Case Law[2025] ZAGPPHC 666South Africa
Abrahams and Others v Health Professions Council of South Africa and Others (A216/2024) [2025] ZAGPPHC 666 (1 July 2025)
High Court of South Africa (Gauteng Division, Pretoria)
1 July 2025
Headnotes
Summary: Section 20 of the Health Professions Act 56 of 1974 — appeal against the decision of the HPCSA Disciplinary Appeals Committee — rule 22 of the Ethical Rules of Conduct for Practitioners Registered Under the Health Professions Act read together with the Scope Regulations published in terms of section 33 of the Health Professions Act — the appellants neither transgressed the HPCSA's Business Policy nor did they allow themselves to be exploited — conviction of the appellants is unsustainable — The decision of the Disciplinary Appeals Committee set aside
Judgment
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# South Africa: North Gauteng High Court, Pretoria
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## Abrahams and Others v Health Professions Council of South Africa and Others (A216/2024) [2025] ZAGPPHC 666 (1 July 2025)
Abrahams and Others v Health Professions Council of South Africa and Others (A216/2024) [2025] ZAGPPHC 666 (1 July 2025)
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sino date 1 July 2025
IN
THE HIGH COURT OF SOUTH AFRICA
GAUTENG
DIVISION, PRETORIA
Case
Number: A216/2024
(1)
REPORTABLE: NO
(2)
OF INTEREST TO OTHERS JUDGES: NO
(3)
REVISED:YES
DATE
1 JULY 2025
SIGNATURE
In
the matter between:
TARRYN
ABRAHAMS
First Appellant
AJAY
BEERBAL
Second Appellant
NICOLETTE
ENGELBRECHT
Third Appellant
THULISILE
MOLOI
Fourth Appellant
OKUHLE
NXUSANI
Fifth Appellant
ANTHONY
PIERDICA
Sixth Appellant
and
HEALTH
PROFESSIONS
COUNCIL
OF SOUTH AFRICA
First Respondent
THE
CHAIRPERSON OF THE
AD
HOC APPEALCOMMITTEE OF
THE
HEALTH PROFESSIONS
COUNCIL
OF SOUTH AFRICA: ADV JN MOGOTSI
Second Respondent
Summary:
Section 20 of the Health Professions Act 56 of 1974
—
appeal against the
decision of the HPCSA Disciplinary Appeals Committee
—
rule 22 of the Ethical Rules of Conduct for
Practitioners Registered Under the Health Professions Act read
together with the Scope
Regulations published in terms of section 33
of the Health Professions Act
—
the
appellants neither transgressed the HPCSA's Business Policy nor did
they allow themselves to be exploited
—
conviction
of the appellants is unsustainable
—
The
decision of the Disciplinary Appeals Committee set aside
JUDGMENT
MUDAU,
ADJP
:
Introduction
[1]
This is an appeal pursuant to section 20 of
the Health Professions Act 56 of 1974 (the Health Professions Act)
against the decision
of a Disciplinary Appeals Committee of the first
respondent, the Health Professions Council of South Africa (HPCSA).
Section 20 of the Health Professions Act allows
any person who is aggrieved by any decision of the HPCSA, the
Professional Board
or a Disciplinary Appeals Committee, to appeal to
the appropriate Division of the High Court against such decision.
[2]
The
Disciplinary Appeals Committee had concluded that the appellants were
unfairly treated by their employer, Netcare Hospitals
Proprietary
Limited (Netcare), for not performing their clinical duties for three
months in an instance where there was imminent
monetary benefit in
favour of Netcare, which conduct allegedly fell within the provisions
of rule 22 of the Ethical Rules of Conduct
for Practitioners
Registered Under the Health Professions Act of South Africa, 1974
(the Ethical Rules)
[1]
. The
findings of unethical conduct by the Professional Conduct Committee
were confirmed an appeal but the sanctions imposed were
reduced.
[3]
The
appeal is ultimately against the orders handed down by the
Disciplinary Appeals Committee.
In
the event that the findings of guilty are confirmed, the appellants
contend that the Disciplinary Appeals Committee's substituted
sanctions were unreasonable, and that a caution or reprimand would
have been appropriate.
The
appeal is also aimed at the decision of the Disciplinary Appeals
Committee in failing to set aside the decisions by the Professional
Conduct Committee in refusing the recusal application. In argument
before us, the recusal argument was not seriously pursued. In
any
event, in case the appellants are successful on the merits, the
aspect of recusal is rendered academic. Furthermore, whether
the
Disciplinary Appeals Committee dealt with the recusal applications or
not is of no consequence, as they never had any jurisdiction
to do
so. An appeal against their decision relating to the recusal is of no
avail
[2]
.
Background facts
[4]
The background facts are largely common
cause and therefore undisputed. At all relevant times the appellants
were registered with
the HPCSA as medical technologists.
They
were previously employed by Lancet Laboratories (Lancet). The
appellants took up employment with Netcare after resigning from
Lancet. This was after Netcare had advertised positions for regional
laboratory managers and medical technologists.
Employment
agreements were entered into between Netcare and the appellants. The
sixth appellant, Mr. Pierdica, commenced employment
on 1 April 2020,
while others started on 1 October 2020.
[5]
Dr. John Douglas, Chairperson of the
National Pathology Group (NPG), filed a complaint and requested an
investigation through NPG's
attorneys on 16 September 2020.
The
NPG is made up of the three big private
laboratories (Lancet, Ampath and Pathcare) in the country.
The
NPG's complaint claimed that registered medical laboratory personnel
took employment with Netcare and continued working there
despite
Netcare not being a registered entity per the Health Professions Act.
It was alleged that
neither Netcare nor the
personnel received permission to engage in such an employment
relationship, violating accepted medical practice
standards in South
Africa.
The nub of the complaint alleged
contraventions of, inter alia; HPCSA's policy on business practices
dated 26 October 2016; facilitating
corporate ownership in private
practice; permitting a fee-sharing arrangement with a corporate not
registered under the Health
Professions Act; and permitting a
corporate entity to violate section 39(2) of the Health Professions
Act.
[6]
The appellants subsequently had their
employment contracts transferred to
a newly
created practice, Dr. Eshile Nomlomo Inc. These employment transfer
agreements were signed between Netcare, Dr. Eshile Nomlomo
Inc., and
the appellants during February 2021 (mostly on 5 February 2021), but
same became effective retrospectively, with the
practitioners being
employed by Dr. Eshile Nomlomo Inc. from 1 February 2021.
[7]
The nature of the complaints as described
above were narrowed down by the HPCSA. Consequently, the following
charge was levelled
against the appellants:
“
THAT
you are guilty of unprofessional conduct or conduct which, when
regard is had to your profession, is unprofessional, in that
during
the period 2019 and 2020, as a registered medical technologist with
the HPCSA in terms of section 17of the Health Professions
Act, 1974,
you acted in a manner that is not in accordance with the norms and
standards of your profession in that you engaged
in an undesirable
business practice or model by entering into a contract with a
non-approved entity and in doing so you allowed
yourself to be
exploited in contravention of Ethical Rule 22 of the conduct of
practitioners registered under the Health Professions
Act, 1974 which
prevents a practitioner from permitting herself to be exploited in
any manner”.
[8]
The core of the defence raised by
appellants in their response was that they neither performed nor were
asked to perform any clinical
or professional work during the short
period of their employment with Netcare. Therefore, they believed
they did not contravene
any policy on business practices.
Netcare also addressed a letter on 9 February
2021, suggesting that the idea was to assist a black female-owned
pathology entity
as part of an enterprise strategy. Thus, the
appellants were only employed to do some preparatory work.
[9]
After hearing evidence on 15 December 2022,
the Professional Conduct Committee unanimously made the finding that
the appellants
were guilty as charged. As a sanction, the
Professional Conduct Committee imposed a fine of R 20 000.00 to be
paid over a period
of four months in instalments of R5 000.00 per
month by each appellant.
The appellants
thereafter appealed the finding of the Professional Conduct Committee
to an Ad Hoc Appeal Committee appointed by
the HPCSA.
On
8 July 2024 the Appeal Committee confirmed the Professional Conduct
Committee's decision to find the appellants guilty of unethical
conduct.
The Ad Hoc Appeal Committee,
however upheld the appeal against sentence. The penalties were
reduced to a fine of R10 000.00 for
each of the appellants. These
findings are the subject of the current appeal.
Issues on appeal
[10]
The appellants dispute that the employment
contracts with a non-approved entity was precluded by the Policy
Document.
The
appellants further dispute
that their acceptance and the entering into the employment contracts
with Netcare resulted in the appellants
allowing themselves to be
exploited within the meaning of "exploited" as alleged.
Even though the appellants admitted that they were
employed by Netcare, they contend that the fact that they did not do
any work
within the scope of the profession of medical technology did
not as a result transgress paragraph 2.4 of the Policy Document.
[11]
They maintain that whilst they were
employed with Netcare, they did not do any activities within the
scope of their professional
practice. In this regard, the appellants
rely on the exception (the rider) in the specific portion of the
paragraph in the Policy
Document which reads as follows:
“
...
save that any employment which falls beyond the Professional Practice
is not required to lodge an application with the HPCSA”.
[12]
In this regard they were supported by a
letter from Netcare, which apparently was not challenged, to the
effect that the appellants
performed nothing more than administrative
work, which was preparatory work under the banner of Enterprise
Development in the setting
up of a pathology practice.
[13]
In this regard, section 2 of the Scope
Regulations published in terms of section 33 of the Health
Professions Act, the scope of
the profession of medical technology is
provided for a follows:
“
2(1)
Subject to the provisions of sub regulation (2), all acts performed
during the analysis of human tissue, body fluid or excretion,
where
such analysis is carried out to enable a medical practitioner or did
this to make a diagnosis or is acute medical or dental
treatment from
the results of such analysis, shall for the purposes of the act be
deemed to be acts pertaining to the profession
of medical technology.
(2) The following acts,
carried out during an analysis referred to in sub regulation (1),
sample for the purposes of the act also
be deemed to be acts
pertaining to the profession of medical technology:
(a) interpretation,
consultation or advice regarding information obtained as a result of
the acts referred to in sub regulation
(1);
(b) quality control with
regard to the acts referred to in sub regulation (1);
(c) teaching, training
and research with regard to the acts referred to in sub regulation
(1).
(3) The following acts,
carried out during an analysis referred to in sub regulation (1)
shall for the purposes of the act be deemed
not to be acts pertaining
to the provision of medical technology:
(a) the labelling,
primary tube centrifuging at transporting of specimens or the
transcribing of results already manually or mechanically
recorded;
(b) the preparation of
equipment, culture media and reagents;
(c) the staining of
slides for microscopic examination.”
[14]
In terms of the Policy Document:
“
2.4
Employment of Practitioners: Generally, employment of practitioners
by non-registered persons is not allowed, except for recognized
agencies like the Public Service, Universities for training/research,
Mining companies/NPOs/NGOs with approval, and other registered
practitioners. Any other agent, institution, person may lodge an
application with the HPCSA for the purpose of employment of a
practitioner registered with the HPCSA, save that any other
employment which falls beyond the professional practice is not
required
to lodge an application with the HPCSA.”
[15]
The
HPCSA's case was that the appellants allowed themselves to be
exploited by not practising their profession and by doing nothing
whilst in the employ of Netcare. However, the appellants reject the
contention advanced by the respondent that, by entering into
such
employment contract as they did, the appellants allowed themselves to
be exploited by Netcare, to their own detriment. Exploitation
means:
"the use of someone to your advantage (for one's own ends)"
[3]
.
Analysis
[16]
In my view, the HPCSA’s reasoning
that the appellants: “were unfairly treated by Netcare which
employed them for not
performing their clinical duties for three
months in an instance where there was imminent monetary benefit in
favour of Netcare”
does not accord with the ordinary meaning of
“exploitation” regard being had to Ethical Rule 22
.
Neither is this finding supported by the common cause facts. A
conclusion that any exploitation had occurred in this matter has
no
factual basis.
[17]
It
is trite that courts must properly contextualise statutory provisions
when ascribing meaning to the words used therein.
Words
should generally be given their ordinary grammatical meaning; our
superior courts have long recognised that a contextual and
purposive
approach must be applied to statutory interpretation
[4]
.
Accordingly, courts are obliged to have due regard to the context in
which the words appear, even where “the words to be
construed
are clear and unambiguous”.
[5]
[17] Against the
above background, rule 22 of the Ethical Rules needs to be read
together with the Scope Regulations published
in terms of section 33
of the Health Professions Act referred in paragraph [12] above. Quite
clearly, the mischief the Health Professions
Act seeks to address is
the conduct of any pathology services whilst in the employ of any
unregistered entity.
[18] The appellants
neither transgressed the HPCSA's Business Policy nor did they allow
themselves to be exploited and accordingly
were not guilty of the of
charges levelled against them. It follows accordingly that the
conviction of the appellants is unsustainable
and falls to be set
aside with costs following the result.
Order
[19] In the
results, I make the following order:
1.
The appeal succeeds with costs.
2.
The order of the Disciplinary Appeals Committee is set aside and
replaced with the following order:
“
The
appellants are acquitted of all the charges”.
MUDAU
ADJP
JUDGE OF THE HIGH
COURT
GAUTENG DIVISION,
JOHANNESBURG
I agree
DAVIS ADJP
JUDGE OF THE HIGH
COURT
GAUTENG DIVISION,
PRETORIA
Date
of Hearing: 22 April 2025
Date
of Judgment: 1 July 2025
APPEARANCES:
For
the Appellants:
Adv
A. Govender
instructed by
Werksmans Inc.
For
the Respondents:
Adv
T. Strydom SC
instructed by
Gildenhuys
Malatji Inc.
Delivered: This judgment
was prepared and authored by the Judge whose name is reflected and is
handed down electronically by circulation
to the Parties /their legal
representatives by email and by uploading it to the electronic file
of this matter on Case Lines and
to Saflii. The date for hand-down is
deemed to be the 1
st
July 2025.
[1]
Rule 22 of the Ethical Rules provides that a practitioner shall not
permit himself or herself to be exploited in any manner.
[2]
See
Basson
v Hugo
2018(3) SA 46 (SCA).
[3]
Concise Oxford Dictionary Eighth Ed page 412.
[4]
Road
Traffic Management Corporation v Waymark (Pty) Limited
2019 (5) SA 29
(CC) at para 29 citing
Natal
Joint Municipal Pension Fund v Endumeni Municipality
2012 (4) SA 593
(SCA) at para 18.
[5]
Independent
Institute of Education (Pty) Limited v Kwazulu-Natal Law Society and
Others
2020 (4) BCLR 495
(CC) at para 41.
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