Case Law[2023] ZAGPPHC 227South Africa
Aslam v President: Health Professions Council Of South Africa and Others [2023] ZAGPPHC 227; 34380/2021 (3 April 2023)
Headnotes
by a professional conduct committee be found guilty of improper or disgraceful conduct, such person shall be liable to one or more of the following penalties:
Judgment
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# South Africa: North Gauteng High Court, Pretoria
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## Aslam v President: Health Professions Council Of South Africa and Others [2023] ZAGPPHC 227; 34380/2021 (3 April 2023)
Aslam v President: Health Professions Council Of South Africa and Others [2023] ZAGPPHC 227; 34380/2021 (3 April 2023)
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sino date 3 April 2023
FLYNOTES:
UNFAIR DELAY IN DISCIPLINARY PROCEEDINGS
ADMINISTRATIVE
– Disciplinary proceedings – Delay – Alleged
misconduct of doctor – Proceedings at
Health Professions
Council – Much of evidence lost 13 years after complaint –
Impossible to conduct a fair trial
– Delay inexcusable and
due to incompetence within the structures of Council –
Proceedings set aside and Board
interdicted from taking further
measures – Health Professions Act 56 of 1974.
IN
THE HIGH COURT OF SOUTH AFRICA
GAUTENG
PROVINCIAL DIVISION, PRETORIA
CASE
NO.: 34380/2021
(1)
REPORTABLE:
YES
/ NO.
(2)
OF INTEREST TO OTHER JUDGES: YES /
NO
.
(3)
REVISED.
Date
of hearing: 8
February 2023
Date
of Judgment: 30 March 2023
In
the
matter
between:
DR
M
ASLAM
Applicant
and
THE
PRESIDENT: HEALTH PROFESSIONS COUNCIL
OF
SOUTH
AFRICA
1
st
Respondent
THE
HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA
2
nd
Respondent
THE
CHAIR FOR THE TIME BEING, MEDICAL AND DENTAL
PROFESSIONS
BOARD OF THE HEALTH PROFESSIONS
COUNCIL
OF SOUTH
AFRICA
3
rd
Respondent
THE
CHAIR FOR THE TIME BEING, SECOND MEDICAL
COMMITTEE
OF PRELIMINARY ENQUIRY OF THE MEDICAL
AND
DENTAL PROFESSIONS BOARD OF THE HEALTH
PROFESSIONS
COUNCIL OF SOUTH AFRICA
4
th
Respondent
THE
CHAIRPERSON OF THE PROFESSIONAL CONDUCT
COMMITTEE
OF THE MEDICAL AND DENTAL PROFESSIONS
BOARD
OF THE HEALTH PROFESSIONS COUNCIL
OF
SOUTH
AFRICA
5
th
Respondent
THE
REGISTRAR: HEALTH PROFESSIONS COUNCIL
OF
SOUTH
AFRICA
6
th
Respondent
MR
PVH MOAKA
N.O.
7
th
Respondent
JUDGMENT
1.
This case,
save for its unfortunate tale of institutional inefficiency,
demonstrates the traumatic and adverse prejudicial impact
which the
ineptitude of the officials employed or appointed by the second
respondent and its disciplinary bodies and/or structures
has on the
well-being of a professional medical practitioner, accused of
“unproven” misconduct.
2.
A complaint
issued against the applicant in March 2008 resulted in a decision to
hold disciplinary proceedings, referred to in the
papers as a
professional conduct inquiry, in October 2011 (some two years later).
As at the time of the launching of this application,
some 13 years
after the complaint, it being evident that much of the evidence in
support of the complaint and in defense of the
applicant would have
been lost, the proceedings had not properly commenced. Yet the
respondents, notwithstanding the glaring inequity
that would result,
remained steadfast in prosecuting the applicant by means of its
disciplinary process in the year 2021 again,
some 7 years after it
had been postponed.
3.
That was the
last straw. The applicant launched the present application
effectively seeking a permanent stay of the pending proceedings.
I
shall revert to the relief sought.
4.
The first
respondent is the president of the Health Professions Council of
South Africa (herein the “
HPCSA
”
).
The second respondent is the HPSCA, and the applicant is member of
the HPSCA. The HPSCA is established in terms of section 2
of the
Health Professions Act 56 of 1974 (herein
“
the
Act”
).
One of its objects is to uphold and maintain professional and ethical
standards within the health profession. It must also ensure
that
complaints are investigated by the appropriate structures, and
disciplinary action is taken where required to protect the
interests
of the public.
5.
The third
respondent is the chairperson of the Medical and Dental Professions
Board of the HPCSA. The fourth respondent is the chairperson
of the
Second Medical Committee of Preliminary Inquiry of the Medical and
Dental Professions Board of the HPCSA.
6.
The fifth
respondent is the chairperson of the Professional Conduct Committee
of the Medical and Dental Professions Board of the
HPCSA. It was
appointed on 21 February 2014 to chair the professional conduct
inquiry into the charge of unprofessional conduct
against the
applicant. The sixth respondent is the registrar of the HPCSA. The
seventh respondent is the pro forma complainant.
All the respondents
actively oppose the application of the applicant, and all of them
play a pivotal role in the prosecution of
the complaint against the
applicant.
7.
The Medical
and Dental Professions Board is a board established in terms of
section 15 of the Act. The objects of this board include
the
maintenance and enhancement of the dignity of the health profession
as well as the integrity of medical practitioners. A decision
made by
the board, falling within its ambit, is not subject to ratification
by the HPCSA.
8.
Section 41 of
the Act provides that a professional board shall have the power to
institute an inquiry in allegations of unprofessional
conduct, and on
finding a person guilty of the said conduct impose penalties as
prescribed in section 42(1). The latter section
stipulates that
should a medical practitioner after an inquiry held by a professional
conduct committee be found guilty of improper
or disgraceful conduct,
such person shall be liable to one or more of the following
penalties:
8.1.
a caution or a
reprimand or a reprimand and a caution.
8.2.
suspension for
a specified period from practicing or performing acts generally
pertaining to the practitioner’s profession.
8.3.
removal of
his/her name from the register.
8.4.
a prescribed
fine.
8.5.
a compulsory
period of professional service as may be determined by the
professional board.
8.6.
the payment of
costs of the proceedings or a restitution or both.
9.
For purposes
of my judgment, this is an important facet, because any of the above
possible penalties remain looming for as long
as the inquiry or
disciplinary hearings have not been finalized. That this may weigh
heavy on a professional medical practitioner
requires no explanation.
10.
A person whose
conduct is the subject of an inquiry, in terms of the Act, shall be
afforded the opportunity of answering the charge
and of being heard
in his/her defense. The professional board conducting the inquiry may
summon witnesses and require the production
of any book, record,
document, or thing and hear the testimony of witnesses under oath.
The non-appearance of a witness summoned
constitutes an offence.
11.
Section
15(5)(fA) of the Act envisages that regulations relating to
professional boards must provide for the establishment of
professional
conduct committees consisting of so many persons as may
be prescribed, which shall consist of at least three board members or
members
of the relevant profession and at least two public
representatives, one of whom shall be the chairperson of the
committee.
12.
In terms of
section 61(1) of the Act the Minister published
inter
alia
the
2001 and 2009 professional conduct regulations. The latter replacing
the former, but the former remained applicable to the
inquiry into
the conduct of the applicant. In terms of the 2001 regulations:
12.1.
“
committee
of preliminary inquiry
”
means a committee established by a professional board.
12.2.
“
proforma
complainant
”
means a person appointed by the professional board to represent the
complainant and to present the complaint to a professional
conduct
committee. As such, the proforma complainant is an appointee of the
professional board.
12.3.
“
professional
conduct committee
”
means a committee established by a professional board.
13.
In terms of
regulations 3(2), (3) and (4) of the professional conduct regulations
applicable, the committee of preliminary inquiry
is mandated to
conduct a sifting process and to thereafter decide, following due
consideration of the information at its disposal,
whether there are
grounds for an inquiry, or not, and/or whether an inquiry must be
held into the conduct of the accused in which
event the committee of
preliminary inquiry must direct the registrar of the HPCSA to arrange
the holding of such an inquiry. Further,
in terms of the relevant
regulations, the proforma complainant is obliged to formulate a
charge sheet and the registrar is then
obliged to issue a notice
addressed to the accused stating where and when an inquiry will be
held which has to include the charge
sheet.
14.
The accused is
then entitled to request and receive further particulars to the
charge sheet and the proforma complainant and the
accused are obliged
to convene a pre-inquiry discussion with the view of expediting and
facilitating the smooth running of the
professional conduct inquiry.
15.
Important is
the fact that, in terms of the professional conduct regulations:
15.1.
the accused is
obliged to formally plead to the charge sheet or, failing such a
plea, a plea of not guilty will be entered.
15.2.
evidence is to
be led by the proforma complainant under oath in support of its case
and the accused is entitled to cross-examine
the witnesses, and the
professional conduct committee, through the chairperson, is also
permitted to examine the witnesses; the
accused is then again
permitted to cross-examine the witnesses arising from the examination
by the chairperson and other members
whereafter the proforma
complainant may re-examine his/her witnesses.
15.3.
the accused
may apply for a discharge after the proforma complainant has closed
his/her case. If not discharged, the accused can
lead evidence in
support of his/her case and the same procedure as outlined in
subparagraph 15.2 shall be followed.
15.4.
the
professional conduct committee, upon conclusion of the case,
deliberates in camera and thereafter announces its finding and,
in
the event of a guilty finding, receives address and evidence
concerning a suitable penalty to be imposed and thereafter deliberate
in camera upon the penalty to be imposed and impose it.
16.
It follows
that this process is akin to a criminal hearing and the applicant,
for all intents and purposes, is and presently remains
an accused
person. This brings me to the applicant and the incident that led to
the complaint.
17.
As indicated,
the applicant is a medical practitioner and specialist orthopedic
surgeon who practices as such in Gqeberha in the
Eastern Cape
Province. The applicant has, since 21 January 1999, been registered
as a specialist orthopedic surgeon, with the second
respondent.
18.
The applicant
brings an application for judicial review. In the alternative the
applicant seeks interdictory relief. At the hearing
of the
application prayers 2, 3 and 4 of the notice of motion had been
abandoned by the applicant. As such, the only relief that
remains is
this, and I quote:
“
1.
The disciplinary proceedings pending against the applicant in terms
of Chapter IV of the Health Professions
Act 1974 (Act 56 of 1974) (as
amended) in relation to the complaint by Mr. AF Olivier and being
dealt with under reference number
MP0376272/336/2008 be and are
hereby permanently set aside.
”
and
“
5.
The Medical and Dental Professions Board of the Health Professions
Council of South Africa be and is
hereby interdicted and restrained
from taking all or any further disciplinary measures against the
applicant in terms of Chapter
IV of the Health Professions Act, 1974
(Act 56 of 1974) (as amended) in relation to the complaint of AF
Olivier being dealt with
under reference No MP0376272/336/2008, and
all existing disciplinary proceedings in relation thereto are
terminated.
”
“
6.
The applicant’s costs are to be paid:
6.1.
by the third, fourth and seventh respondents jointly and severally,
the one paying the other to be absolved, and
6.2.
by any other opposing respondent, jointly and severally, the one
paying the other to be absolved, with the respondents
in paragraph
6.1 supra.
”
19.
Supplementary
heads were filed by the applicant prior to the hearing motivating a
punitive costs order to be granted against the
respondents.
20.
Most of the
facts, and the chronology of events, in this case seem to be common
cause. In paragraph 43 of their answer, the respondents
admit the
factual history, but elected to elaborate upon the history. That
elaborating for most parts constituted a mere repetition
of what the
applicant had already set out.
21.
The applicant
was charged with unprofessional conduct. According to the charge, the
applicant is alleged to have failed or neglected
to properly assess
and manage a patient, being a Mrs. A Olivier, on 24 August 2007. It
is alleged that the applicant failed to
diagnose a severe injury to
the patient’s thoraco-lumber spine, by failing to obtain an
adequate history from her and by
failing to adequately examine her
thoraco-lumber junction both clinically and radiologically.
22.
The applicant
denies that he is guilty of unprofessional conduct, as charged, and
confirms that he has always had the intention
of defending the charge
had he been given the reasonable opportunity to do so. That
opportunity or right to defend himself, as
the history will
demonstrate, was not afforded to the applicant.
23.
The patient
was treated by the applicant on 24 August 2007. The applicant
rendered orthopedic and medical services to the patient.
As already
mentioned, she is identified as a Mrs. A Olivier (herein “
the
patient
”).
She was referred to the applicant by a casualty doctor at the Cuyler
Netcare Private Hospital. The referring doctor did
obtain a history
from the patient and would have had examined her clinically, did
refer her for X-rays, and had to diagnose her
condition. This all
happened on the same day on which the applicant also treated the
patient. The applicant who says that he has
treated thousands of
patients since cannot recall who the casualty doctor was.
24.
The patient’s
medical history presented to the casualty doctor, his or her findings
following a clinical examination of the
patient, and the reason for
referring the patient for selective X-rays, are, without doubt,
material to the defense of the applicant
in respect of the charge of
unprofessional conduct. This fact is not contested by the
respondents, although the respondents seem
to claim that the
non-existence of evidence operates also to the prejudice of the pro
forma complainant, who bears an evidentiary
onus. I shall revert to
the absurdity of that claim.
25.
When the
patient was discharged from the hospital, she would have been given
all the original views of her radiological investigations
whilst she
was a patient. The applicant has, despite requests therefore, no been
given the original views, and it is unknown whether
they still exist.
The respondents, notwithstanding undertakings to provide the views,
have failed to do so, which leaves the inference
that they have
become lost. The original views are also material to the applicant’s
defense in respect of the charge levied
against him.
26.
The patient
was discharged from the Cuyler Hospital and from the applicant’s
care on 29 August 2007. Some 13 days later, the
applicant was
contacted telephonically by the late Dr GHJ Coetzee, who was a
specialist neurosurgeon practicing in Cape Town. The
latter had
allegedly been consulted by the patient. Further X-rays as well as a
CT scan had been performed on the patient. The
late Dr Coetzee
diagnosed the patient with an unstable fracture of the T12 thoracic
vertebra and had performed surgery on the patient
in the form of an
instrumented fusion of the T12 vertebra.
27.
The late Dr
Coetzee wrote a report on 3 November 2008 setting out his diagnosis
and assessment of the patient. It confirms that
the patient sustained
no neurological deficits; that the instrumented fusion was successful
and uncomplicated, and that the patient
was successfully mobilized
and rehabilitated.
28.
The applicant
inter alia
denied the
charge of unprofessional conduct, premised thereon that there was at
the time of him treating the patient no clinical
or radiological
evidence available to him suggesting or evidencing an injury to the
patient’s thoraco-lumber spine. In addition,
the applicant
explains that, if there was such an injury to the patient’s
spine, it was not reasonably diagnosable in the
absence of
radiological evidence such as X-rays. The existence of X-rays is
therefore central to the defense of the applicant.
29.
As between the
applicant and the respondents there exists a dispute of fact
concerning the history provided to him by the patient
and the history
which the patient alleges had been given to him. The examination of
the disputed history which was presented to
the applicant is
therefore pivotal to the charge of unprofessional conduct. As a
result, the history received by the casualty officer
and the
documents and records of the Cuyler Hospital of 24 August 2007 are
crucial to the determination of that dispute. That such
evidence is
of utmost importance was also confirmed by the respondents’
expert witness.
30.
The original
views of the X-rays and CT scan performed on the patient on the
instruction of the late Dr. Coetzee also constitute
material evidence
in the disciplinary proceedings. The applicant is not in possession
of the evidence. The different proforma complainants
intended to
present the evidence and testimony of the late Dr. Coetzee. In my
view, his evidence is naturally material to the complaint
of
unprofessional conduct. Coetzee passed away on 25 July 2015, being
some 4 years after it was decided to hold the disciplinary
inquiry.
Save for the fact that he is not a witness anymore, the other
material evidence seems to be concededly non-existent. The
respondents’ response in this regard is somewhat astonishing. I
quote from their answer:
“
203.
I have already dealt with the absence of merit in the applicant’s
allegation that the sad
demise of Dr Coetzee has a bearing on his
defence. It is stated that Dr Coetzee’s records may have been
destroyed to the
applicant’s disadvantage. But this would
equally apply to the pro-forma complainant’s case. The
pro-forma complainant
would not have access to any material to the
exclusion of the applicant and the applicant’s attorney. The
pro-forma complainant
bears the onus to prove the charge against the
applicant.”
31.
This
constitutes a concession by the respondent that, notwithstanding the
onus that they bear, and the absence of the material evidence,
which
seems to have concededly gone astray, they wish to persist with the
hearing. The attitude lacks compassion and demonstrates
a deep
misappreciation of the most fundamental principles of justice. I
shall revert to this aspect.
32.
It is the
applicant’s case therefore, which ought to be largely common
cause, and which case I accept in my judgment, that
at a minimum the
following evidence is material to the applicant’s defense on
the charge of unprofessional conduct:
32.1.
the quality of
the images of the X-rays, and consequently,
32.2.
that the
anatomical structures imaged by the first X-rays are required to
determine whether the applicant should have insisted on
new X-rays to
be conducted.
32.3.
the evidence
of Dr Coetzee, who has passed away, and
32.4.
in addition,
the original views of the second X-rays ordered by Dr Coetzee and his
clinical notes as well as the operation report
in respect of the
surgery which he performed on the patient.
33.
The existence,
or non-existence, of material evidence is particularly relevant to
this case, since it can be accepted that the inexplicable
delays in
the adjudication of the disciplinary proceedings, constitutes the
predominant contributing factor to the loss of such
evidence. In this
regard the failure to timeously collect the evidence, as will be
dealt with in my judgment, was occasioned by
slothfulness within the
structures of the respondents.
34.
The dilatory
conduct of the respondents permeates this case. It is thus important
to set out the chronology of events in respect
of the professional
conduct proceedings.
34.1.
as already
indicated, on 24 August 2007 the applicant treated the patient.
34.2.
on 20 March
2008 the patient’s husband issued the complaint to the second
respondent.
34.3.
on 2 April
2008 the applicant was notified of the complaint issued to the second
respondent, the HPCSA.
34.4.
on 15 July
2008 the applicant submits his letter of explanation to the registrar
of the HPCSA in response to the complaint. On 22
August 2022 the
applicant was notified in writing that the investigations have not
yet been concluded since the registrar was allegedly
awaiting the
hospital records and the report of Dr. Coetzee.
34.5.
on 30
September 2010 the complaint was considered by the first meeting of
the Second Medical Committee of Preliminary Inquiry of
the HPCSA
(‘the preliminary committee”). It decided to defer the
complaint until a next meeting. It failed to consider
the 26-month
delay between the response provided by the applicant and 30 September
2010.
34.6.
on 13 and 14
September 2011 a resolution was passed by the preliminary committee
that a professional conduct inquiry be held into
the conduct of the
applicant. Again, no explanation is provided for the further delay of
another year (cumulatively already 3 years)
from the applicant’s
response, and four years since the incident.
34.7.
by means of an
email of 12 December 2011 the applicant was informed that the
professional conduct inquiry would be held on 5 and
6 March 2012. The
appointed pro forma complainant was Thabang Baloyi. By agreement
between the parties those dates were moved to
22 and 23 March 2023.
Due to the unavailability of witnesses, the inquiry was postponed at
the request of Baloyi.
34.8.
in May 2012 it
was agreed that the inquiry would be enrolled for 17 and 18 July
2012. No notice of set down was provided by Baloyi
in respect of the
agreed dates. A notice of set down is a pre-requisite in terms of the
applicable regulations.
34.9.
Baloyi
unilaterally amended the dates to 22 and 23 August 2012. New dates
were proposed by the applicant, but that written proposal
was
ignored.
34.10.
almost a year
later, on 4 July 2013 Baloyi unilaterally enrolled the professional
conduct enquiry for 29 and 30 August 2013. On
15 July and 1 August
2013 Baloyi in writing informed that the applicant would be available
for the hearing unilaterally enrolled.
34.11.
on 1 August
2013 Baloyi again unilaterally postponed the professional conduct
inquiry which was enrolled for 29 and 30 August 2013.
He undertook to
provide alternative dates and respond to previous unanswered letters
dealing with outstanding required particulars
and documents for the
hearing.
34.12.
on 5 September
2015 the proforma complainant again unilaterally enrolled the
professional conduct inquiry to be conducted on 30
September 2013 and
1 October 2013. To this the applicant objected as it constituted
inadequate notice, and the applicant’s
attorney was
unavailable. Several further dates were proposed to Baloyi.
34.13.
on 9 September
2013 Baloyi enrolled the professional inquiry for 12 and 13 November
2013 and the applicant confirmed his availability.
34.14.
on 12 November
2013 was the first sitting of the professional conduct inquiry,
however, it was before an incorrectly constituted
professional
conduct committee, and the inquiry was postponed to 5 and 7 March
2014.
34.15.
a pre-inquiry
hearing was held between the applicant’s attorney and Baloyi.
The attorney informed Baloyi that he intended
to raise an
in
limine
point
of unreasonable delay at the hearing and to seek a stay. Baloyi
undertook to provide a report by an expert, Professor Walters,
a
factual report by Dr Coetzee and to provide “any radiology
images” to be used in the inquiry. He confirmed that Dr
Coetzee
would be his witness. The promised information was not provided
within the time agreed upon.
34.16.
on 27 February
2014 Baloyi provided the applicant with a so-called bundle of
documents which only contained an expert report by
Professor Walters
and other less relevant documents. No original radiology documents
were provided, and the report of Dr Coetzee
was also not
incorporated.
34.17.
on 28 February
2014 the applicant’s attorney wrote and enquired in respect of
the outstanding documents and recorded the intention
to oppose any
attempt to postpone the inquiry.
34.18.
the conduct
inquiry eventually commenced on 5 March 2014. The applicant’s
attorney argued in
limine
the delay in prosecution point. After having heard the point in
limine
,
but prior to a ruling, Baloyi made an application for postponement.
The committee granted the postponement and determined that
the matter
would be finally adjourned to a next date which should be within 14
days from the hearing.
34.19.
in response to
the ruling, Baloyi stated that it would be best if the case be
postponement
side
die
but he
promised that within 14 working days he would have arranged a date
with the applicant. It follows that the basis upon which
the
postponement was issued was that a new date must be arranged within
14 days of 5 March 2014.
34.20.
on 17 March
2014 the applicant proposed that the inquiry be enrolled for three
consecutive days and provided a variety of dates.
34.21.
Baloyi
responded on 19 March 2014 setting the inquiry down for 5 and 6
August 2014 which were not dates that the applicant’s
attorney
had proposed and went against the notion of an expedited hearing.
34.22.
on 24 July
2014 the applicant was informed that the inquiry would not proceed on
5 and 6 August 2014 as the committee had not been
timeously informed
of and reserved for the inquiry.
34.23.
Baloyi’s
appointed as proforma complainant had been terminated and he was
replaced by Advocate Esther Pillay-Naidoo.
34.24.
on 4 August
2014 the applicant’s attorney wrote to Pillay-Naidoo requesting
that, due to the delays in prosecuting the inquiry,
the matter be
referred back to the preliminary committee for reconsideration and
that further delays would be unfair, unreasonable
and unjust to the
applicant. On the same day further dates were proposed in November
2014 should there not be a referral back to
the preliminary
committee.
34.25.
Pillay-Naidoo,
in response, suggested dates in February and March 2015. She did not
deal with the request that the matter be referred
to the preliminary
committee.
34.26.
on 8 October
2014 the applicant’s attorney recorded in two letters an
intention to raise the issue of delay again and enquired
about
progress in respect of the referral back to the preliminary
committee. These letters went unanswered.
34.27.
on 24 October
2014 the applicant proposed that the matter be proceeded with on 2
days during the period 2 to 13 February 2015. The
letter remained
unanswered. On 19 November 2014 a further enquiry was made about the
previous letter. That letter went unanswered.
34.28.
again, on 10
December 2014, an enquiry was made about the proposed dates in
February 2015, but no response was received.
34.29.
the
applicant’s attorney wrote to Pillay-Naidoo on 13 January 2015,
mentioning that it was no longer possible to set the matter
down for
hearing in February 2015. That letter went unanswered. In the
meantime, the attorney’s secretary also attempted
to make
telephonic contact with Pillay-Naidoo on 14 January 2015 but was
unsuccessful.
34.30.
Pillay-Naidoo
finally wrote, on 29 January 2015. She undertook to provide new dates
by the next week.
34.31.
further
enquiries were made on 20 February 2015, 22 April 2015 and 15 June
2015. The applicant was ignored.
34.32.
on 14 August
2015 the applicant’s attorney wrote to Pillay-Naidoo informing
her of Coetzee’s death and enquired whether
the respondents
intended, in the circumstances, to proceed with the matter. A
reminder was sent on 12 October 2015 and 20 November
2015, but
Pillay-Naidoo failed to respond.
34.33.
on 22 February
2016 the applicant’s attorney’s secretary managed to
contact Pillay-Naidoo. During that conversation
Pillay-Naidoo
informed the attorney’s secretary that the case had been
referred back to the preliminary committee for consideration.
This
was recorded in a letter, which letter also remained unanswered.
34.34.
on 14 June
2016 the applicant was informed that Advocate Mapholisa had replaced
Pillay-Naidoo as proforma complainant. On 23 August
2016 a letter was
addressed to Advocate Mapholisa enquiring whether the preliminary
committee was reconsidering the matter. The
letter went unanswered.
34.35.
the
applicant’s legal team wrote to Advocate Mapholisa on 18
November 2016, 7 March 2017, 2 May 2017, 6 September 2017, 4
December
2017, 19 March 2018, 21 June 2018, 1 October 2018, and 7 January
2019. All these letters were unanswered. The letters
recorded the
prejudice and recorded the failure to answer. Since none of the
letters were answered, although it could be seen by
means of read
receipts that they were read, the applicant’s attorney stopped
writing.
35.
Given the
applicable legal principles, which will be considered hereinafter,
the inordinate delays are inexcusable. The applicant
was proactive
and sought to get the disciplinary hearing finalized within a
reasonable time. The respondents, on the other hand,
deliberately,
alternatively due to sheer incompetence, ignored the plight of the
applicant. Already at the first commencement of
the hearing before
the professional conduct committee, the delay caused, and the
concomitant absence of relevant and material evidence,
ought to have
warranted a stay in prosecution. More disconcerting is the fact that
the committee itself had made an order that
new dates be obtained as
a matter of expediency. This was ignored and no reasonable
explanation exists for such ineptitude.
36.
This brings me
to the next phase in this tale of tardiness:
36.1.
the
applicant’s attorney, whilst speaking telephonically to the
seventh respondent, Mr Moaka, about another unrelated matter,
the
latter mentioned in passing that he had been appointed as the new
proforma complainant in the applicant’s matter. He
did not
regard it important to tell the applicant’s attorney that he
was also a member of the professional conduct committee
that had
convened on 5 March 2014, which is something that the applicant and
the applicant’s attorney realised somewhat later.
36.2.
during the
telephone call of 20 November 2020 with the seventh respondent, the
latter told the applicant’s attorney that he
wanted the inquiry
to be enrolled for hearing to which the attorney for the applicant
responded that:
36.2.1.
although he
would facilitate the identifying of dates, he would do so subject to
taking instructions on how to deal with the issues
of delay.
36.2.2.
he would
strenuously object to the inquiry reconvening after all the
intervening years, in view of the irretrievable loss of evidence;
and
36.2.3.
conveyed that
the matter had been returned to the preliminary committee for
reconsideration following the death of Dr Coetzee.
36.3.
the seventh
respondent stated that he was unaware that the matter had been
referred to the preliminary committee and would make
enquiries on the
subject. He then agreed to provisional dates for 7 and 8 April 2021
on which dates both parties were available.
36.4.
the telephone
call was confirmed in a letter dated 22 February 2021 which letter
again went unanswered. On 1 March 2021 a follow-up
was written.
36.5.
on 11 March
2021 Moake responded stating that the complaint had never been
referred to the preliminary committee and that he saw
no reason to
refer the complaint to the preliminary committee and would not do so.
He confirmed that he was intent on setting the
inquiry down for 7 and
8 April 2021.
36.6.
on 31 March
2021 a notice was issued stating that the disciplinary inquiry had
been set down again for hearing on 7 and 8 April
2021. Both the
notice and attached charge sheet seem to be irregular, but that issue
is not relevant for purposes of this application.
36.7.
this was
followed up by a demand, sent by the applicant’s attorney to
the respondents, that due to the inordinate delay the
inquiry should
be stayed. This evoked a response which was nothing but an attempt to
avoid culpability on the side of the respondents
and conveyed an
unequivocal intention to persist with the professional conduct
inquiry at all costs.
37.
That attitude
led to the launching of this application.
38.
The
applicant tells the court that all the above had a very traumatic
adverse prejudicial impact on him. The pending professional
conduct
proceedings are the first and only professional conduct proceedings
that the applicant (then
[1]
in
his 21 years as registered orthopedic surgeon) faced. He conveys that
he, in his day-to-day interaction with his patients, makes
every
effort to treat them to the best of his ability, competently,
compassionately, empathetically, respectfully and in a dignified
manner.
39.
He was
devastated when he first learnt about the complaint in April 2008. He
expresses that he was profoundly disappointed by the
fact that the
patient was apparently not satisfied with his care. He was saddened
by the fact that he would need to explain his
professional conduct to
his professional regulatory body and that it was an event which he
had hoped to avoid during the whole
of his career. It played heavily
on his mind and his emotional well-being.
40.
When he, in
October 2011, heard about the fact that a professional conduct
inquiry would be held into his conduct, he became even
more
distraught. He learned about the possible penalties envisaged in
section 42(1) of the Act in the event of a conviction. It
was most
distressing, and he has lived with this sword hanging over him for
many years.
41.
Over the
years, he has requested numerous potential dates and every time a
date was agreed, he would become increasingly anxious
having to face
the inquiry. He would properly consult and prepare and usually, at
the last minute, find out that the inquiry would
not proceed. He
explains that this brought him untold despair. He thought at many
times about the inquiry which thinking would
usually happen over
weekends, at night or while on holiday, being at times when he was
not that busy. It weighed heavily on him
and his family and has
deleteriously affected his phycological and emotional well-being.
42.
He also tells
that he has been incredibly frustrated and distressed by the
dismissive way in which he has been handled by the respondents.
He
experienced the treatment as being undignified, unfair and
high-handed. In addition, he conveys that the perpetual,
unreasonable,
unexplained, and unjustifiable delays in dealing with
his professional conduct inquiry have not and do not install
confidence in
him that the Medical and Dental Professional Board, or
any of its functionaries are intent or capable of upholding and
maintaining
the professional standards of the profession and/or
protecting the rights of the public. The postponed professional
conduct inquiry
of March 2014 was reported in a local newspaper,
which added to his distress and reputational embarrassment. This list
is not exhaustive,
and the applicant raises numerous other
complaints.
43.
I interject
this judgment to point out what the respondents’ response in
the answering affidavit was to these sincere issues
raised by the
applicant. This is contained in paragraphs 212 and further of the
answering affidavit. I quote:
“
212
The applicant complains about the effect of the delay on his health
and well-being. This
is regrettable and sad, but I have explained
above that the solution to any delay that may be found, should not
deprive the Complainant
of Justice. It is not unreasonable to imagine
that the well-being of the Complainant may equally be adversely
affected by the non-conclusion
of the Inquiry.
213
Further, the applicant is ‘frustrated and distressed by the
dismissive way’
in which he feels this matter or Inquiry was
handled by the Board and its functionaries, he ultimately charges
that he has no confidence
that he will receive a fair hearing.
214
I reiterate, with respect, that the charge of lack of fair hearing is
far-fetched and simply
aimed at stroking controversy. I have dealt
with this above and explained that the independence and impartiality
of the Conduct
Committee has not been brought into doubt. The persons
the applicant reportedly dealt with in his interaction with the HPCSA
do
not sit to determine the Complaint at the Inquiry, but the Conduct
Committee. There is nothing tangible to sustain this wild accusation.
215
Regarding the newspaper report of the matter in 2014, the HPCSA has
no control or influence
over that. But obviously the applicant does
not appear to complain of bad press or defamation.
216
The applicant incessantly refers to the length of the period that had
elapsed but at the
same time very meticulously record what has
happened in those years. This suggests that the matter was not just
left a limbo but
had remained active all these years. It was always
clear that he will be subjected to a disciplinary process.
217
It is also untrue that beyond March 2014 up to March 2021 ‘there
was simply no attempt’
to deal with the Inquiry. On the
applicant’s own version there were events towards the holding
of the Inquiry. The applicant
was not helpless in influencing the
pace of matters towards finalization of the Inquiry. The options
available to the applicant
includes an approach to the Honourable
Court, which could have been done years ago. The applicant waited all
these years in an
attempt to bolster his case for interdictory relief
to avoid facing the Conduct Committee at the Inquiry. The Honourable
Court
ought not to countenance this type of conduct and abuse of its
process.
218
I have dealt with the unfortunate issue of the staff turnover or the
change of hands in
the office of the pro forma complainant. This
applied to everyone interacting with the HPSCA and was not
selectively applied or
meted out to the applicant. There was no
sending of the case from ‘pillar to post’.
”
and
“
221
As
I
have already stated, any loss of evidence would apply to both sides,
(i.e. the applicant’s and the proforma complainant).
This
cannot be used to halt the Inquiry or to quash the charge. The
Conduct Committee will listen to the evidence adduced and decide
the
outcome. The playing field will be the same for all the players so to
metaphorically speak, with respect. Above all, the pro
forma
complainant bears the onus to proof the charge against the
applicant.
”
44.
In this
high-handed fashion the respondents elected to react. Instead of
showing genuine compassion with the plight of the applicant,
whose
distress was caused largely by the respondents’ ineptitude, the
response is disrespectful and unbecoming of a body
that represents
professional medical practitioners and wishes to uphold the public
interest. Cognizance should be given to the
fact that the answering
affidavit was deposed to by the acting registrar and chief executive
officer of the HPSCA, being an important
public function, who should
have known better.
45.
That brings me
to the legal position. As indicated the facts are mostly common
cause. The respondents seek to tell this Court that
the relief sought
by the applicant is somehow incompetent. Shortly prior to hearing of
this application, the respondents filed
supplementary heads of
argument, which they said contained the main arguments they would
rely upon I court. Yet, the new heads
incorporated the first set of
heads of arguments, which I was also asked to consider and take in
account.
46.
The first
heads raised initial points, one of them being that a tender was made
that the matter could now eventually be referred
back to the
preliminary committee. This tender the applicant refused, but I
cannot see how the preliminary committee, a statutory
created body,
that has strict and limited legislated powers, could ever reconsider
its own decision to have referred the complaint
for an inquiry. It
has no powers to do so, and the tender therefore lacks legal
competency. This shall be elaborated upon hereunder.
47.
The further
points raised are that:
47.1.
the applicant
seeks relief akin to a permanent stay of criminal prosecution, and
has, so it is argued not complied with the trite
requirements for
such relief. This contention was, a bit astonishingly so, premised on
the argument that it was the applicant itself
that “contributed”
to the delays.
47.2.
that the
applicant has not made out a case for interdictory relief, which the
respondents equate to relief to nullify the decision
to prosecute,
namely that the applicant failed to demonstrate the trite
requirements for an interdict; and
47.3.
that the
applicant has failed to exhaust its internal remedies as envisaged in
section 7(2) of PAJA, and failed to demonstrate exceptional
circumstances to be excused from exhausting internal remedies first;
and
47.4.
the review,
insofar as it is premised upon PAJA, is not brought within a
reasonable time or within 180 days from the offending decision;
and
47.5.
insofar as the
relief sought is premised upon a legality review, it is also
unreasonably delayed.
47.6.
In the
respondents’ supplementary heads, the argument was limited to
the points in 47.3
and
47.4
above.
48.
I intend to
deal with the defenses raised. Prior to this, I mention the
following. Section 33(1) of the Constitution provides that
everyone
has the right to administrative action that is “
procedurally
fair
”.
In this respect our courts have held that this is not a promise of a
just outcome but that the process, as one sees in
this case, must not
be so tainted with irregularities, that it will inevitably result in
an unfair outcome.
49.
In
C
Hoexter & G Penfold Administrative Law in South Africa Third
Edition (2021)
at
page 501 it is said that:
“
In
the context of s 33 the ‘procedural’ qualification
remains significant, since the administrative-law notion of fairness
is not substantive in nature – or at least, not yet. As the
Constitutional Court indicated in Bel Porto School Governing
Body v
Premier, Western Cape
2022 (3) SA 265
(CC), under our Constitution
‘procedural fairness’ does not promise fairness or
equitability in a substantive sense.
It does not promise a just
outcome. But even in a purely procedural sense, fairness or ‘natural
justice’ (its more
ancient name) remains a crucially important
component of administrative law. Listening fairly to both sides has
aptly been described
as ‘a duty lying upon everyone who decides
anything’.
As
with reasonableness (discussed in Chapter 6), procedural fairness is
a principle of good administration that requires sensitive
rather
than heavy-handed application. Context is all-important: the content
of fairness is not static but must be tailored to the
particular
circumstances of each case. There is no room now for the
all-or-nothing approach to fairness that characterized our
pre-democratic law, an approach that tendered to produce results that
were either overly burdensome for the administration or entirely
unhelpful to the complainant. In this regard the relevant parts of
PAJA are generally a positive contribution to our law. The principle
of legality, too, may in limited instances demand procedural
fairness, but so far it has done so only as a matter of rationality.
In other words, as the Constitutional Court has indicated, this is a
form of ‘procedural rationality’ rather than ‘procedural
fairness’ as such.
”
50.
There was some
debate before me in court whether the present application classified
as a PAJA review or it is best suited as a legality
review. The
reliance on legality reviews has gained popularity in recent
judgments of our courts. In this respect I refer to the
case of
Pharmaceuticals
Manufacturers Association of SA: In re Ex parte President of Republic
of South Africa
[2000] ZACC 1
;
2000 (2) SA 674
(CC)
at para. 85:
“
It
is a requirement of the rule of law that the exercise of public power
by the Executive and other functionaries should not be
arbitrary.
Decisions must be rationally related to the purpose for which the
power was given, otherwise they are in effect arbitrary
and
inconsistent with this requirement. It follows that in order to pass
constitutional scrutiny the exercise of public power by
the Executive
and other functionaries must, at least, comply with this requirement.
If
it does not, it falls short of the standards demanded by our
Constitution for such action.
”
51.
In the case of
Democratic
Alliance v President of Republic of South Africa
2013 (1) SA 248
(CC)
the court held that not only the decision itself but also the process
must be rational. This is confirmed in paragraphs 33 up to
37 of that
judgment.
52.
If it is
accepted that the outcome of the inquiry, which is the subject of
this decision, is reliant upon the procedures as envisaged
in the
regulations which allows for the production of all material and
relevant evidence, whether it supports the applicant’s
case or
not, it follows, in my view, that the outcome will be tainted by
irregularity if the evidence is lost due to the dilatory
procedural
conduct of the respondents. The decision, in these circumstances, to
recommence with the inquiry some seven years, after
it had been
postponed, is irrational. The present application therefore neatly
falls within the concept of a legality review.
53.
To the extent
that the process adopted by the respondents constitutes
administrative action as defined in s 1 of PAJA, s 3(1) of
PAJA
requires that the administrative action must be procedurally fair.
Section 3(1)(b)(ii) requires that to give effect to the
right to
procedurally fair administrative action an administrator must give a
person a reasonable opportunity to make representations.
54.
In the recent
case of
Dyantyi
v Rhodes University and Others
2023 (1) SA 32
(SCA)
the Supreme Court of Appeal held in paragraph 21:
“
...
At
common law the opportunity of an individual to present evidence that
supports his or her case and to controvert the evidence
against him
or her ‘is the essence of a fair hearing and the courts have
always insisted upon it’. See Lawrence Baxter
Administrative
Law 1 ed (1984) (3
rd
impression 1991) at 553. Today this forms part of the reasonable
opportunity to make representations under
s
3(2)
(b)(1)(ii)
of PAJA. In Bel Porto School Governing Body and Others v Premier of
the Western Cape Province and Another
[2002] ZACC 2
;
2002
(3) SA 265
(CC) para 104 Chaskalson P said that ‘what procedural fairness
requires depends on the particular circumstances of each case’.
And in Minister of Public Works and Others v Kyalami Ridge
Environmental Association and Others (Mukhwevho Intervening)
2001
(3) SA 1151
(CC) para 102 he said:
‘
Ultimately,
procedural fairness depends in each case upon the balancing of
various relevant factors including the nature of the
decision, the
‘rights’ affected by it, the circumstances in which it is
made, and the consequences resulting from it.’
”
55.
The applicant
brought the review both in terms of the provisions of PAJA as well as
premised on a legality review. The applicant
also applies for an
interdict for a permanent stay of the proceedings against the
applicant. Should a review be inappropriate,
and in my view, it is
not, an interdict is surely appropriate in this case. I shall deal
with this aspect as well.
56.
I proceed to
deal with the defenses raised. I disagree that there exists an
internal remedy that had to be exhausted first.
57.
Relying on the
case of
Dengetenge
Holdings (Pty) Ltd v Southern Sphere Mining and Development Company
Ltd and Others
(2014) (3) BCLR 265
(CC)
the respondents argue that a person applying for a review of an
administrative act must exhaust his/her internal remedies failing
which he/she is precluded from reviewing the administrative action.
It is contended for the respondents that the applicant in fact
concedes that there is some internal process he should have followed,
because in the transcript of the professional conduct inquiry
which
was held on 4 March 2014 the applicant’s attorney had the
following to say:
“
I
say that the matter should be remitted to the Committee of
Preliminary Inquiry with a recommendation that the inquiry be
discontinued
due to the unreasonable delay in finalising the matter.
”
58.
And then
further in the transcript:
“
If
the committee were not to follow that recommendation, well then it
will be open to Dr Aslam to approach a High Court with an
application
for a permanent stay of proceedings against him. And that would
probably be the course that we would take but, that
would be running
ahead of ourselves of course, because I believe first we should
exhaust the internal remedies and the matter should
be remitted back
to the Preliminary Committee for them to make a finding. They have an
inherent authority to discontinue disciplinary
proceedings.
”
59.
Relying solely
on this say-so of the applicant’s attorney, the respondents
argued that, on the applicant’s own version,
there is an
internal remedy that the applicant should have exhausted. The
respondents, however, save for the presentation of the
applicant’s
attorney made to the committee, did not refer me to any legal right
for such a referral to the preliminary committee.
In my view, the
applicant’s attorney erred, maybe inadvertently so, when he
made the submissions to the professional conduct
committee.
60.
The
preliminary committee has no powers bestowed upon them by legislation
or the regulations to make a finding that an inquiry be
discontinued
due to unreasonable delay. It, in my view, is
functus
officio
once
it has made its initial recommendation to hold the inquiry. It has no
self-review powers. The committee has only certain “preliminary”
functions. I am also not bound by incorrect legal submissions that
may have been presented at the disciplinary hearing.
61.
In paragraph
13
of
my judgment hereinabove, I already pointed out that in terms of
regulations 3(2), (3) and (4) of the professional conduct regulations
applicable, the committee of preliminary inquiry is mandated to
conduct a sifting process and to thereafter decide, following due
consideration of the information at its disposal, whether there are
grounds for an inquiry, or not, and/or whether an inquiry must
be
held into the conduct of one of the members, in which event the
committee of preliminary inquiry must direct the registrar of
the
HPCSA to arrange the holding of such an inquiry. That is where its
mandate stops.
62.
The
preliminary committee has no power to review its own decision to
direct the registrar to arrange the holding of the inquiry
and/or to
alter its decision to hold an inquiry. As such, it is in my view
incorrect to say that a referral back would constitute
an internal
remedy available to the applicant. In addition, any internal remedy
envisages or requires at a minimum a remedy that
an applicant can
procedurally follow “as of right”. The applicant has no
power or legal right, as one usually has with,
for example, an
internal appeal, to insist that the preliminary committee reconsiders
its earlier decision. It would therefore
not constitute a remedy
available to the applicant.
63.
The lateness
of the review defense. Accepting that the present review constitutes
a legality review, it was argued that even in
a legality review a
delay in bringing the judicial review requires to be explained. This
argument is premised on the case of
State
Information Technology Agency SOC Ltd v Gijima Holdings (Pty) Ltd
2018 (2) SA 23
(CC)
where it was held that where there is no explanation for the delay,
the delay will be necessarily unreasonable. In the case of
Buffalo
City Metropolitan Municipality v Asla Construction (Pty) Ltd
200 (4)
SA 331
(CC)
the Constitutional Court also decided that courts have the power in a
legality review to refuse an application where there is an
undue
delay in initiating the proceedings.
64.
The
respondents correctly argue that, insofar as it is a PAJA review, it
must be brought without unreasonable delay and within 180
days.
65.
During
argument I enquired with counsel for the respondents how this court
should go about to find the moment in history from where
one is to
count the days to get to the point of reasonableness or
unreasonableness. I asked this indicating to counsel for the
respondents that I could not discern from the papers which decision
or administrative action would be relevant for purposes of
the
calculation of the so-called 180 days or the reasonable or
unreasonable delay in bringing the review. In my view it is the
cumulative effect of all the conduct that I have dealt with in this
judgment that infringes upon the procedural right to fairness
and a
fair hearing.
66.
In any event,
the event that led to this application was the decision of the
seventh respondent to, in the year 2021, recommence
the prosecution
of the applicant after a 7-year postponement. This decision was made
in the face of the conceded fact that material
evidence has gone
astray. The decision was further taken against the objective fact of
the fact that the professional conduct committee
had for seven years
neglected to pronounce upon the application made by the applicant to
permanently stay the proceedings. In my
view it should have been
evident to the pro forma complainant that the delay in procedure and
its consequent loss of evidence has
tainted the process to such an
extent that the continuation of the proceedings would be irregular
and unfair.
67.
The
respondents, however, contended that the moment that I should
consider as being relevant is May 2014 when the case was postponed
without a pronouncement having been made on the request for a
permanent stay. This, in my view, is incorrect. Since that day the
applicant’s attorney (and this is conceded) has made numerous
attempts to get to a point to have the inquiry recommence with
the
view to get a decision on his request for a permanent stay,
alternatively to get some finality. This did not occur. After the
applicant an/or his attorney’s enquiries fell on deaf ears, it
was early in the year 2019 that the applicant and his attorney
gave
up, accepting that there would probably not be a prosecution any
further. It is the decision to recommence the prosecution
therefore
that spurred them into action.
68.
The
respondents, in their supplementary heads of argument, explained that
any of the following time periods were relevant in respect
of my
decision on whether the delay was reasonable or unreasonable:
68.1.
14 September
2011 when the preliminary committee resolved that an inquiry be held
into the conduct of the applicant.
68.2.
3 October 2011
when the applicant was informed of the decision.
68.3.
20 February
2014 at a pre-inquiry meeting where the applicant raised the point of
undue delay.
68.4.
on 5 March
2014 where the professional conduct committee sat for the first time
and the applicant raised the point of undue delay.
69.
The initial
decision to hold an inquiry has no bearing on the question before me,
because the initial decision is not being objected
against. Instead,
the applicant did everything in his power to fast-track the inquiry
and have it finalized. He co-operated. He
has no battle with the
initial decision to prosecute. It is true that the delay was in 2014
already evident, and that they delay
was then already unjust, but at
that hearing the applicant in fact argued unreasonable delay. The
problem is that he did not receive
the courtesy of a decision on the
point raised in
limine
.
70.
Since then,
however, Dr Coetzee passed away and it became more and more evident
that material evidence had become lost. The decision
to recommence
proceedings in the circumstances, read against the backdrop of the
other dilatory conduct of the respondents, constitutes
the point from
where the days must be counted. The application was launched within a
short period after that decision was taken
and there is no
unreasonable delay.
71.
In my view the
applicant has made out a proper case for its review. In any event, I
further hold the view that a case for a final
interdict, as
requested, has also been properly made.
72.
Insofar as it
relates to interdictory relief, I make the following remarks. Save
for the right to administrative action that is
lawful, reasonable,
and procedurally fair, as envisaged in s 33 of the Constitution, s
35(3) bestows upon every accused person
the right to a fair trial
which includes
inter
alia
the
right to have his/her trial begin and conclude without unreasonable
delay and to adduce and challenge evidence. These are constitutional
rights and surely constitute the notion of a “
clear
right
”,
being a prerequisite for an interdict. I have alluded to the fact,
earlier in my judgment, that the position of the applicant
is to be
equated to an accused person in a criminal trial. At a minimum, the
applicant is “
accused
”
of improper or unprofessional conduct and must defend himself against
that charge.
73.
In that
respect, it is therefore prudent to consider the authorities that
deal with a stay of prosecution. In the case of
Bothma
v Els and Others
2010 (2) SA 622
(CC)
the Constitutional Court considered four elements, although it warned
that they do not constitute a definite checklist (
vide
para. 37). It considered the length of the delay, the reason the
government (in this case, the prosecuting body) proffer to justify
the delay, the accused assertion of a right to a speedy trial and
prejudice to the accused.
74.
In the case of
Zanner v
Director of Public Prosecutions, Johannesburg,
[2006] ZASCA 56
;
2006 (2) SACR 45
(SCA)
the Supreme Court of Appeal had the following to say about the nature
of the defense:
“
The
right of an accused to a fair trial requires fairness not only to
him, but fairness to the public as represented by the State
as well.
It must also instil public confidence in the criminal justice system,
including those close to the accused, as well as
those distressed by
the horror of the crime… It is also not an insignificant fact
that the right to institute prosecution
in respect of murder does not
prescribe... Clearly, in a case involving a serious offence such as
(murder), the societal demand
to bring the accused to trial is that
much greater and the Court should be that much slower to grant a
permanent stay.
”
75.
In this case,
the applicant stands accused of unprofessional conduct in allegedly
having misdiagnosed a patient who, on the objective
facts on the
papers, was fully rehabilitated within a very short time after the
alleged diagnoses made by the applicant. Although
one should steer
away from describing such professional misconduct as being
negligible, comparing it with reprehensible conduct
such as murder or
the humiliating, degrading and brutal invasion of dignity as one
would find in cases of rape, it surely is an
offence that is to be
regarded as
de
minimis
in
comparison.
76.
The contention
of the respondents that the prejudice that the complainant may suffer
must be weighed against the prejudice of the
applicant is untenable
in this case. As indicated, the complainant, and this issue has not
been challenged, has fully rehabilitated
after being treated by Dr.
Coetzee and no evidence exists of any prejudice that the patient
continues to suffer.
77.
If
that is compared with the prejudice that I have outlined that the
applicant suffers, and has conveyed to this court, it is bleak
in
comparison. It is also an uncontested fact that, save for this
pending complaint, the applicant has an impeccable professional
record, and has treated thousands of patients through all these years
without another complaint. The applicant provides the citizens
of
this country therefore with a needed service. A proper functioning
society demands that professional doctors, who contribute
positively
to the well-being of its people, should not be subjected to the
stresses, with the concomitant negative impact on his
own health, of
an inquiry looming for an unacceptable extensive period. It surely is
in the public interest that this court steps
in and stops the
prosecution of the applicant.
[2]
78.
Insofar as it
relates to the trial prejudice, it is common cause that Dr. Coetzee
passed away at a point in time where the professional
conducts
proceedings should have been completed already several years earlier.
It is an uncontested fact that much of the evidence,
whether it
favors the applicant or not, is not to be found. It is simply
impossible in those circumstances to conduct a fair trial.
The
proposition that this prejudice is also suffered by the proforma
complainant and/or the complainant is of no moment. If the
respondents had acted prudently and with due diligence, the
disciplinary inquiry would have been finalized shortly after the
event
complained about; and no evidence would have gone astray.
79.
If one
considers, against this backdrop, the length of the delay as well as
the reasons proffered by the respondents for the delay,
it follows
that the delay is inexcusable. It is, as I have already pointed out
hereinabove, due to the sheer incompetence within
the structures and
offices of the respondents. It has caused tremendous prejudice
towards the applicant; it has caused years of
hardship towards the
applicant and is, in my view, not only inexcusable but also
ill-explained. That harm exists and is continuing
is self-evident in
this case.
80.
Insofar as one
must consider whether an alternative remedy is available to the
applicant, in my view, there is no adequate alternative
relief
available to the applicant, save to have approached this court. The
applicant’s plight has been ignored by the respondents
and
their officials. The applicant, having brought an application for the
stay of the execution, did not even get the courtesy
of a ruling on
that application. Notwithstanding it being patently clear that the
inquiry cannot proceed due to a lack of evidence,
the seventh
respondent insisted on a recommencing with the inquiry. This has
brought the applicant to this court. The applicant
had no other
choice but to seek the assistance from this court to get protection
from the continuing unconstitutional conduct (the
infringement of ss
33 and 35 of the Constitution).
81.
As such, I
intend to, although it may be somewhat superfluous, issue the
interdict as sought.
82.
The last
aspect in this judgment is the issue of costs. The applicant filed
supplementary submissions seeking costs as against the
respondents,
jointly and severally, on an attorney and client scale. In the
submissions in support of such a costs order made,
the applicant
points out that, in conducting the current litigation, the
respondents have:
82.1.
unjustifiably
and recklessly charged the applicant with abusing court process,
engineering the application to avoid the professional
conduct
proceedings, of being himself dilatory and of making averments that
are “
far-fetched
”
and simply aimed at stoking controversy.
82.2.
contemptuously
failed to comply with the provisions of Uniform Rule 53 and failed to
explain non-compliance with the rule.
82.3.
filed an
unnecessary prolix answering affidavit which mainly duplicated the
common cause facts made by the applicant, which failed
to disclose a
substantive defence to the applicant’s relief, and which was
replete of irrelevant potentially misleading averments.
82.4.
unjustifiably
adopted a high-handed, if not conceited, attitude towards the
applicant’s request for the relief.
83.
Some other
grounds were also raised, but I am mainly in agreement with the above
quoted submissions made.
84.
I also agree
that if one considers the respondents’ conduct that gave rise
to the application, the respondents have unapologetically
and
materially failed to execute the statutory obligations with which
they are clothed in terms of the Health Professions Act and
have
failed to exercise their public power in an accountable, responsive,
open, rational, and lawful manner.
85.
I agree that
the respondents’ conduct in this case, both pre-litigation and
during the litigation, is conduct that is unacceptable
of a body that
should instill confidence in the medical profession. The facts of
this case are lamentable and demonstrate a lack
of accountability. At
a minimum, one would have expected the respondents, being faced with
the application as presented by the
applicant, to concede the relief
and agree to a permanent stay of prosecution. The subsequent
accusations levelled at the applicant,
already being traumatized by
the dilatory conduct of the respondents, is unbecoming.
86.
In the
premises, I agree that a costs order against the respondents, jointly
and severally, on the scale as between attorney and
client, is
justified in this case.
87.
I issue the
following order:
87.1.
the
disciplinary proceedings pending against the applicant in terms of
Chapter IV of the Health Professions Act, No. 56 of 1974,
in relation
to the complaint by Mr AF Olivier and being dealt with under
reference number MP0376272/33/2008 is hereby permanently
set aside.
87.2.
the Medical
and Dental Professions Board of the Health Professions Council of
South Africa is herewith interdicted and restraint
from taking any
further disciplinary measures against the applicant in terms of
Chapter IV of the Health Professions Act, No. 56
of 1974, in relation
to the complaint by Mr AF Olivier and being dealt with under
reference number MP0376272/336/2008
,
and all existing disciplinary proceedings in relation thereto are
herewith forthwith terminated.
87.3.
the first,
second, third, fourth, fifth, sixth and seventh respondents are
ordered to pay the costs of this application, jointly
and severally,
the one paying the other to be absolved, on the scale as between
attorney and client.
D
VAN DEN BOGERT
Acing
Judge
High
Court of South Africa
Gauteng
Division, Pretoria
Counsel
for the Applicant:
ST
Farrell SC
Instructed
by:
MacRobert
Incorporated Attorneys
Ref.:
Mr G vd Merwe/719861
Counsel
for the Respondents:
JJ
Potgieter
Instructed
by:
Madiba Law
Incorporated
Ref.:
HH0001
[1]
The
year 2021.
[2]
see
also the unreported judgment of Moodley v Health Professions Council
of South Africa and Another, case number 73859/2009,
North Gauteng
High Court, Pretoria, where a similar approach had been adopted.
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