South Africa Grapples with Rise in Unqualified Medical Practitioners
The practice of medicine without proper qualifications and registration is a growing concern in South Africa, posing a direct threat to patient safety and eroding trust in the healthcare system. Authorities are increasingly identifying individuals falsely presenting themselves as doctors, physiotherapists and other healthcare professionals, though the full extent of the problem remains unclear.
Dr. Magome Masike, Registrar of the Health Professions Council of South Africa (HPCSA), emphasized the gravity of the situation. “If you’re in the hands of an unqualified person, you’re as well as dead, and we think it is not fair for the country,” he stated. The HPCSA is responsible for registering medical doctors and other health professionals within South Africa.
Recent Cases Highlight the Problem
Public attention was drawn to the issue in late 2023 with the case of Matthew Lani, who gained notoriety on TikTok while falsely claiming to be a medical doctor. Despite his arrest at Helen Joseph Hospital in Johannesburg, prosecutors ultimately decided not to pursue charges. This case underscored the challenges in prosecuting individuals who misrepresent their medical credentials.
More recently, in early February , the HPCSA facilitated the arrest of a woman allegedly practicing medicine at a facility in Midrand, north of Johannesburg, without being correctly registered. This demonstrates the ongoing nature of the issue and the HPCSA’s continued efforts to address it.
Healthcare Fraud: A Broader Issue
The presence of “bogus doctors” is linked to a larger problem of healthcare fraud in Africa. Research from risk management firm D-Finitive estimates that such fraud costs African countries more than USD 50 billion annually, with the South African private sector accounting for approximately R22-28 billion each year. This fraud extends beyond unqualified practitioners to include inflated billing, manipulated diagnostic codes, and even claims submitted by deceased doctors.
Dr. Katlego Mothudi, Managing Director of the Board of Healthcare Funders (BHF), noted that even a small number of fraudulent actors can inflict widespread damage. “While the majority of practitioners are honest and committed to patient care, it takes only a small number of bad actors, whether unregistered impostors or credentialed professionals abusing the system, to inflict widespread damage,” she said.
Increasing Numbers, but Challenges in Tracking
The HPCSA has been actively working to identify and arrest unqualified practitioners. From March to February , 49 individuals were caught and arrested. Between April and December , that number was 17. While these figures don’t necessarily indicate a year-over-year increase, Dr. Masike believes the overall trend is upward.
The HPCSA’s annual report reveals that 589 investigations into unregistered persons were concluded during the year, with a total of 3,708 complaints received over the past five years. The majority of cases have been identified in the economic hubs of the Western Cape, Gauteng, and KwaZulu-Natal, where the potential for financial gain is higher. However, rural communities are also vulnerable.
A common tactic employed by these individuals is to use or forge the credentials of legitimately registered practitioners, making detection more difficult. Dr. Masike acknowledged the difficulty in quantifying the full scope of the problem, stating, “We can tell you the problem is bigger than we think.”
Risks to Patients and the Healthcare System
The presence of unqualified practitioners poses significant risks to patients, including misdiagnosis, improper treatment, and potential physical harm. Foster Mohale, spokesperson for the National Department of Health, warned that unregistered medical doctors lack the necessary training, ethical standards, and qualifications to provide safe care.
Dr. Zanele Bikitsha, National Vice Chairperson of the South African Medical Association, highlighted the potential for procedures to be performed in unsafe or unsterile environments. “They’re not going to go to a registered facility, because they know they’ll be caught, so this puts patients in danger as well,” she explained.
The problem extends to financial fraud as well. Unqualified practitioners often submit claims to medical schemes, either using stolen credentials or colluding with registered providers who allow their details to be misused for a fee.
Identifying and Reporting Suspicious Practitioners
The HPCSA conducts compliance inspections, but public vigilance is also crucial. Practitioners are legally required to display their registration information prominently in their practices and on official documents. Members of the public can verify a doctor’s credentials through the HPCSA’s digital register, which is searchable online.
Dr. Masike recommends that patients pay attention to how doctors conduct themselves, noting that a properly trained physician will typically take a thorough medical history and use appropriate medical terminology.
Complaints can be filed with the HPCSA Inspectorate, even anonymously, by calling 0123389300/1 or emailing office@hpcsa.co.za. Suspicious practitioners can also be reported to hospitals, the Department of Health, SAMA, or other medical organizations.
Ongoing Efforts to Combat the Problem
Investigations typically involve collaboration between the HPCSA Inspectorate, SAHPRA, the Office of Health Standards Compliance, the Special Investigating Unit (SIU), and the South African Police Service. Recent collaboration with the police has led to a conviction rate of around 77% in these cases, although updated statistics are pending.
Practicing medicine without proper registration is a violation of Section 17(1) of the Health Professions Act, 56 of 1974, and can result in fines or imprisonment. Sentences have ranged from fines of R12,000 to 20 years’ imprisonment in some cases.
Dr. Bikitsha suggests that upgrading to biometric and digital systems for verifying qualifications could help prevent fraud. Increased public awareness and education are also essential to empower patients to protect themselves.
Dr. Masike emphasized the need for community involvement. “We need society to stand up to this,” he said. “We need a participating community to get rid of this malaise, otherwise it will continue forever.”
