Case Law[2024] ZAGPJHC 455South Africa
Health Professions Council of South Africa v Haeck (A2023/050722) [2024] ZAGPJHC 455 (7 May 2024)
High Court of South Africa (Gauteng Division, Johannesburg)
7 May 2024
Headnotes
the referral to the expert went “beyond a mere fact finding mission.” The PCI did not decide the matter independently but had “outsourced” the complaint to the expert, who did not merely establish additional facts, in violation of the Act. Dr Haeck was entitled to audi and due process at every step of the proceedings and not only during the PCC inquiry. The court a quo ruled that the process adopted by the PCI was unfair and unjust. Dr Haeck could not be expected to be “satisfied with an unjust trial and a fair appeal.”
Judgment
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## Health Professions Council of South Africa v Haeck (A2023/050722) [2024] ZAGPJHC 455 (7 May 2024)
Health Professions Council of South Africa v Haeck (A2023/050722) [2024] ZAGPJHC 455 (7 May 2024)
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FLYNOTES:
LEGISLATION – Health Professions Act –
Misconduct
–
Preliminary
Investigating Committee investigating complaint and referring
matter to Professional Conduct Committee –
Appeal under
section 20 is one in ordinary sense – Appealable decision
must mean final decision – Contention
that “any
decision” includes an investigative decision cannot be
supported – Would lead to untenable result
where all
decisions including interlocutory decisions to investigate a
complaint are subject to appeal directly to High Court
even before
merits have been disposed of – Health Professions Act 56 of
1974, s 20.
IN
THE HIGH COURT OF SOUTH AFRICA
(GAUTENG
LOCAL DIVISION, JOHANNESBURG)
Case No: A2023/050722
1.
REPORTABLE:
NO
2.
OF
INTEREST TO OTHER JUDGES: NO
3.
REVISED
7 May 2024
IN
THE MATTER BETWEEN:
HEALTH
PROFESSIONS
APPELLANT
COUNCIL
OF SOUTH AFRICA
(HPCSA)
AND
SANDRINA
VALERIE PHYLLIS
RESPONDENT
LUDWIG
HAECK
JUDGMENT
Siwendu
J (Windell ADJP and Unterhalter J concurring):
Introduction
[1]
The issue before us turns on the scope of the right to appeal in
section 20 (1) and (2) of the Health Professions Act
No 56 of 1974
(the Act), read with Regulation 4 of the Act. The main question is
whether an appeal lies to the High Court against
a decision of a
Preliminary Investigating Committee (PIC) to refer a charge of
misconduct to the Professional Conduct Committee
(PCC) for an inquiry
under the section.
[2]
The appellant, the Health Professions Council of South Africa (the
HPCSA), is the health professions regulator,
established
in terms of the Act.
The HPCSA
keeps a register of regulated health professionals.
The
respondent, Dr Sandrina Valerie Phyllis Ludwig Haeck (Dr Haeck), is a
clinical psychologist and therapist practicing under the
name and
style of Haeck House Family Wellness Centre.
[3]
The HPCSA has established constituent Professional Boards for each
regulated health profession.
[1]
The Professional Board for Psychology is the relevant constituent
Professional Board.
[2]
It must
ensure that appropriate disciplinary action is taken in accordance
with the Act to protect the public interest.
[3]
I
t
is
mandatory
to
register with the HPCSA to practice as a psychologist.
Dr
Haeck
is
duly registered. As
a
constituent Professional Board falling under the HPCSA, t
he
Professional
Board
for
Psychology oversees the
conduct
of her trade.
[4]
The appeal stems from a complaint
lodged
against
Dr Haeck by her erstwhile
clients, Mr A J Little and Ms D L Little (the Littles). The
background to the complaint can be summarised
briefly. Dr Haeck and
Mr Richard Wands, an attorney, incorporated a private company called
the ‘Divorce Diplomats (Pty) Ltd’
to provide a
non-therapeutic service to couples contemplating divorce to avoid
litigation and help them divorce amicably. Dr Haeck
counselled the
Littles in her capacity as a psychotherapist in November 2016.
[5]
In July 2017, she recommended the couple enters the Divorce Diplomat
programme. Although the Littles reconciled after
participating in the
programme, they accused Dr Haeck of unprofessional conduct, alleging
that she took an up-front payment for
both the marriage counselling
services and the Divorce Diplomats program, but refused to refund
them the balance of the amount
for hours not used or required. They
alleged that she acted both as a marriage counsellor and divorce
counsellor, and operated
outside of the ethical rules of conduct of
the HPSCA.
[6]
A PCI investigated the complaint and concluded that Dr Haeck was
“guilty of unprofessional conduct.” It resolved
to refer
the complaint to a PCC for an inquiry in terms of the Regulations
for
the conduct of inquiries into allegations of unprofessional conduct,
published in
GN
R102 of 6 February 2009 (the Regulations)
.
[4]
[7]
Dr Haeck approached the High Court for relief to set aside the
finding of misconduct and the resolution to refer the complaint
to
the PCC. The chief complaint was that the PCI found her guilty
without affording her
audi alteram partem
and the failure
infringed her constitutional right to a fair hearing. She alleged
that the PCI referred the complaint to an expert,
and thus abdicated
its responsibility by
deferring it
to an expert who failed to afford her
audi alteram partem
while preparing the report
.
[8]
Her further grievance was that
the
PCI amended the complaint. T
he referral to the PCC
e
xtended
the ambit of the inquiry to wrongs which were not the subject of the
original complaint by the Littles, with no option for
her to pay an
admission of guilt fine.
[9]
The court
a quo
accepted that an appeal lies in terms of
section 20 of the Act. It decided Dr Haeck was deprived of
audi
alteram partem
in forming a
prima facie
view in breach of
section 41A (8)
(b)(i)
and
(iii)
of the Act. It held
that the referral to the expert went “beyond a mere fact
finding mission.” The PCI did not decide
the matter
independently but had “outsourced” the complaint to the
expert, who did not merely establish additional
facts, in violation
of the Act. Dr Haeck was entitled to
audi
and due process at
every step of the proceedings and not only during the PCC inquiry.
The court
a quo
ruled that the process adopted by the PCI was
unfair and unjust. Dr Haeck could not be expected to be “satisfied
with an
unjust trial and a fair appeal.”
[10]
The
court
a
quo
set aside the preliminary finding as well as the
resolution referring the matter to the PCI for an inquiry. It also
set aside the
misconduct complaint which was the genesis of the
investigation and the referral. Aggrieved by the decision, the HPCSA
appealed
to the Full Court with the leave of the court
a quo
.
The
Appeal
[11]
The position of the HPCSA on appeal is that the PCI simply
investigated and verified whether there was merit in the complaint.
It made a
prima facie
finding, akin to a decision to prosecute
after an investigative process. Mr Vimbi (for the HPCSA) contended
that since the misconduct
was referred to the PCC, there has been no
final finding of guilt. The referral decision by the PCI was not
appealable to the high
court.
[12]
Ms Andrews (for Dr Haeck) disagreed and contended that the PCI
pronounced itself on the question of guilt and tied the
hands of the
PCC by referring the complaint without an option to pay a fine. It
failed to afford Dr Haeck her
audi
rights on two fronts.
First, it arrived at the decision without hearing all the evidence.
The papers before the court
a quo
, made much of the virtual
meeting and the quality of her engagement with the PCI in October
2020 to buttress this complaint.
[13]
The second claim to
audi
is in respect of the report furnished
by the expert. Ms Andrews sought to persuade us that Dr Haeck had a
right to be heard by
the expert before the resolution taken by the
PCI. She submitted that the obligation arose because the expert
expanded the scope
of the inquiry into matters which were not the
substance of the initial complaint by the Littles. The additional
matters were not
canvassed with Dr Haeck. It was intimated that the
PCI may have concluded differently had it granted Dr Haeck the right
to
audi.
For these reasons, the PCI acted
ultra vires.
Issues
on Appeal
[14]
The appeal raises intersecting issues.
i.The
first issue concerns the scope of the right of appeal conferred by
section 20.
ii.A
second issue involves the nature of the functions performed by the
PCI in respect of the complaint against Dr Haeck, and whether
its
decision to refer the complaint is appealable under the section.
iii.The
ultimate issue is whether on a proper interpretation of the section,
the court
a
quo
was correct in setting aside the resolution and the referral of the
misconduct.
[15]
The HPCSA’s conduct and those structures falling under it is
constrained by the Act. It was evident during the
hearing that the
Act creates several disciplinary structures, with overlapping
functions and powers. It is necessary to deal
with the
statutory arrangements and how the HPCSA dealt with the complaint in
some detail, before dealing with the merits of the
appeal.
Framework
for investigating Complaints.
[16]
As the statutory Council, the HPCSA has its own committees
constituted in terms of section 10 of the Act. Notwithstanding,
the
Act devolves the function and power to investigate a complaint, and
if there is reason, to institute an inquiry into a complaint
or
charge to the relevant Professional Board, in this case, the
Professional Board for Psychology.
[5]
[17]
The Professional Board has the power to consult and seek advice from
any person if in doubt whether to hold an Inquiry.
[6]
Section 15(5)(f) and (fA) of the Act enjoins the Minister to pass
regulations to establish committees deemed necessary within a
specific Professional Board.
[7]
[18]
The Regulations classifies two committees, responsible for assessing
and dealing with misconduct complaints, namely (a)
the PCI
(PCI) and (b) the PCC (PCC). Both committees thus give effect to
section 15(5)
of the Act. The two committees are constituted as committees of the
Professional Board for Psychology.
[19]
Although the power to investigate and institute disciplinary
proceeding devolves to the Professional Boards, referred
to above,
complaints
against
health professionals must be directed to the
Registrar.
[8]
The
Registrar has wide powers to assess a complaint or appoint (a)
an officer of the professional board as an investigating
officer and
or (b)
any
person other than a member of the professional board, who is not in
the full-time employment of the professional board
to
establish more facts, investigate the compliant and report the
outcome to the Registrar.
[9]
[20]
Regulation 4 deals with the receipt of a complaint, the notification
of the health professional, and the right to call
for further
information within prescribed periods. Regulation 4 (1)
(c)
and
(d)
affords the Registrar an election to refer the
complaint directly to the PCI or to the chairperson of the committee
for direction.
In the present matter, the Registrar referred the
complaint to the PCI, a committee of the Professional Board for
Psychology.
[21]
Although nothing turns on this on the merits of this appeal, the
complaint at issue is dated September 2017. It
appears
that Dr Haeck was unaware of it until 20 May 2019, when the
investigator assigned to the matter invited her to make written
representations. Nevertheless, consistent with the preliminary
investigation procedure in Regulation 4 (1)
(b)(i),
Dr Haeck was invited to respond to
the allegations. She did so through her attorney on 22 July 2019, and
denied wrongdoing, relying
on the contract signed by the Littles.
[22]
Her answer was furnished to the Littles who in reply informed the
HPCSA that when they joined Divorce Diplomats, they
signed documents
which reflected the HPCSA registration number. They had relied on Dr
Haeck being governed by the HPCSA’s
ethics code. They alleged
that she failed to advise them that the program was sold on a
non-refundable basis and the amount paid
would be forfeited. They
claimed that Dr Haeck had failed to issue them with Tax Invoices, and
the amount paid to her cannot be
recovered from medical aid. In sum,
they stated that Dr Haeck operated outside of the professional and
ethical conduct rules of
the HPCSA that were binding upon them.
[23]
In
December 2019, the PCI invited Dr Haeck to a meeting which did not
materialise because she was travelling overseas. The matter
lay
dormant until 20 October 2020 when Dr Haeck was invited to a meeting
by the PCI for the second time. Convening this meeting
proved
difficult. Dr Haeck had given birth six weeks prior to the meeting.
The PCI refused to reschedule the meeting, but instead
gave her an
election, to either attend or not attend and accept the consequences
of not attending. All this is consistent with
Regulation 4 (2) and
(3)
[10]
which the PCI invoked
after receiving further information from Dr Haeck and the Littles. Dr
Haeck ultimately attended the meeting
virtually.
[24]
On
2 November 2020, the
investigator informed Dr Haeck that:
“
In
October 2020, the Committee RESOLVED to defer and refer the matter
for an expert opinion to consider the bridging of ethical
rules i.e.
sharing of rooms, informed consent and performing of psychological
act in an enterprise not registered as a psychology
practice.”
[25]
It is common cause that the expert, Dr M Kganya delivered her report
in December 2020. T
he PCI formed
the view that an inquiry was warranted. Acting in terms of
Regulation 4(8), the PCI resolved to refer the matter
to a PCC
Regulation 4(8) which states that:
“
If a preliminary
committee of inquiry decides, after due consideration of the
complaint, any further information which may have
been obtained in
terms of sub regulation (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.”
[26]
The resolution referring the matter to a PCC for an inquiry reads:
“…
.
the Committee RESOLVED that the practitioner is guilty of
unprofessional conduct the matter be referred to Professional conduct
inquiry in terms of Reg 4(8) of Regulations relating to Conduct
Inquiries into alleged unprofessional conduct with no option to
pay
admission of guilty fine.”
[27]
It framed the ambit of the inquiry as follows:
“
Sharing
of rooms with an entity not registered in terms of the Act.
Entering
into potential conflicting roles with the client, by acting as a
clinical psychologist and a life coach under the divorce
diplomat
program company.
Referring
clients to the company in which the practitioner has financial
interest.
Charging
fees for services not rendered.”
[28]
Th
e PCC had scheduled the inquiry for 12 and 13
May 2021. Dr Haeck launched the application to the High Court in
March 2021.
The
ambit of the right to Appeal in section 20.
[29]
Dr Haeck sourced the right of appeal to the court
a quo
from
section 20 which provides that:
“
(1)
Any person who is aggrieved
by
any decision
of the
council, a professional board or a disciplinary appeal committee
,
may appeal to the appropriate High Court against such decision.
(2)
Notice of appeal must be given within one month from the date on
which such decision was given.” [own emphasis]
[30]
On the plain reading of the section, the right to appeal to
the High Court is confined to decisions
of: (a)
the council, (b) a professional board or (c) a disciplinary appeal
committee. T
he section does not provide for an appeal
from a decision of the PCI.
[31]
Ms Andrews’ point of departure is that section 20 confers Dr
Haeck a broad right of appeal to “
any
decision”
of the council,
professional board, or a disciplinary committee.
She submitted
that since the PCI is a structure of a Professional Board, its
decision is by implication, appealable. She contended
that t
he
referral to the PCC, without the option to pay a fine before the
merits were fully ventilated rendered the decision of the PCI
final
in this respect. The suggestion is that the reference to
“
any
decision”
in the section must be construed to mean a
decision to refer a complaint to the PCC.
[32]
The submission disregards
the decision maker whose decision is the subject of appeal. That
would widen the scope of the appeal and
contradicts the
decision of the Supreme Court of Appeal in
Emergency
Medical Supplies and Training CC t/a EMS V Health Professions Council
of South Africa.
[11]
There
the Court determined that an appeal under the
section is one in the ordinary sense, and involves “a
rehearing
on the merits but limited to the evidence or information on which the
decision under appeal was given, and in which the
only determination
is whether the decision was right or wrong.”
[33]
Since an appeal under the
section involves the rehearing of the merits, an appealable decision
must mean a final decision on the
issue determined by the designated
structure in the Act. In the present case, the Registrar
referred the complaint to the
PCI under
Regulation
4(c), to
investigate
the complaint to establish whether it has merit and to determine what
steps to take. This investigative function of
the PCI was confirmed
by the Supreme Court of Appeal
i
n
Roux
v Health Professions Council of SA (Roux)
[12]
where
the Court observed that the PCI fulfils a “sifting”
function to ensure that only sustainable complaints procced
to a
disciplinary inquiry.
[34]
It is so that the PCI may decide that a complaint lacks sufficient
gravity and constitutes a minor transgression, in
which event, the
PCI is empowered to make a final decision as
contemplated
in section 42 (1)
[13]
read
with Regulation 4(9).
[14]
T
hose
adjudicative
functions are limited to “minor transgressions.” The PCI
did not reach this conclusion and did not impose
a penalty in this
instance.
[35]
Although
the resolution referring the compliant expresses itself in a
definitive way, it must be read purposefully and holistically,
having
regard to the context
[15]
, and
the powers enjoyed by the PCI. The substance of the referral
makes it clear there was still a further action to be taken
on the
matter. The
referral
of the misconduct connotes there was no finality or a definitive
finding on the issue regardless of the forceful way it
is expressed.
The PCI performed an investigative function in relation to the
complaint.
An
investigation is not a finding of guilt but may result in a referral
before an adjudicative body that is empowered to determine
the
question of whether misconduct has taken place, and its
consequence.
[16]
The PCI did not reach a
final decision because it referred the matter to the PCC to do so.
[36]
The contention that “
any decision”
includes
an investigative decision cannot be supported. It would lead to an
untenable result where all decisions, including interlocutory
decisions to investigate a complaint are subject to appeal directly
to the High Court even before the merits have been disposed
of. No
appeal can lie from the decision of the PCI because it is ultimately
a decision to refer, it is not a final decision, and
a referral
decision is not appealable.
[37]
To the complaint that there was a failure to grant Dr Haeck the right
to
audi
,
Ms Andrews agreed that if we find as we have that the PCI performed a
purely investigative function, then there would be no right
of
audi
enjoyed by her. The concession is well made and applies with equal
force to the submission that Dr Haeck was entitled to
audi
by the expert engaged by the PCI to
advise on the complaint. The expert did no more than provide an
internal opinion which
the PCI was free to accept or reject.
That
the resolution was based on the report of the expert does not change
the effect of the PCI’s resolution. In particular,
Dr
Haeck is afforded
audi
under Regulation 8 and 9 at the inquiry before the PCC. The procedure
to be followed affords her
pre- trial rights including the
exchange of documents to be relied on.
[38]
Equally, the criticism that the PCI impermissibly
reformulated and expanded the complaint is without merit. The PCI
merely decided
there were grounds to charge Dr Haeck for professional
misconduct, consistent with its investigative function. It formulated
a
charge based on all the information before it, including the expert
report. As the Court in
Roux
emphasised, the PCI “…
are
best suited to decide whether there are grounds on which to conduct
an inquiry into unprofessional conduct. It is that
committee's
function to
specify the conduct
the subject of inquiry.” As the body entrusted with the
investigation, the PCI formulated the charges which were the
subject
of the investigation, by specifying the ambit of the inquiry to be
referred to the PCC. As the Court in
Roux
tells us, it was in the remit of the PCI to do so. [own emphasis].
[39]
The decision by the PCI to refer a complaint to the PCC is not
appealable to the High Court under section 20.
The
rationale is evident. Only the decision makers mentioned in the
sections are the final arbiters on any disciplinary matter before
the
HPCSA or the Professional Board of Psychology is appealable to the
High Court.
[40]
Significantly, Regulation 11(1)
[17]
first directs an appeal against a finding or penalty of a PCC to the
ad
hoc
appeal
committee of the Council.
[18]
Had Dr Haeck abided with the inquiry process, she would have been
obliged to exhaust internal remedies, and appeal that decision
to the
ad
hoc
appeal
committee of the Council before approaching the High Court.
[41]
In conclusion, it does not appear that the judgments of the Supreme
Court of Appeal were brought to the attention of
the court
a
quo
.
Its reasoning and conclusion cannot be sustained. In setting aside,
the PCI’s resolution and dismissing the misconduct complaint,
the court
a quo
erred.
It exercised wide appeal powers not conferred by the Act. There was
no evidence before it
as
the merits of the charge had not yet been ventilated.
The
matter was still pending before the PCC.
[42]
Accordingly, the resolution to refer the misconduct to the
Professional Conduct Committee for an inquiry in terms of
Regulation
4(8) of Regulations is reinstated together with the charges
formulated therein.
[43]
In the result, I propose the following order:
a.
The appeal is upheld.
b.
The order of the court a quo is set aside and substituted with the
following order:
“
The
appeal is dismissed with costs.”
c.
The respondent is ordered to pay the costs of the appeal.
NTY
SIWENDU J
L
WINDELL J
DN
UNTERHALTER J
This
judgment is handed down electronically by circulation to the
Applicants and the Respondents’ Legal Representatives by
e-mail, publication on Case Lines and release to SAFLII. The date of
the handing down is deemed to be 7 May 2024.
Date
of appearance: 20 March 2024
Date
Judgment delivered: 7 May 2024.
Appearances:
For
the Appellant:
Advocate Vimbi
Instructed
by:
Z and
Z Ngogodo Attorneys
For
the Respondent: Advocate R
Andrews
Instructed
by:
HJW Attorneys.
[1]
See
Section
15
[2]
The Professional Board
for
Psychology
is
established in terms of Regulation No. R 1249 dated 28 November 2008
[3]
See
Section
3 (a) and (n)
[4]
The Regulations were subsequently amended by GN 53 in GG 42980 of 31
January 2020 and GN R3564 in GG 48838 of 23 June 2023.
[5]
41
(1) A
professional board shall have power to institute an inquiry into any
complaint, charge or allegation of unprofessional
conduct against
any person registered under this Act, and, on finding such person
guilty of such conduct, to impose any of the
penalties prescribed
in
section
42 (1)
.
[6]
Section
41 (2) A professional board may, whenever it is in doubt as to
whether an inquiry should be held, in connection with the
complaint,
charge or allegation in question consult with or seek information
from any person, including the person against whom
the complaint,
charge or allegation has been lodged.
[7]
See Section 15 (5) (f) and (FA)
[8]
See
Section
12
[9]
Section
41A (1) and (2)
states
that the registrar may, where necessary to establish more facts,
appoint an officer of the professional board as an investigating
officer for the purposes of this section.
[10]
Regulation
4(2) states that on receipt by the registrar of the further
information and written response referred to in sub regulation
(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.
[11]
[2013]
4 All SA 1
(SCA); see also
Health
Professions Council of SA v De Bruin
[2004]
4 All SA 392
(SCA)
at paragraph 23.
[12]
[2012]
1 All SA 49
(SCA)
paras
20 and 21.
[13]
Section 42
(1)
states that: “Any person registered under this Act who, after
a determination made by a preliminary committee of inquiry
on minor
transgressions or an inquiry held by a professional conduct
committee, is found guilty of improper or disgraceful conduct,
or
conduct which, when regard is had to such person’s profession,
is improper or disgraceful, shall be liable to one or
more of the
following penalties …”
[14]
Regulation 4(9) states that: “if a preliminary committee of
inquiry decides, after due consideration of the complaint,
any
further information which may have been obtained in terms of sub
regulation (1) (a) and the respondent's explanation of the
subject
matter of the complaint, that the respondent acted unprofessionally,
but the conduct in question is found to constitute
only a minor
transgression, it must determine, as a suitable penalty to be
imposed, one or more of the penalties provided for
in section 42 (1)
(a) and (d) of the Act…”
[15]
See
Natal
Joint Municipal Pension Fund v Endumeni Municipality
[2012]
2 All SA 262
(SCA);
Capitec
Bank Holdings Limited and another v Coral Lagoon Investments 194
(Pty) Ltd and other
s
[2021]
JOL 50742
(SCA)
[16]
Viking
Pony Africa Pumps (Pty) Ltd t/a Tricorn Africa v Hidro-Tech Systems
(Pty) Ltd and Another
2011
(1) SA 327
(CC) at para 38.
[17]
The
respondent or the pro forma complainant may appeal to the appeal
committee against the findings or penalty of the professional
conduct committee or both such finding and such penalty."
[18]
See
section
10.
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