scope of work, hence constituted a personal attack on her part.

“We, therefore, advise you to refrain from your illegal campaign, otherwise a lawsuit will be lodged against you as a person and your personal assets will be attached to realise an order of court sounding in your payment of client’s monies. We hope this letter suffices for now,” Sehapi wrote.

The issue of nonpayment of call allowances has been a long-standing concern for doctors in the public sector.

The LMA announced in February that doctors would no longer participate in work beyond ordinary hours without remuneration.

They demanded fair compensation for working during nights, weekends, and public holidays.

In response to the ongoing dispute, Health Minister Selibe Mochoroane earlier this month urged the doctors to fulfill their duties and criticised what he perceived as a prolonged game being played by the medical professionals.

“I have told doctors in our meeting this morning that this game they are playing has taken too long and they should go and provide services to the people,” Mochoboroane said.

He made the remarks while at the Motebang Hospital in Leribe.

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