Case Law[2024] ZAGPPHC 595South Africa
Pretorius v Health Professions Council of South Africa and Another (130502/2023) [2024] ZAGPPHC 595 (18 June 2024)
High Court of South Africa (Gauteng Division, Pretoria)
18 June 2024
Judgment
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## Pretorius v Health Professions Council of South Africa and Another (130502/2023) [2024] ZAGPPHC 595 (18 June 2024)
Pretorius v Health Professions Council of South Africa and Another (130502/2023) [2024] ZAGPPHC 595 (18 June 2024)
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sino date 18 June 2024
REPUBLIC
OF SOUTH AFRICA
IN
THE HIGH COURT OF SOUTH AFRICA
GAUTENG
DIVISION, PRETORIA
1.
REPORTABLE: NO
2.
OF INTEREST TO
OTHER JUDGES: NO
3.
REVISED.
18
June 2024
Case No:130502/2023
In the matter between:
DR
JOHAN (LETS)
PRETORIUS
Applicant
and
HEALTH
PROFESSIONS COUNCIL OF SOUTH AFRICA
First Respondent
MINISTER
OF HEALTH, NATIONAL GOVERNMENT
Second Respondent
JUDGMENT
SK HASSIM J
# Introduction
Introduction
[1]
The applicant is a medical practitioner
registered under the Health Professions Act, Act No 56 of 1974 (“the
HPA”).
He applied on a semi-urgent basis, for an interdict
against the Health Professions Council (“the HPCSA”) from
proceeding
with a professional conduct inquiry (“Disciplinary
Inquiry”) into alleged unprofessional conduct pending the
finalisation
of a review application under the Promotion of
Administrative Justice Act, Act No 3 of 2000 (“PAJA”)
launched by him
on 26 October 2023 (“the review application”).
[2]
The applicant claimed an interim interdict
in the following terms –
“
2.
First respondent is prohibited from proceeding with the disciplinary
proceedings against the applicant, pending the final
resolution and
determination of the relief sought in the main application instituted
by the applicant against the respondents under
case no 2023/111240.
3. First
respondent shall pay the costs of this application on an attorney and
client scale including the costs of two counsel.”
[3]
The application came before me in the
urgent court. Only the first respondent, the HPCSA opposed it. Ms
Manganye who appeared for
the HPCSA moved for the application to be
struck from the roll with costs for want of urgency, failing which
for it to be dismissed
with costs.
[4]
The
application was issued in early December 2023. The respondents were
afforded five (5) days to deliver a notice of intention
to oppose the
application and ten (10) days to deliver an answering affidavit. The
customary three sets of affidavits were delivered,
as well as heads
of argument. The interim interdict was directed at restraining a
disciplinary inquiry by a professional conduct
committee (“a
disciplinary committee”) from proceeding
[1]
before
the review application is finalised.
[5]
The urgent court was the only route to
legal redress with the current case load in this division. If t
he
application for an interim interdict was not heard before the
Disciplinary Inquiry commenced,
it
would have become academic.
The application
was accordingly sufficiently pressing to warrant attention in the
urgent court.
[6]
I was not persuaded that the applicant
would be afforded substantial redress at a hearing in due course. The
application was argued.
I issued an order dismissing it. This
judgment constitutes the reasons for the order.
[7]
A patent error in the order has been
brought to my attention. Instead of ordering the applicant to pay the
costs of the application,
I inadvertently ordered the respondent to
do so. The order therefore stands to be varied to read:
“
1.
The application is dismissed.
2. The applicant is
to pay the costs of the application.”
[8]
The disciplinary proceedings stem from a
complaint to the HPCSA that the applicant was guilty of
unprofessional conduct in that
he was serving a sentence of
imprisonment.
[9]
Mr
Du Plessis SC, who appeared for the applicant, correctly
characterised the HPCSA’s disciplinary process as a
multi-staged
decision-making process. The issue in this application
as I saw it, was a narrow one; do the impugned decisions constitute
“administrative
action” as defined in PAJA, thereby
rendering it (them) susceptible to review thereunder. The application
was however not
opposed on this basis, and neither party addressed
whether a prelim committee’s determination on the appropriate
manner of
dealing with a complaint
[2]
constitutes
administrative action as defined in PAJA.
# The incorporation of
the papers in the review application
The incorporation of
the papers in the review application
[10]
Even though this is procedurally a
self-standing application, for reasons that will emerge, the review
application is an integral
part of this application. Consequently,
something must be said about the formulation of the papers in this
application, and the
review application. This will explain why the
affidavits in the review application appear to have assumed greater
importance than
the affidavits in this application.
[11]
The applicant did not identify in the
founding affidavit in this application the grounds upon which he
seeks to review and set aside
the impugned decisions. Instead, he
imported into the founding affidavit the whole of the review founding
affidavit. Moreover,
he did so without identifying the specific
averments which he relied upon for the interim interdict. In his
papers the applicant
requested that the averments in the founding
affidavit in the review application be regarded as if “they
have all been incorporated
into [the] founding affidavit [in this
application]”.
[12]
However, the founding affidavit in the
review application is beset with its own problems. The review grounds
are discussed superficially;
the applicant lists and then adopts the
various review grounds listed in PAJA as reasons for challenging the
HPCSA’s decisions.
I trudged through
the review application, and this application, to identify the review
grounds and then to locate the supporting
facts, if any, in either
the review founding affidavit or the founding and replying affidavits
in this application.
Save for the
audi
complaint, the applicant scarcely
revealed facts to support his claims that the decisions were
impeachable on the grounds contended
by him.
[13]
The HPCSA, probably taking the lead from
the applicant, stated in the answering affidavit that for its
opposition it relied on the
averments in its review answering
affidavit.
[14]
I had reservations whether it is
appropriate, or proper, for a litigant to rely on averments in
affidavits in other proceedings,
related or unrelated, without at
least identifying the evidence on which it relied.
Regardless,
t
he applicant and the respondent were
ad
idem
that their respective affidavits
in the review application must be read by the court and considered
when deciding the application.
Despite my reservations, I decided the
application as if the averments in the affidavits in the review
application are contained
in the affidavits in this application, as
requested by the parties in their affidavits. The applicant’s
failure to deliver
a replying affidavit in the review application has
consequences; the averments in the answering affidavit in the review
application
stand unchallenged.
# Relevant provisions of
the Regulations relating to the Conduct of Inquiries into Alleged
Unprofessional Conduct under the HPA
Relevant provisions of
the Regulations relating to the Conduct of Inquiries into Alleged
Unprofessional Conduct under the HPA
[15]
Professional
conduct inquiries (“disciplinary inquiries”) are governed
by the Regulations relating to the Conduct of
Inquiries into Alleged
Unprofessional Conduct under the Health Professions Act, 1974
promulgated in
Government
Notice
R102 dated 6 February 2009 and published in
Government
Gazette
31859
(“the Regulations”). A disciplinary inquiry under the HPA
is preceded by a preliminary inquiry.
[3]
The
preliminary committee of inquiry (“prelim committee”)
considers whether there are grounds for a professional conduct
inquiry into the conduct of a medical practitioner. If it finds such
grounds, then it must direct the holding of a disciplinary
inquiry.
[4]
[16]
Regulation 4 deals with the role and powers
of a prelim committee, Regulations 5 and 6 deal with the steps to be
taken in arranging
the disciplinary inquiry and giving effect to the
direction from the prelim committee under sub-regulation 4(8).
Regulation 8 deals
with the holding of a pre-inquiry conference and
regulation 9 deals with the procedure at the disciplinary inquiry.
The relevant
parts of Regulations 4, 5, 6 and 8 are set out below:
4.
Preliminary
inquiry
—
(1)
The registrar—
(
a
)
may, after receiving a complaint, call for further information or an
affidavit confirming the allegations
by the complainant;
(
b
)
must, subject to paragraph (a)
,
after receiving a complaint, register the
complaint and notify the respondent
of
the
complaint
by
forwarding
a
copy
of
the
complaint,
together
with
copies
of
any further information or affidavits
referred to in paragraph (a)
,
to him or her—
(i)
requesting a written response
from him or her within 40 working days from th e date of receipt of
the notification by the respondent,
or within such further period as
the registrar may reasonably allow, failing which the complaint,
together with any further information
or affidavit referred to in
paragraph
(a),
must
be
submitted
to
the
preliminary
committee
of
inquiry
without
the respondent's written response;
(ii)
advising him or her that
failure to respond to the notification or the complaint as
contemplated in subparagraph (i) will constitute
contempt of council,
and that a response may consist of a written communication by the
respondent that he or she invokes his or
her right to remain silent;
and
(iii)
warning him or her that the written
response referred to in subparagraph (i) may be used as or in
evidence against him or her:
Provided
that a notification referred to in this paragraph will be deemed to
have been received—
(
aa
)
on the day such notification is
hand-delivered, to the registered address of the respondent, or
(
bb
)
if such notification is sent by registered
post, on the seventh day following the date on which it was so
posted;
(c)
… ;
(d)
…
(2) On receipt by
the registrar of the further information and written response
referred to in subregulation (1)(a) and (b),
he or she must submit
the complaint, such further information and the written response to
the preliminary committee of inquiry,
and if no further information
or written response is received, the registrar must record this fact
and report it to the preliminary
committee of inquiry.
(3)
The preliminary committee of inquiry
may, after due consideration of the matter referred to it in terms of
subregulation (2), direct
the registrar to issue a notice in writing
to the respondent, to be delivered in the manner contemplated in the
proviso to subregulation
(1)(b)
,
instructing him or her to appear in person with his or her legal
representative, if any, before the preliminary committee of inquiry
at its next meeting to inquire why he or she did not respond to the
council correspondence and to give his or her response to the
complaint or exercise his or her right to remain silent.
(4)
If the preliminary committee of inquiry decides, after due
consideration of the explanation by
the respondent for his or her
failure to respond to the council correspondence, that the respondent
is in contempt of council,
it must—
(
a
)
make a finding of guilty of contempt of council and impose one or
more of the penalties provided
for in section 42(1)(a) and (d) of the
Act;
(
b
)
order the respondent to submit, within such period as may be
determined by the committee, his or
her written response to the
complaint or a written communication to indicate his or her
exercising his or her right to remain silent;
and
(
c
)
direct the registrar to confirm its decision in writing to the
respondent stating the reason(s)
for the decision.
(5)
If the respondent fails to attend the meeting of the preliminary
committee of inquiry after having
been duly notified in writing to
appear before the committee, the committee may—
(a)
make a finding of guilty of contempt of council and impose one or
more of the penalties
provided for in section 42 (1) (a) and (d) of
the Act;
(
b
)
order the respondent to submit, within such period as may be
determined by the committee, his or
her written response to the
complaint or a written communication to indicate his or her
exercising his or her right to remain silent;
and
(
c
)
direct the registrar to confirm its decision in writing to the
respondent stating the reason(s)
for the decision.
(6)
….
(7)
…
(8)
If a preliminary committee of inquiry decides, after due
consideration of the complaint, any further
information which may
have been obtained in terms of subregulation (1)(a) and the
respondent's explanation of the subject matter
of the complaint or
the lack of such explanation, that there are grounds for a
professional conduct inquiry into the conduct of
the respondent, it
must direct that an inquiry be held and that the registrar
communicate its decision in writing to the complainant
and the
respondent and arrange for the holding of such inquiry, or it may
allow the respondent to pay an admission of guilt fine
in terms of
section 42(8) and (9) of the Act.
(9)
…
5.
Arranging
an
inquiry.
—
(1)
After receipt of a directive
referred to in regulation 4 (8) or a notice of rejection of the
penalty or if no response is received
by the due date as contemplated
in regulation 4(9)(b), the registrar must issue
a notice, essentially in the
form of Annexure A to
these
regulations,
addressed
to
the
respondent,
stating
the
date
and
time
when
and
the
place
where
the
inquiry
will
be
held
and
enclosing
a
charge
sheet
as formulated by the
pro
forma
complainant.
(2) The notice and
the charge sheet referred to in sub-regulation (1) must be served on
the respondent …, at least
60 days prior to the date of the
inquiry, and a copy of the notice and charge sheet must be served or
posted to the respondent’s
legal representative, if appointed
at the time of service or posting to the respondent.
6.
Constitution
of
the
professional
conduct
committee.
—
(1)
The chairperson of the professional board must, at the request of the
registrar, appoint a professional
conduct committee at least seven
days before the inquiry….
…
7
Request for further particulars…
8.
Pre-inquiry
conference.
—
(1)
In order to determine the issues in
dispute, the
pro
forma
complainant must arrange a pre-inquiry conference, which must be
attended by both parties or their legal representatives, if any,
on
any date at least seven days before the date of the inquiry at a
mutually convenient time and venue,…”
Context to the
application: The impugned decisions and the relief sought in the
review application.
[17]
The
review application is brought on the basis that the HPCSA is a
statutory body established under the HPA, is an organ of state,
and
its decisions constitute “administrative decisions”
[5]
which
are subject to PAJA.
[18]
Two acts are impugned in the review
application.
[19]
On 18 March 2016, in terms of
sub-regulation 4(8) of the Regulations, the Committee of Preliminary
Inquiry (“the Prelim Committee”)
directed that a
disciplinary committee must hold a Disciplinary Inquiry into the
applicant’s alleged unprofessional conduct.
This decision will
be referred to as “the first decision”. The applicant
seems to have been under the impression that
the first decision was
taken in 2015. This is not supported by the papers. However, the
HPCSA’s averment that the decision
was taken on 18 March 2016,
is.
[20]
Due to the applicant’s incarceration,
the HPCSA was unable to secure his attendance at a disciplinary
hearing. Resultantly,
the Disciplinary Inquiry could not get off the
ground. The applicant was released on parole on 29 June 2020. Steps
to hold the
Disciplinary Inquiry resumed thereafter.
[21]
The
applicant has concluded from an e-mail sent to his wife’s
e-mail address on 21 November 2022, that a decision had been
taken in
2022 to continue the disciplinary proceedings. In paragraph 4 of Part
B
[6]
of
the notice of motion in the review application (“the review
notice of motion”), he refers to this as “the decision
of
first respondent to continue with the disciplinary proceedings
against the applicant of 2022”.
[7]
I
refer to this as ‘the second ‘decision’” and
deal with the e-mail in paragraph [38]
below.
[22]
I have found no evidence of a second
‘decision’ in the papers. What I have though come across
is a document dated 21
January 2023 seemingly signed by the
Chairperson (“the Chairperson”) of the Medical and Dental
Professions Board (“the
Board”). It reads –
“
21
January
2023
TO: THE CHAIRPERSON
MEDICAL AND DENTAL
PROFESSIONS BOARD
APPOINTMENT OF
PROFESSIONAL CONDUCT COMMITTEE
The Committee of
Preliminary Inquiry has resolved that a professional conduct hearing
into the conduct of:
Dr J Pretorius
should be held.
In terms of a resolution
taken at a Board meeting, it was RESOLVED that the power to
constitute a Professional Conduct Committee
be delegated to the
Chairperson of the Board.
The inquiry is set down
for 02 February 2023. The pro forma complainant in this matter will
be Mr Z Gajana.
The following names are
proposed for the constitution of the Professional Conduct Committee
for your consideration and approval:
…
..
APPROVED
Sgd
2023/01/21
CHAIRPERSON:
MEDICAL AND
DATE
DENTAL PROFESSIONS
BOARD
Kindly sign this document
and return to us at your earliest convenience, as an indication of
your approval of the Committee
Yours faithfully
Coordinator: Professional
Conduct”
[23]
It is not clear whether the Chairperson’s
act of constituting a Disciplinary Committee on or about 21 January
2023 to hear
the matter on 2 February 2023 is connected to the second
‘decision’ (i.e., the 2022 decision referred to in
paragraph
4 of Part B of the review notice of motion), or whether
this act on or about 21 January 2023 is being challenged.
[24]
The inconsistencies regarding the date of
the first decision and the second ‘decision’ are
ultimately of no moment.
There is no ambiguity that the applicant is
challenging a decision by the Prelim Committee, whenever it may have
been taken, for
an inquiry to be held into his alleged unprofessional
conduct. Nor is there an ambiguity that he is challenging what he
asserted
is a ‘decision’ which led to the Disciplinary
Inquiry being convened for 2 February 2023. To my mind, it is
irrelevant
whether the first decision was taken in 2015 or 2016, and
the second ‘decision’ in November 2022 or on or about 21
January 2023.
[25]
The first decision and the second
‘decision’ are collectively referred to as “the two
decisions”.
[26]
In part A of the review notice of motion
the applicant applied for an interim interdict pending the
finalisation of the relief in
Part B in which an order is sought
amongst others to review and set aside the two decisions. The relief
is framed thus:
“
PART
A
“
1.
First respondent is prohibited from proceeding with the disciplinary
proceedings against the applicant, pending the final
resolution and
determination of the relief sought in part B hereunder.
PART B
2. Condonation is
granted to the applicant in terms of
section 9(1)(b)
of the
Promotion
of Administrative Justice Act, No 3 of 2000
, pertaining to the
180-day period referred to in
section 7(1)
thereof.
3. The decision of
the first respondent of 2015 to institute disciplinary proceedings
against applicant is reviewed and set
aside.
4. The decision of
the first respondent to continue with disciplinary proceedings
against the applicant of 2022, is reviewed
and set aside.
5. The first
respondent is prohibited from further pursuing any disciplinary
proceedings against the applicant based
on the applicant’s
criminal record.”
[27]
Before an answering affidavit was delivered
in the review application (“the review answering affidavit”)
this application
was issued on 8 December 2023. The review answering
affidavit was deposed to on 14 December 2023. It was not disputed
during argument
that a replying affidavit has not been delivered.
[28]
Ms Manganye argued, amongst others, that
the dispute was
lis pendens
because the relief claimed in this application is also claimed in
Part A of the notice of motion in the review application. In
view of
my decision on the application, it was not necessary for me to
consider the issue.
[29]
One of the applicant’s grievances is
that the HPCSA has unreasonably delayed the Disciplinary Inquiry. He
asserted that the
unreasonable delay was evidence of vexatiousness
and an ulterior motive to the Disciplinary Inquiry. Due to this, I
recount the
events between July 2015, when the complaint was sent to
the applicant, and 27 November 2023 when the proceedings were
postponed
to 18 April 2024. Amongst others, there was a grievance
that the applicant had been deprived
audi
alteram partem (“
audi
”
)
before the two decisions were taken, and that he had not received
timeous and proper notice of the Disciplinary Inquiry scheduled
for 2
February 2023.
# Factual background
Factual background
[30]
During 2013, the applicant was found guilty
of treason and sentenced to 30 (thirty) years’ imprisonment, a
portion of which
was conditionally suspended. He was incarcerated at
the Zonderwater Correctional Centre in Cullinan (“the
Correctional Centre”).
Having served a sentence of direct
imprisonment from around 29 November 2013 he was released on parole
on 29 June 2020.
[31]
Around
28 May 2015, Ms Venter the Manager: Records at the HPCSA, learnt of
the applicant’s conviction and sentence. On 17
June 2015,
whilst the applicant was incarcerated, she lodged a complaint (“the
complaint”) with the General Manager:
Legal Department at the
HPCSA on the basis that the applicant had been found guilty of
attempting to overthrow the government and
was serving a sentence of
imprisonment for twenty-five (25) years.
[8]
She
expressed that the applicant’s incarceration constituted
unprofessional conduct.
[32]
In the founding affidavit in the review
application (“the review founding affidavit”) the
applicant denied receiving
the complaint. However, it appears from
annexure “A-2” to that affidavit that the complaint was
sent to the applicant
under cover of a letter dated 27 July 2015
despatched to the address in the HPCSA’s records, being a post
office box in Sinoville
(“the Sinoville address”). He was
notified that the complaint would serve before the HPCSA’s
Prelim Committee
for consideration and that the Regulations required
him to provide an explanation before the complaint was placed before
the Prelim
Committee, and he had to do so by 25 September 2015.
[33]
Mr Madube, an investigator at the HPCSA,
handed the letter dated 27 July 2015 to the applicant personally at
the Correctional Centre.
At Mr Madube’s request, and in his
presence, the applicant signed “at the bottom of [the] letter”
as proof of
personal receipt. Mr Madube’s confirmatory
affidavit is attached to the HPCSA’s review answering
affidavit. A copy
of the letter which Mr Madube handed to the
applicant is attached to the review answering affidavit marked “AA4”.
Two
signatures appear thereon –
(i)
The one, appears on the second half of the
page (described in the affidavit as “the bottom of the page”).
The date “31/7/2015”
appears in manuscript above the
signature which the HPCSA asserts was placed by the applicant in Mr
Madube’s presence.
(ii)
The other signature appears on the first
half of the page within the imprint of a rubberstamp of the Head:
Correctional Centre,
Cullinan, Correctional Services, Zonderwater.
Within the imprint, appears an imprint of a rubber stamp with the
date “31
July 2015”, and in manuscript the time “12h15”.
[34]
The rubber stamp imprint, and the signature
within the imprint, in my view signify receipt of the letter at the
Correctional Centre.
I am therefore satisfied that on the
probabilities, the applicant received the letter dated 27 July 2015
from Mr Madube at the
Correctional Centre. My finding finds support
in the applicant’s failure to deliver a replying affidavit in
the review application
disputing that the letter was handed to him.
[35]
In
the answering affidavit in this application the HPCSA averred that
the applicant did not respond to correspondence sent to him.
In this
regard, it referred to the letters and e-mails attached marked “AA2”
to the answering affidavit in the review
application. One of these
letters is dated 6 October 2015. It was sent to the Sinoville address
and also transmitted by e-mail.
[9]
The
applicant was alerted that a response had not been received to the
letter dated 27 July 2015. Another letter is dated 21 January
2016,
also sent to the Sinoville address. The applicant was notified
that the complaint had been placed on the Prelim Committee’s
agenda for its meeting on 17 and 18 March 2016. In the replying
affidavit in this application,n the applicant denied receiving
any
correspondence from the HPCSA.
However,
the averments in the review answering affidavit remain undisputed.
[36]
On
18 March 2016, the Prelim Committee decided in terms of
sub-regulation 4(8) of the Regulations that a disciplinary committee
should hold a Disciplinary Inquiry. A letter dated 18 March 2016 was
sent to the Sinoville address informing the applicant that
the Prelim
Committee had resolved in terms of sub-regulation 4(8) of the
Regulations that a disciplinary committee should hold
a Disciplinary
Inquiry.
[10]
[37]
In the review answering affidavit, the
HPCSA also discussed its unsuccessful attempt at holding a
Disciplinary Inquiry at the Correctional
Centre on 17 and 18 July
2019. The inquiry did not take place due to a lack of co-operation
from officials at the Correctional
Centre.
[38]
On
21 January 2023, the Chairperson of the Board constituted the
Disciplinary Committee to hold an inquiry into the complaint on
2
February 2023.
[11]
I
am satisfied that notice of the date of the hearing was given to the
applicant and came to his attention. The applicant’s
actions
and those of his attorney bear this out. In the review founding
affidavit, the applicant averred that a notice and a charge
sheet
were sent to his wife’s e-mail address “dated 21 November
2022”. In support, he referred to documents that
were attached
to the founding affidavit marked A5’.
[12]
The
applicant does not disclose when the e-mail and the documents
attached thereto came to his attention. However, on 27 January
2023,
the applicant delivered to the HPCSA a document captioned “Points
in limine” (annexure A6 to the review answering
affidavit). Its
delivery days before the inquiry was to commence, strongly suggests
that the applicant was aware of the Disciplinary
Inquiry and intended
for the document to serve as an objection at the impending hearing.
Additionally, the applicant’s attorney
stated in a letter to
the
pro
forma
complainant
dated 16 February 2023 that the document captioned “Points in
limine” set out the problems with “trial
readiness”.
I infer from this that the applicant and his attorney had been aware
of the date for the hearing but believed
that the matter was not ripe
for hearing on that day. Significantly the applicant’s attorney
did not complain that the applicant
had not been given timeous notice
of the Disciplinary Inquiry. On 21 February 2023, the
pro
forma
complainant sent an e-mail to the applicant’s attorney
recording that the applicant was informed during November 2022 that
the Disciplinary Inquiry would take place on 2 February 2023. The
applicant’s attorney responded to the e-mail on the same
day.
He did not dispute the assertion. On the probabilities, the e-mail
sent to the applicant’s wife’s e-mail address
was
notification of the hearing scheduled for 2 February 2023, and on the
probabilities that e-mail came to the applicant’s
attention on
21 November 2022, or soon thereafter. I am consequently satisfied
that the applicant was notified in November 2022
that the
Disciplinary Inquiry would take place on 2 February 2023.
[39]
The applicant did not appear at the
Disciplinary Inquiry on 2 February 2023. As such the Disciplinary
Inquiry was postponed to 27
February 2023 to allow him an opportunity
to do so.
[40]
It is evident from the papers in the review
application that the applicant’s attorneys protested to the
holding of a Disciplinary
Inquiry. The record of the first decision
and of the second ‘decision’, as well as reasons for both
were requested.
Some documents were provided, but not reasons. The
Disciplinary Inquiry convened several times in 2023 but was postponed
at the
instance of the applicant for the HPCSA to provide documents
for him to institute review proceedings.
[41]
On 27 February 2023, the applicant’s
counsel applied for a postponement of the proceedings on the grounds
that the applicant
intended bringing a review application and was
waiting on documents from the HPCSA to do so. The proceedings resumed
on 22 June
2023 on which day they were postponed to 17 August 2023.
On 17 August 2023, they were postponed to 23 November 2023.
[42]
The review application was served on the
HPCSA on 6 November 2023. On 23 November 2023, the applicant’s
legal representative
applied for the postponement of the Disciplinary
Inquiry. The application was refused because the inquiry had not been
interdicted.
Even though the Disciplinary Committee had refused the
applicant’s application for a postponement of the proceedings,
after
the applicant and his legal representatives left the hearing,
the proceedings were postponed to 18 April 2024 “unless there
[was] an interdict or a court order interdicting the hearing of the
matter”.
# Interim
interdicts pending a review application
Interim
interdicts pending a review application
[43]
The requirements for an interim interdict
are well-established:
(i)
a
prima facie
right, albeit open to some doubt;
(ii)
a reasonable apprehension of irreparable
harm, and imminent harm, to the right if the interdict is not
granted;
(iii)
the balance of convenience favouring the
grant of an interdict; and
(iv)
an alternative remedy not being available
to the applicant.
[44]
These
requirements were reaffirmed in
National
Treasury and Others v Opposition to Urban Tolling Alliance and
Others
[13]
(“
OUTA
”)
as well as in
SA
Informal Traders Forum v City of Johannesburg
[14]
where
Moseneke DCJ reiterated the requirements for an interim interdict and
the threshold that an applicant must overcome to establish
a
prima
facie
right.
He pointed out –
“
Interim
interdict
[24]…Foremost
is whether the applicant has shown a
prima facie
right that i
s
likely to lead to the relief sought in the main dispute
. This
requirement is weighed up along with the irreparable and imminent
harm to the right if an interdict is not granted and whether
the
balance of convenience favours the granting of the interdict. Lastly,
the applicant must have no other effective remedy.
A
prima facie
right?
[25]
A
prima facie
right may be established by
demonstrating prospects of success in the review
…”
[Foot
notes in text excluded. Underlining inserted for emphasis]
[45]
An
applicant who applies for an interim interdict pending a review
application has to satisfy the court that there are good prospects
of
success in the application. This can be shown by demonstrating that
the review is based on strong grounds which are likely to
succeed.
[15]
However,
the applicant seeks to restrain the HPCSA from exercising a statutory
power and discharging its statutory obligation to
inquire into
unprofessional conduct pending a review application. In such cases
interdicts are granted only in exceptional circumstances
in which a
strong case for that relief is made out.
[16]
For
an applicant to succeed in an interim interdict it must on a
prima
facie
basis prove facts that establish that the impugned decisions are
unlawful and therefore subject to being reviewed and set aside,
and
additionally that the respondent’s unlawful conduct
[17]
threatens
a right which if not protected by an interim interdict will result in
irreparable harm to the right.
[18]
(a)
The threatened rights
[46]
The applicant contends that (i) his right
to review and set aside the two decisions; (ii) his right of access
to courts in section
34 of the Constitution of the Republic of South
Africa, 1996 (“the Constitution”) and a fair trial in
terms of section
35 are threatened and they need the protection of an
interim interdict
pendente lite
which
restrains the HPCSA from holding a Disciplinary Inquiry into his
conduct. There is also a faint complaint that his right to
choose
and/or practice his profession under section 22 of the Constitution,
and his right to dignity under section 10, are also
threatened.
# (b)The right to
review the impugned decisions
(b)
The right to
review the impugned decisions
[47]
The
prima
facie
right which the applicant must establish is not merely the right to
approach a court to review the impugned decisions. He must
establish
a right, which if not protected by an interim interdict, will result
in irreparable harm.
[19]
The
applicant’s right to review the impugned decisions is not
threatened by a disciplinary hearing and it will not result
in
irreparable harm to the right. The right to review does not
require any preservation
pendente
lite
.
[20]
# (c)The
audi complaint:The nature of
the impugned acts
(c)
The
audi complaint:
The nature of
the impugned acts
[48]
The
target of the review application is two alleged acts by the Prelim
Committee. The applicant’s burden is thus to prove
on a
prima
facie
basis that the failure to afford him
audi
alteram partem
was unlawful
[21]
and
therefore subject to being reviewed and set aside.
[49]
The role and powers of the prelim
committee, as well as the applicant’s rights when the prelim
committee exercises its powers,
are governed by Regulation 4 of the
Regulations. The powers of the prelim committee and a medical
practitioner’s rights determine
the lawfulness of the Prelim
Committee’s actions, as well as the applicant’s
prima
facie
right.
[50]
A
prelim
committee
does
no more than consider complaints to determine the appropriate manner
of dealing with them. This emerges from the definition
of
“preliminary committee of inquiry”
[22]
and “preliminary inquiry”
[23]
in the Regulations. A
prelim
committee considers whether there are grounds for a professional
conduct inquiry into the conduct of a medical practitioner.
[24]
If
it decides that there are grounds for a professional conduct inquiry,
it must direct that an inquiry is held by a professional
conduct
committee into the complaint.
[25]
The
function described in sub-regulation 4(8) is what the Supreme Court
of Appeal in
Roux
v the Health Professions Council of South Africa
referred to as a “sifting function” to ensure that only
sustainable complaints are proceeded with.
[26]
[51]
The
function of a prelim committee of inquiry under the “Regulations
Relating to the Conduct of Inquiries held in terms of
section 41(1)
of Act 56 of 1974”
[27]
(“the
1976 Regulations”) was discussed in
Tucker
v SA Medical and Dental Council
[28]
and
in
Veriava
v President, South African Medical and Dental Council
[29]
where
it was found that the only function of the committee of preliminary
inquiry was to conduct a preliminary investigation to
determine
whether the evidence furnished in support of the complaint disclosed
prima
facie
evidence of improper or disgraceful conduct in respect of the
practice of the profession.
[30]
It
merely assisted the Council by holding a preliminary inquiry into
disciplinary complaints
[31]
and
did not embark on “an inquiry proper” into the charges
and complaints.
[32]
Its
role and function, and the nature of its decisions were summed up in
Veriava
thus –
“
The
inquiry committee merely does preliminary investigation, the type of
work for which it was appointed. If the preliminary investigation
shows that the evidence furnished in support of the complaint
discloses
prima
facie
evidence of improper or disgraceful conduct in respect of the
practitioner’s profession, then there is a complaint to be
inquired into by … the disciplinary committee. It should be
noted that the very concept of
prima
facie
evidence involves an opportunity of controverting….the only
function of the inquiry committee is to conduct a preliminary
investigation to determine whether the evidence furnished in support
of the complaint discloses
prima
facie
evidence of improper or disgraceful conduct in respect of the
profession of the practitioner”
[33]
And,
“…
the
only function of the [committee of preliminary inquiry] is to conduct
a preliminary investigation to determine whether the evidence
furnished in support of the complaint discloses
prima
facie
evidence of improper or disgraceful conduct in respect of the
profession of the practitioner…. The ultimate decision as
to
the inadequacy or baselessness of a complaint remains with the
Council. No provision exists conferring any discretion on either
the
[committee of preliminary inquiry] or the Council in this regard. It
should be stressed that up to that stage … the
[committee of
preliminary inquiry does not hear or consider] evidence under oath
…to determine whether the evidence available
in fact
substantiates the complaint or whether such evidence as is available
is in fact evidence of improper or disgraceful conduct.
Those
decisions are made by either the council or the disciplinary
committee after a proper inquiry, that is to say trial, when
evidence
under oath …and arguments by both the
pro
forma
complainant
and the accused practitioners have been heard. If there is evidence
to support the complaint and it discloses
prima
facie
evidence of improper disgraceful conduct, then the council or the
disciplinary committee, as the case may be, enters into the inquiry
into the complaint. All this seems to indicate that the inquiry
committee merely investigates the factual position relating to
the
complaint and that no discretion is exercised by …the
[committee of preliminary inquiry] … at that stage.”
[34]
[52]
Under the 1976 Regulations, the prelim
committee had to decide “whether the evidence furnished in
support of the complaint
discloses
prima
facie
evidence of improper or
disgraceful conduct” whereas under the current Regulations the
prelim committee has to decide whether
“there are grounds for a
professional conduct inquiry into the conduct of a [practitioner]”.
[53]
Notwithstanding amendments to the HPA and
the Regulations, the establishment of the HPCSA and professional
boards in whom the power
to hold inquiries now vests, the role and
functions of the committee of preliminary inquiry, its powers, and
the nature of its
decisions have not changed from what they were
under the 1976 Regulations. It still undertakes only a preliminary
investigation
of complaints
against a practitioner
and
determines whether there are grounds for a disciplinary inquiry.
[54]
The
prelim committee’s function is to investigate and decide
whether there is cause for holding a disciplinary hearing. To
this
end it merely investigates the factual position relating to the
complaint and no discretion is exercised by it.
[35]
It
neither investigates, nor determines, the culpability of a medical
practitioner.
[36]
It
does not embark on a proper inquiry into the charges and
complaints
[37]
and
is concerned only with the question whether there ought to be an
inquiry at all
[38]
and
not a decision whether the charge will be proven actually.
[39]
This
is the disciplinary committee’s function.
[40]
If
the prelim committee finds grounds for a professional conduct
inquiry, then it must direct a disciplinary inquiry by a professional
conduct committee.
[41]
The
complaint triggers an investigation which may eventually lead to a
direction from the prelim committee for the holding of a
disciplinary
inquiry by a disciplinary committee. The prelim committee process is
a preliminary step in the multi – stage
decision making process
which does not affect the applicant’s rights. The principles of
administrative justice will be observed
at the hearing before the
Disciplinary Committee.
[42]
[55]
Neither the 1976 Regulations nor the
Regulations applicable in this case authorise the prelim committee to
determine whether the
charge against the medical practitioner has
been proven, or not. That competence vested, and now vests, in the
disciplinary committee
after a proper inquiry. A prelim committee
simply decides whether a disciplinary inquiry should be held, or not.
[56]
The
applicant conflates a medical practitioner’s right when a
prelim committee decides whether a medical practitioner is in
contempt of council with the medical practitioner’s rights at
the stage when the prelim committee decides whether there are
grounds
for a professional conduct inquiry. And has superimposed the right of
a medical practitioner to a hearing when a disciplinary
committee
investigates and decides whether the medical practitioner is guilty
of unprofessional conduct,
[43]
onto
the process when the prelim committee determines whether there are
grounds for a disciplinary inquiry into the conduct of the
medical
practitioner.
[57]
A
medical practitioner is entitled to be heard when the prelim
committee considers whether the practitioner is in contempt of
council
[44]
and
not when it considers whether there are grounds for a disciplinary
inquiry. In the former, the Regulations expressly confer
the
right.
[45]
There
is no similar provision when the prelim committee determines whether
there are grounds for a disciplinary inquiry into the
conduct of the
medical practitioner. On the application of the
maxim
expressio unius est exclusio alterius
a right to a hearing at this stage is not contemplated. The prelim
committee is concerned with the availability of evidence to
support
the charge and complaint.
[46]
That
is its role; it determines nothing more than a question of fact.
[47]
The
applicant did not have a right to a hearing before the Prelim
Committee because of the of the prelim committee’s role
and
function, the nature of the proceedings before it and the
determination it makes.
[48]
[58]
For
the reasons that follow, I am not satisfied that the applicant has
established a
prima
facie
right that is likely to lead to the impugned decisions being reviewed
and set aside.
[49]
# a.
Audi complaint: First decision
a.
Audi complaint: First decision
[59]
The applicant’s core grievance
against the first decision is that he was not informed of the
complaint and could not respond
thereto before the Prelim Committee
considered it on 18 March 2016. He argues that this led to his right
to
audi
being
infringed.
[60]
There
is no merit to the complaint that the applicant was not informed of
the complaint. Mr Madube delivered the complaint to the
applicant
personally, and the applicant acknowledged receipt of it.
Furthermore, the applicant has not demonstrated on a
prima
facie
basis that the Regulations conferred upon him the right to
audi
before the Prelim Committee considered the complaint.
[50]
The
Prelim Committee undertook a preliminary inquiry “in order to
make a determination on the appropriate manner of dealing
with …
a complaint”.
[51]
It
did not decide whether the applicant is guilty of unprofessional
conduct, it has left that for the Disciplinary Committee to
decide.
The multi-stage decision-making process governing the investigation
and determination of complaints of unprofessional conduct
does not
confer upon the medical practitioner a right to be heard at the stage
when the prelim committee considers whether there
are grounds for a
professional conduct inquiry.
b.
The
audi
complaint:
Second ‘decision’
[61]
The applicant’s argument for a right
to be heard before a disciplinary inquiry can commence, or continue,
or a date allocated
for a hearing, would have the consequence that
the prelim committee itself, or some other person or body, can decide
that in spite
of the Prelim Committee having determined on 18 March
2016 that there are grounds for a disciplinary inquiry, and therefore
being
enjoined by the Regulations to direct that an inquiry is held,
did so, the decision and direction can be revisited, and overturned.
To find that the applicant had a right to be heard I have to find the
empowering provision which stipulates that (i) notwithstanding,
and
in addition to, the Prelim Committee’s decision that there are
grounds for a professional conduct inquiry, the commencement
or
continuation thereof must be authorised by some person or body or the
Prelim Committee itself; and (ii) before the disciplinary
inquiry
directed by the prelim committee can commence, or continue, or a date
for a hearing allocated, the applicant had a right
to be heard, and
on what. The applicant has not identified such empowering provisions
and I have found none. The Regulations do
not support the right
contended for.
[62]
No person or body other than the prelim
committee has the power to decide whether there are grounds for a
disciplinary inquiry,
or not. I was not referred to, nor have I found
a provision in the HPA or the Regulations which empowers any person
or body, including
a prelim committee itself, to revisit the finding
that there are grounds for a professional conduct inquiry, or to
interfere with
that finding. I have also not found any provision
which authorises the prelim committee, the Board or the HPCSA to
decide whether
to continue or discontinue a disciplinary inquiry
which the prelim committee was obliged to direct must be held because
it had
found grounds for a disciplinary inquiry. Nor for that matter
have I found a provision which requires a separate decision by the
prelim committee or another body or person, for the appointment of a
disciplinary committee, the appointment of a date for a disciplinary
inquiry, or for the continuation of a disciplinary inquiry which the
prelim committee directed must be held under its obligation
under
sub-regulation 4(8). Such decisions would effectively overturn the
Prelim Committee’s finding on 18 March 2016 without
the
authority to do so and breach the statutory obligation to hold a
professional conduct inquiry where grounds to hold such an
inquiry
have been found.
[63]
The Prelim Committee found that there were
grounds for a professional conduct inquiry. It was therefore obliged
under sub-regulation
4(8) to direct that a disciplinary inquiry is
held, and that the Registrar arrange it. The Registrar was obliged to
implement the
Prelim Committee’s decision of 18 March 2016.
This entailed, amongst others, appointing a date, time and place for
the disciplinary
inquiry, and requesting the Board to appoint a
Disciplinary Committee. The appointment of the date for, and time of,
the inquiry,
the Registrar’s request to the Chairperson to
appoint a disciplinary committee and the appointment of the
Disciplinary Committee
by the Chairperson on 23 January 2013 were
steps in implementing the Prelim Committee’s decision of 18
March 2016. The Prelim
Committee’s decision that grounds exist
“for a professional conduct inquiry” was the only
decision taken.
[64]
The applicant has not established on a
prima
facie
basis,
that a decision had been taken to continue the Disciplinary Inquiry.
In any event, even if this was established, the applicant
has not
made out a
prima facie
case
for a right to
audi
when the second ‘decision’, if any, was taken.
# c.Non-compliance with sub-regulations
4(3), 4(7) and 4(8)
c.
Non-compliance with sub-regulations
4(3), 4(7) and 4(8)
[65]
There
is also no merit to the complaint that the HPCSA failed to comply
with sub-regulations 4(3), 4(7) and 4(8).
[52]
While
both sub-regulations 4(3) and 4(7), refer to an investigation, they
apply to different investigations.
[66]
Sub-regulation 4(3) applies to the inquiry
and finding contemplated in sub-regulation 4(4) whether the medical
practitioner is in
contempt of council due to the failure to respond
to correspondence from the HPCSA. A medical practitioner has a right
to be heard
when the prelim committee enquires into and considers
this question; not the question in sub-regulation 4(8) whether there
are
grounds for a professional conduct inquiry.
[67]
Sub-regulation 4(7) deals with a prelim
committee’s obligations when it finds that there are no grounds
for taking further
action in respect of a complaint of unprofessional
conduct. The circumstances contemplated in this sub-regulation do not
exist
in the applicant’s case. In any event a prelim
committee’s decision under sub-regulation 4(7) is favourable to
a medical
practitioner, not prejudicial to him/her. It is not clear
to me why sub-regulation 4(3) or 4(7) constitutes a basis for
invalidating
one or both impugned decisions.
[68]
The inquiry, and decision, by a prelim
committee contemplated in regulation 4(8) involves the prelim
committee considering the written
complaint, the information received
in response to the HPCSA’s call for information, and the
medical practitioner’s
explanation (or lack thereof) to
determine whether grounds exist for a professional conduct inquiry.
If it finds such grounds,
then the prelim committee must direct that
such an inquiry is held. The Prelim Committee’s decision of 18
March 2016 concerned
the question whether there were grounds for a
professional conduct inquiry. The absence of a response from the
practitioner did
not preclude the Prelim Committee from considering
the issue.
[69]
Sub-regulation 4(3) does not apply to the
decision which the Prelim Committee makes under sub-regulation 4(8).
# d.Failure to comply with mandatory and
material procedure: Regulation 4
d.
Failure to comply with mandatory and
material procedure: Regulation 4
[70]
Regulation 4 deals with the role, and the
powers, of the prelim committee. The applicant’s case is that
the provisions of
the Regulation are peremptory, and in the absence
of compliance therewith, a mandatory and material procedure or
condition had
not been complied with, thereby rendering the first
decision invalid.
[71]
The applicant did not identify which of the
sub-regulations of Regulation 4 constitute mandatory and material
procedure or conditions.
It can however be inferred from the papers
that the applicant is contending that sub-regulations 4(3), 4(7) and
4(8) were “material
and mandatory provisions or conditions”.
No other sub-regulations in regulation 4 are identified. I was also
not addressed
on why the provisions are submitted to be mandatory (or
peremptory).
[72]
I
agree with Plasket J in
Intertrade
Two (Pty) Ltd v MEC for Roads and Public Works, Eastern Cape and
Another
that assessing whether non-compliance with a procedure or condition
renders a decision a nullity “is not a mechanical process”
[53]
and
the words “shall” and “may” in themselves do
not determine the validity of actions.
[54]
Plasket
J propounded a “four-point rule-of-thumb approach” which
had been adopted in
Sutter
v Scheepers
[55]
as
a guide to the process of interpreting the relevant provision.
Plasket J described the approach in the following terms:
“
(1)
If a provision is couched in a negative form it is to be regarded as
a peremptory rather than as a directory mandate…
(2) If a provision
is couched in positive language and there is no sanction added in
case the requisites are not carried
out, then the presumption is in
favour of an intention to make the provision only directory. . . .
(3) If, when we
consider the scope and objects of a provision, we find that its terms
would, if strictly carried out, lead
to injustice and even fraud, and
if there is no explicit statement that the act is to be void if the
conditions are not complied
with, or if no sanction is added, then
the presumption is rather in favour of the provision being directory.
(4) The history of
the legislation will also afford a clue in some cases.”
[73]
In
the context of the 1976 Regulations the medical practitioner in
Tucker
[56]
contended
that regulations 2, 3 and 4 had not been complied with. The court
found that the 1976 Regulations,
[57]
in
so
far
as
they
related
to
the
way
in
which
the
Council
(whose
functions were later carried out by the professional boards)
initially dealt with complaints against medical practitioners
at the
prelim committee stage were of administrative nature only. They were
only a framework of the administrative machinery to
deal with
complaints and merely indicated how the Council functions before it
prosecutes a practitioner. The court consequently
concluded that the
1976 regulations in so far as they related to the way in which the
complaint was initially to be dealt with,
were directory and of
administrative nature. The prelim committee only determined whether
a
prima
facie
case
existed against the practitioner concerned.
[58]
It
was only after the prelim committee decided that there was
prima
facie
evidence of improper or disgraceful conduct and that a disciplinary
inquiry should be held, that a medical practitioner had enforceable
rights,
[59]
and
a right to be heard.
[60]
[74]
In my view, notwithstanding the decision
preceding the constitutional era, the position articulated in
Tucker
prevails under the Regulations and it
remains sound considering the role of the prelim committee, the
nature of the proceedings
before it and the determination it makes.
[75]
I
have found that sub-regulations 4(3) and 4(7) do not apply when the
prelim committee considers whether there are grounds for a
disciplinary inquiry. As far as sub-regulation 4(8) is concerned, it
serves to guide the professional board and its committees
on how to
initially deal with complaints.
[61]
On
the “four-point rule-of-thumb approach” referred to by
Plasket J, sub-regulation 4(8) has the hallmarks of a directory,
not
a mandatory provision.
[62]
It is couched in positive language and no sanction is imposed for
non-compliance with its requisites. There is no explicit statement
that the prelim committee’s process, or what follows upon it,
would be void if the provisions were not complied with. Considering
that the history of the legislation could afford a clue in some
cases, I find the decision in
Tucker
instructive.
# (d)Non-compliance with mandatory and
material procedure in regulation 5:
(d)
Non-compliance with mandatory and
material procedure in regulation 5:
[76]
Sub-regulations
5(1) and 5(2) oblige the Registrar to notify the applicant at least
60 days prior to the holding of the disciplinary
inquiry of the date
and time of the inquiry and the place where the inquiry would be
held. The applicant claims that he was not
given proper notice of the
disciplinary inquiry. However, the applicant was notified on or about
21 November 2022 that the disciplinary
hearing would take place on 2
February 2023. This was more than 60 days’ notice. In the
document captioned “Points
in limine”
[63]
(annexure
A6 to the review answering affidavit) and attached to the review
founding affidavit, the applicant had protested that
the notice of
the inquiry did not indicate the venue at which the Disciplinary
Inquiry would be held. However, this was not
raised in the
affidavits in this application, nor in the review founding affidavit.
I was also not addressed on how the lack of
proper notice for the
Disciplinary Inquiry on 2 February 2023 tainted decisions which had
been taken in the past or why the failure
to indicate the venue of
the hearing less than 60 days before the date for the hearing renders
the process invalid.
(e)
Non-compliance with regulation 8
[77]
Regulation 8 regulates pre-inquiry
procedure. The
pro forma
complainant
is required to arrange a pre-inquiry conference with the medical
practitioner at least seven (7) days before the date
of the inquiry.
I was not addressed on how the failure to hold a pre-inquiry
conference seven (7) days before the date of the hearing
taints
decisions taken in the past. In any event, on 21 February 2023 the
pro forma
complainant
informed the applicant’s attorney that he wanted to hold a
pre-inquiry conference and conveyed that he was readily
available at
the applicant’s attorney’s convenience. The applicant’s
attorney’s response was that a pre-inquiry
conference was
premature at that stage. That attitude would not have changed even if
the request was made earlier. The response
to the request for a
pre-inquiry conference was –
“
As
to a pre-trial, we will make an arrangement for a pre-trial upon
receipt of the documentation requested. We can only prepare
for a
pre-trial and trial upon receipt thereof and to hold a pre-trial
without the requested info and documents would be nonsensical.”
# (f)Arbitrariness, capriciousness,
ulterior motive, irrationality and unreasonableness
(f)
Arbitrariness, capriciousness,
ulterior motive, irrationality and unreasonableness
[78]
The applicant contends that the second
‘decision’ was arbitrary and capricious, as well as
irrational and unreasonable,
taken for an ulterior purpose or motive
and constituted an abuse of the disciplinary process because of the
seven (7) year delay
(that is between 2015 when the complaint was
lodged and 2022). And therefore, it falls to be reviewed and set
aside. The HPCSA
was not supine in that time. Letters were sent to
the applicant’s Sinoville address, the complaint was hand
delivered to
the applicant at the Correctional Centre and efforts
were made to hold the Disciplinary Inquiry at the Correctional
Centre.
[79]
Whether a delay is unreasonable is dictated
by the circumstances leading to the delay. The applicant had been
incarcerated for,
five of the seven years. During this time the HPCSA
unsuccessfully attempted to convene an inquiry. The five-year delay
was not
of the HPCSA’s making and does not constitute an
unreasonable or unjustifiable delay. On the applicant’s own
version,
the HPCSA started arranging the Disciplinary Inquiry in
November 2022. At worst, there was a delay from June 2020 when the
applicant
was released on parole and November 2022. This is a far cry
from the seven (7) years’ delay contended for by the applicant.
The applicant asserts that the delay has been prejudicial to him, but
he has not disclosed how. As I see it, the applicant has
benefitted
from the delay. He has continued practising as a medical practitioner
and earning an income.
[80]
The factual foundation for the averments
that the delay indicates that the second ‘decision’ was
arbitrary, capricious,
irrational, unreasonable, taken in bad faith
and for an ulterior purpose or motive is missing.
[81]
The
decision to continue the inquiry is further contended to be
unreasonable and irrational because the offences committed by the
applicant were not related to his ability and fitness to practice as
a medical practitioner and the conviction, sentence and incarceration
had nothing to do with any unprofessional conduct as contemplated in
section 4(1) of the HPA. It was contended additionally that
the
decision was irrational because the purpose of disciplinary
proceedings is to regulate unprofessional conduct of medical
practitioners
in respect of their profession. I am not satisfied that
the review application is likely to succeed on this basis. This flies
in
the face of section 45(1) of the HPA. If a person registered under
the HPA has been convicted of “
any
”
offence by a court of law, section 45(1) authorises the relevant
professional board to hold an inquiry if it is of the opinion
that
the offence constitutes unprofessional conduct. Aside from this, the
supervision of the conduct of registered medical practitioners
has
been entrusted to the professional boards. The inquiry whether a
medical practitioner has acted unprofessionally, is a matter
resting
in the exclusive function of the relevant professional board
[64]
and
it is the final arbiter on what is proper for a medical
practitioner.
[65]
In
Meyer
the
court refused to interdict a disciplinary hearing pending the outcome
of an action because it found that the South African Medical
and
Dental Council was the sole repository of the power to determine
whether a medical practitioner was guilty of unprofessional
conduct.
[66]
[82]
More
recently in the
Health
Professions Council of South Africa v Grieve,
[67]
the
Supreme Court of Appeal found –
“
[12]
The [HPCSA] is… not merely a medical malpractice watchdog; It
is also the primary guardian of morals of the health profession.
As
this court held in
Preddy and Another v
Health Professions Council of South Africa
[2008
(4) SA 434
(SCA) paragraph 4]:
‘
It
has been said of the various predecessors of the council that each
was the repository of power to make findings about what is
ethical
and unethical in the medical practice and the body
par
excellence
to set the standard of
honour to which its members should conform’.”
[83]
It
lies in the province of the HPCSA and the Board to determine whether
the applicant’s conviction constitutes unprofessional
conduct.
This is not justiciable in a court of law.
[68]
# a.The section 34 and 35 rights
a.
The section 34 and 35 rights
[84]
The rights afforded by section 35 of the
Constitution attach to arrested, detained, and accused persons. The
applicant is none of
these. He has not explained how he comes to
enjoy the rights in section 35, nor how those rights are threatened
by a disciplinary
inquiry.
[85]
Section 34 guarantees the right to have a
dispute decided in a fair hearing before a court or where appropriate
another independent
and impartial tribunal or forum. The applicant’s
case is not that he will not receive a fair hearing before the
disciplinary
committee, save for the averment that the chairperson
has exhibited bias, which I will return to. I have not understood the
applicant’s
case to be that section 34 of the Constitution
applies to the prelim committee’s process. After all the prelim
committee
does not determine a dispute, a disciplinary committee
does. The prelim committee undertakes a preliminary investigation of
complaints.
[86]
The applicant can exercise the rights
guaranteed under section 34 before the Disciplinary Committee which
is the body that will
hear the evidence and argument and thereafter
decide whether the evidence supports the complaint and whether the
applicant’s
conduct fell short of the standard of honour to
which medical practitioners must conform.
[87]
Section
42(2) of the HPA preserves the applicant’s rights under section
34 of the Constitution. He has the right to
answer the charge
against him and be heard in his defence. Regulation 9 of the
Regulations regulates the procedure at a disciplinary
inquiry. The
applicant has, amongst others, the right to be represented by a legal
representative
[69]
,
he has the right to cross examine the pro-forma complainant’s
witnesses,
[70]
to
apply for his discharge after the
pro
forma
complainant has closed its case,
[71]
to
address the disciplinary committee
[72]
,
lead witnesses in support of his case,
[73]
re-examine
his witnesses after cross examination by the
pro
forma
complainant,
[74]
and
after all the evidence has been adduced, he has the right to address
the disciplinary committee on the evidence and the legal
position.
[75]
Moreover,
sub-regulation10(1) confers a right to appeal the disciplinary
committee’s findings to an appeal committee. The
applicant has
not identified which of these rights are threatened, and in what
manner. The applicant has the right and will have
the opportunity to
challenge the complaint before the disciplinary committee. The
applicant’s right under section 34 of the
Constitution is not
threatened and does not have to be protected pending the review
application.
# b.Bias
b.
Bias
[88]
The charge of bias rests in a remark by the
Disciplinary Committee’s chairperson at the Disciplinary
Inquiry on 17 August
2023 that notwithstanding a review application
the Disciplinary Inquiry will continue. The remark does not establish
a case for
bias, not even on a
prima
facie
basis. Disciplinary proceedings
are not suspended by a pending review application. Moreover, the
HPCSA has the statutory obligation
to hold an inquiry into
unprofessional conduct by medical practitioners registered under the
HPCSA. In the circumstances, the chairperson’s
remark is an
expression of the Disciplinary Committee’s understanding of the
law and of its obligation to implement the Prelim
Committee’s
direction of 18 March 2016.
# (g)Right to dignity: section 10
(g)
Right to dignity: section 10
[89]
It
was argued that the continuation of the disciplinary proceedings in
the face of the irregularities preceding the Disciplinary
Inquiry
would infringe and irreparably harm the applicant’s right to
dignity in terms of section 10 of the Constitution.
However, the
applicant has not disclosed in what manner his right to dignity will
be infringed. The applicant is registered as
a medical practitioner
under the HPA. He must adhere to the professional and ethical
standards of the medical profession and is
subject to the HPCSA’s
disciplinary processes. The HPCSA is not acting unlawfully by
inquiring into a charge of unprofessional
conduct against the
applicant. To the contrary, the HPCSA is discharging its statutory
obligation to uphold and maintain the professional
and ethical
standards within the health professions,
[76]
to
ensure the investigation of complaints concerning a person registered
in terms of the HPA and to ensure that appropriate disciplinary
action is taken against such a person in accordance with the HPA to
protect the interests of the public.
[77]
I
cannot find that the exercise of a statutory obligation, constitutes
an unlawful infringement of the applicant’s right to
dignity.
[90]
The applicant wants to be protected from
being suspended from practice or having his name struck from the roll
of medical practitioners
if found guilty of unprofessional conduct.
However, the Disciplinary Inquiry which is the act the applicant
wishes to interdict
is not unlawful. Nor is the imposition of a
penalty if he is found guilty of unprofessional conduct. If the
applicant is found
guilty of unprofessional conduct, the Disciplinary
Committee is enjoined to impose one of six penalties contemplated in
section
42(1)(a) to (f) of the HPA. The applicant is not entitled in
law to protection from lawful conduct.
# (h)Right to practice profession:
section 22
(h)
Right to practice profession:
section 22
[91]
The
health professions are regulated by the HPA. The applicant is
therefore subject to the supervision of the HPCSA “a statutory
custos
morum
of the medical profession, the guardian of the prestige, status and
dignity of the profession”
[78]
and
to its disciplinary and penal powers. Because the right in section 22
of the Constitution may be regulated by law, the right
to practice a
profession is not absolute. Whilst the applicant’s right to
practice as a medical practitioner may be withdrawn,
it is sanctioned
by section 42(1)(c) of the HPA and the limitation of his right to
practice as a medical practitioner or the withdrawal
of that right is
not unlawful and therefore the right does not need protection.
[92]
The applicant also claims that his right to
earn an income is under threat. The applicant’s right to earn
an income is not
threatened by the Disciplinary Inquiry. If the
applicant’s name is removed from the register of medical
practitioners, he
will not be able to earn an income practising as a
medical doctor, but he will not be precluded from earning an income
from other
activities.
# Has a case for an
interim interdict been made out?
Has a case for an
interim interdict been made out?
[93]
The
applicant has not on a
prima
facie
basis proven facts which establish that the HPCSA’s conduct is
unlawful and therefore subject to being reviewed and set aside.
[79]
I
am not satisfied that the applicant has shown prospects of success on
review on any of the grounds raised by him, let alone a
strong case
for review.
[94]
I
cannot find that the review is based on strong grounds which are
likely to succeed. This thus detracts from the requirement of
a
prima
facie
right and there is no basis upon which the HPCSA can be required to
endure the strictures of an interim order, pending the final
determination of the review application.
[80]
[95]
The applicant failed in establishing a
strong case for an interdict to temporarily restrain the HPCSA from
exercising its statutory
power, nor has he established exceptional
circumstances. This conclusion renders it unnecessary for me to
consider the other requisites
for an interim interdict. Nonetheless I
add that apart from not having established a
prima
facie
right though open to some doubt,
the applicant has failed to establish a reasonable apprehension of
irreparable harm and imminent
harm to his right to review the
impugned decisions, his rights to a fair hearing and a fair trial
under sections 34 and 35 of the
Constitution, his right to dignity
under section 10 and his right to earn an income and practice his
profession under section 22,
if the Disciplinary Inquiry is not
interdicted pending the review application.
[96]
For all the above reasons, the applicant
failed to make out a case for an interim interdict. Accordingly, the
application was dismissed.
As indicated earlier I intended for the
applicant to bear the costs, but inadvertently ordered the HPCSA to
bear the costs. To
that extent the order falls to be varied
[97]
The order as varied is as follows:
(a)
The application is dismissed.
(b)
The applicant is to pay the respondent’s
costs of the application.
S
K HASSIM
Judge:
Gauteng Division, Pretoria
(electronic
signature appended)
Applicant’s
Counsel:
Adv R du Plessis SC
Respondent’s
Counsel Adv SM Manganye
Hearing:
28 February 2024
Order:
15 April 2024
Reasons:
18 June 2024
This
judgment was prepared and authored by the Judge whose name is
reflected and is handed down electronically by circulation to
the
parties’ legal representatives by e-mail and by uploading it to
the electronic file of this matter on CaseLines. The
date for
hand-down is deemed to be 18 June 2024.
[1]
The
Disciplinary Inquiry was scheduled to start on Thursday, 18 April
2024.
[2]
Cf.
definition of “preliminary inquiry” in regulation 1 of
the Regulations relating to the Conduct of Inquiries into
Alleged
Unprofessional Conduct under the Health Professions Act, 1974
promulgated in
Government
Notice
R102 dated 6 February 2009 and published in
Government
Gazette
31859.
[3]
Regulation 4 of the Regulations, esp. sub-regulation 4(8) of the
Regulations.
[4]
Sub-regulation 4(8) of the Regulations.
[5]
Described
as such in the applicant’s founding affidavit.
[6]
para
26 below.
[7]
para
26 below.
[8]
This
is not accurate. But nothing turns on it. A sentence of 30 years
imprisonment of which 10 years were conditionally suspended
for five
(5) years was imposed.
[9]
The e-mail address to which it was transmitted is reflected as
pretori@absamail.co.za
.
[10]
This
appears in the review answering affidavit.
[11]
para
22
supra
.
[12]
A
charge sheet is not one of the three separate documents that form
Annexure A5. The “Appointment Certificate” appointing
a
pro
forma
complainant signed by the Registrar of the HPCSA on 19 June 2019
which is one of the documents is the only document that pre-dates
21
November 2022. The remaining two documents are dated 21 January
2023. The one on the face of it is the cover page of an agenda
for
the meeting of the Professional Conduct Committee scheduled for 2
February 2023 at 10h00 issued by the Registrar on 21 January
2023.
The other is the document signed by the Chairperson on 21 January
2023 appointing the Professional Conduct Committee. The
last two
documents could not have been attached to an e-mail sent to the
applicant’s wife’s e-mail address on 21
November 2022.
[13]
2012
(6) SA 223
(CC) at para 41.
[14]
2014
(4) SA 371
(CC) para 25.
[15]
Cf.
Economic
Freedom Fighters v Gordhan and Others
2020
(6) SA 325
(CC) para [42].
[16]
OUTA
supra
fn 13 at para [43] and [44].
Gool
v Minister of Justice and Another
1955
(2) SA 682
(C) at 689B-C
See
also
Airoadexpress
(Pty) Ltd v Chairman, Local Road Transportation Board, Durban, and
Others
[1986] ZASCA 6
;
1986
(2) SA 663
(A) at 676B-C.
[17]
Cf.
Pikoli
v President of the Republic of South Africa
2010 (1) SA 400
(T) at 404D-E.
[18]
OUTA
supra
fn
13 at
para
[50] at 237I to 238B. Cf. para [53].
[19]
Outa
supra
fn
13
at para [50] at 237I - 238B.
[20]
Outa
supra
fn
13 at
para
50 at 238B.
[21]
fn.
14 and para [45]
supra
.
[22]
“preliminary committee of inquiry” means the committee
established by a professional board “for the preliminary
investigation of complaints to make a determination thereon.”
[23]
“preliminary inquiry” means “an inquiry held in
terms of the [Regulations] by a preliminary committee of inquiry
to
consider a complaint against a person registered in the register of
the professional board concerned in order to make a determination
on
the appropriate manner of dealing with such a complaint.”
[24]
Sub-regulation
4(8) of the Regulations.
[25]
Sub-regulation
4(8) of the Regulations.
[26]
[2012]
1 All SA 49
(SCA) at para [20].
[27]
Published
in
Government
Notice
R2268 of 3 December 1976.
[28]
1980
(2) SA 207 (T).
[29]
1985
(2) SA 293 (T).
[30]
Veriava
supra
fn 29 at 309J - 310A.
[31]
Cf.
Veriava
supra
fn
29 at 308 F-G.
[32]
Veriava
supra
fn
29 a
t
311H-I.
[33]
Veriava
supra
fn 29
at 309E-F.
[34]
Veriava
supra
fn 29 at 309J-310F.
[35]
Cf.
Veriava
supra
fn 29 at 310F and 312B.
[36]
Cf.
Veriava
supra
fn 29 at 310D-E.
[37]
Cf.
Veriava
supra
fn 29 at 310D-E
[38]
Tucker
supra
fn 28 at 212 F-G.
[39]
Tucker
supra
fn
28 at 212F-G.
[40]
Cf.
Veriava
supra
fn 29 at 310D-E.
[41]
Subreg
4(8). Cf.
Veriava
supra
fn 29 at 309C and 311G-H.
[42]
Cf.
Amongst others,
Competition
Commission v Yara (SA) (Pty) Ltd
2013 (6) SA 404
(SCA) para 24.
[43]
Regulation
9.
[44]
Sub-regulation
4(4), 4(5) read with 4(3).
[45]
Sub-regulation
4(5) read with sub-regulation (4(3) and 4(4).
[46]
Cf.
Veriava
supra
fn
29 at 317F.
[47]
Veriava
supra
fn 29 at 312B.
[48]
Cf.
Tucker
supra
fn
28 at 212F-H and 213G-H.
[49]
Cf.
SA
Informal Traders Forum
supra
fn 14 para [44]
supra
.
[50]
Cf.
Tucker
supra
fn
28 at 212G – H. Cf. 213 G – H.
[51]
Cf.
definition of “preliminary inquiry” in regulation 1 of
the Regulations.
[52]
Para
4.9 of the replying affidavit.
[53]
Intertrade
Two (Pty) Ltd v MEC for Roads and Public Works, Eastern Cape and
Another
2007
(6) SA 442
(Ck) at para 27.
[54]
Intertrade
supra
fn
53 at para 27.
[55]
1932
AD 165
at 173-174.
[56]
Supra
fn
28 at 213E-H. Regulation 4 is similar to the Conduct Regulations,
1976 in material respects, save that the latter did not require
the
decision of the prelim committee to be communicated to the
complainant and medical practitioner. Regardless, the
dictum
is sound on the description of what the prelim committee of
inquiry’s functions and powers are, and its role in the
disciplinary
process under the HPA.
[57]
The
first seven regulations.
[58]
Under
sub-regulation 7(1) of the 1976 Regulations the prelim committee had
to be satisfied that the evidence given in support
the complaint
disclosed
prima
facie
evidence
of improper or disgraceful conduct whereas under sub-regulation 4(8)
of the 2009 Regulations the prelim committee decides
whether there
are grounds for a professional conduct inquiry into the conduct of
the medical practitioner.
[59]
Tucker
supra
fn
28 at 213H.
[60]
Tucker
supra
fn 28 at 212G-H. See also para [54]
supra
.
[61]
Cf.
Tucker
supra
fn
28 at 213 F-H. Professional conduct inquiries were at the time
governed by the Conduct Regulations of 1976. They did not contain
a
provision that required the decision of the prelim committee to be
communicated to the complainant and medical practitioner.
[62]
Para [72]
supra
.
[63]
Para [38]
supra
.
[64]
Meyer
v South African Medical and Dental Council
1982(4)
SA 450(T) at 456A-B.
[65]
Nel
v SA Geneeskundige & Tandheelkundige Raad
1996
(4) SA 1120
(T) at 1128H
.
[66]
Meyer
supra
fn 64 at 455H
[67]
(1356/2019)
[2021] ZASCA 06
(15 January 2021) para 12.
[68]
Meyer
supra
fn 64 at 457H-458A.
[69]
Sub-regulation 9(1).
[70]
Sub-regulation 9(6).
[71]
Sub-regulation 9(7).
[72]
Sub-regulation 9(10).
[73]
Supra
fn 72.
[74]
Supra
fn 72.
[75]
Sub-regulation 9 (14).
[76]
s3(m) of the HPA.
[77]
s3(n) of the HPA.
[78]
Veriava
supra
fn 29
at 307B.
[79]
Cf.
Pikoli
supra
fn
17 at 404E.
[80]
Eskom
v Vaal River Development Association
(Pty)
Ltd and Others
2023
(4) SA 325
(CC) para 66 and para 272.
sino noindex
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