Case Law[2022] ZAGPJHC 701South Africa
South African Municipal Workers Union National Medical Scheme (SAMUMED) v City of Ekurhuleni and Others (5068/2021) [2022] ZAGPJHC 701; [2022] 4 All SA 878 (GJ) (25 August 2022)
High Court of South Africa (Gauteng Division, Johannesburg)
25 August 2022
Judgment
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# South Africa: South Gauteng High Court, Johannesburg
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## South African Municipal Workers Union National Medical Scheme (SAMUMED) v City of Ekurhuleni and Others (5068/2021) [2022] ZAGPJHC 701; [2022] 4 All SA 878 (GJ) (25 August 2022)
South African Municipal Workers Union National Medical Scheme (SAMUMED) v City of Ekurhuleni and Others (5068/2021) [2022] ZAGPJHC 701; [2022] 4 All SA 878 (GJ) (25 August 2022)
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sino date 25 August 2022
REPUBLIC
OF SOUTH AFRICA
IN
THE HIGH COURT OF SOUTH AFRICA
GAUTENG
LOCAL DIVISION, JOHANNESBURG
Case
Number: 5068/2021
REPORTABLE:
YES
OF
INTEREST TO OTHER JUDGES: NO
REVISED:
NO
25/8/2022
In
the matter between:
In
the matter between:
SOUTH
AFRICAN MUNICIPAL WORKERS
UNION
NATIONAL MEDICAL SCHEME (SAMUMED
APPLICANT
AND
CITY
OF
EKURHULENI
FIRST RESPONDENT
MOSO
CONSULTING SERVICES (PTY) LTD
SECOND RESPONDENT
THE
REGISTRAR OF MEDICAL SCHEMES
THIRD RESPONDENT
THE
FINANCIAL SECTOR
CONDUCT
AUTHORITY
FOURTH RESPONDENT
THE
SOUTH AFRICAN LOCAL
GOVERNMENT
ASSOCIATION
FIFTH RESPONDENT
THE
SOUTH AFRICAN MUNUCIPAL
WORKERS’
UNION
SIXTH RESPONDENT
INDEPENDENT
MUNICIPAL AND
ALLIED
WORKERS UNION
SEVENTH RESPONDENT
BONITAS
MEDICAL
FUND
EIGHTH RESPONDENT
HOSMED
MEDICAL
SCHEME
NINTH RESPONDENT
KEY
HEALTH MEDICAL SCHEME
TENTH RESPONDENT
LA
HEALTH MEDICAL SCHEME
ELEVENTH RESPONDENT
THE
EMPLOYEES OF THE CITY OF
EKURHULENI
TWELFTH RESPONDENT
THE
SOUTH AFRICAN
LOCAL
GOVERNMENT
THIRTEENTH RESPONDENT
JUDGMENT
OOSTHUIZEN-SENEKAL
CSP AJ:
Introduction
[1]
In essence, this dispute concerns a
collective agreement entered into between the South African Local
Government Bargaining Council
and SALGA, IMATU and SAMWU in 2015. The
Court is faced with an application from the South African Municipal
Workers’ Union
National Medical Scheme (
“
SAMWUMed”
)
wherein it seeks declaratory relief coupled with interdictory relief
based on the fact that it was a party to the collective agreement,
and due to the appointment of
Moso
Consulting Services (
“
Moso”
),
as sole broker for the employees of the City of Ekurhuleni (
“
COE”
),
its rights having been infringed in terms of the collective
agreement. A further legal point is the question relating to the
legal standing of the SAMWUMed in terms of the collective agreement.
The matter also concerns the interpretation of the appointment
of
medical scheme brokers in terms of the
Medical Schemes Act 131 of
1998
and its Regulations.
[2]
No relief or cost order is sought against
the third and fourth respondents, who are cited herein by virtue of
the regulatory interests
which they have in this matter, or against
the fifth to thirteenth respondents, who are cited herein by virtue
of any interests
which they have or may have in this matter.
[3]
The COE (first respondent) and Moso (the
second respondent) oppose the relief sought.
[4]
The third to thirteenth respondents are not
opposing the application.
Parties
[5]
The applicant is SAMWUMed:
(a)
a self-administered medical scheme duly
registered in terms of
section 24
of the
Medical Schemes Act 131 of
1998
of the Republic of South Africa (“
The
MSA”
);
(b)
which is, in terms of
section 26(1)(a)
of
the MSA, a body corporate capable of suing and being sued and of
doing or causing to be done all such things as may be necessary
for
or incidental to the exercise of its powers or performance of its
functions in terms of its rules from time to time;
(c)
which conducts its business as medical
scheme in a closed sector, namely local government and associated
agencies’ employees;
(d)
which has approximately 75,000 members and
beneficiaries nationwide.
[6]
The first respondent is the COE, a
municipality duly established as such in terms of the
Local
Government: Municipal Structures Act 117 of 1998
and related
legislation and which has more than 600 employees who are members of
SAMWUMed.
[7]
The second respondent is Moso, company duly
registered and incorporated pursuant to the provisions of the Company
Laws of the Republic
of South Africa and an authorised financial
service provider in terms of the
Financial Advisory and Intermediary
Services Act 37 of 2002
(“
the FAIS
Act”
), under FSP no 10108.
[8]
The third respondent is The Registrar of
Medical Schemes (“
the Registrar”
),
who is herein cited in his official capacity, duly appointed as such
in terms of section 18 of the MSA.
[9]
The fourth respondent is The Financial
Sector Conduct Authority (“
the
FSCA”
), a juristic person duly
established in terms of section 56 of the Financial Sector Regulation
Act 9 of 2017 (“
the FSR Act”
).
[10]
The fifth respondent is The South African
Local Government Association
(“SALGA”
),
a voluntary association representing the interests of local
governments; and an employer organization of which the COE is a
member, and which is a party to the collective agreement concluded
between the relevant parties.
[11]
The sixth respondent is South African
Municipal Workers Union (“
SAMWU”
),
a registered trade union and a party to the collective agreement
referred to below.
[12]
The seventh respondent is the Independent
Municipal and Allied Trade Union (“
IMATU”
),
a registered trade union and a party to the collective agreement
referred to below.
[13]
The eighth respondent is Bonitas Medical
Fund, a medical scheme duly registered in terms of section 24 the MSA
and which is one
of the accredited medical schemes in terms of the
collective agreement referred to below.
[14]
The ninth respondent is Hosmed Medical
Scheme, a medical scheme duly registered in terms of section 24 the
MSA and which is one
of the accredited medical schemes in terms of
the collective agreement referred to below.
[15]
The tenth respondent is Key Health Medical
Scheme, a medical scheme duly registered in terms of section 24 the
MSA; which is one
of the accredited medical schemes in terms of the
collective agreement referred to below.
[16]
The eleventh respondent is La Health
Medical Scheme; a medical scheme duly registered in terms of section
24 the MSA and which is
one of the accredited medical schemes in
terms of the collective agreement referred to below.
[17]
The twelfth respondent is, collectively,
the Employees of the COE.
[18]
The thirteenth respondent is the South
African Local Government Bargaining Council, a bargaining council
established as such in
terms of the provisions of the Labour
Relations Act, Act 66 of 1995 (“
The
Bargaining Council”
).
Litigation history
[19]
SAMWUMed served its application on COE and
Moso respectively on 8 and 23 February 2021. Service was effected on
the balance of the
respondents during February 2021.
[20]
The COE served a notice to oppose on 15
February 2021 and the answering affidavit was due on 8 March 2021.
[21]
Due to the COE’s failure to deliver
its answering affidavit the application was set down on the unopposed
roll of 3 May 2021.
A few days prior to the hearing, COE’s
attorneys of record sought a postponement in order to deliver the
answering affidavit,
and they undertook to do so by 7 May 2021.
[22]
On 3 May 2021 the following order was made
by Moorcroft AJ:
“
1.
The application is postponed
sine die
;
2.
The first respondent is ordered to deliver
its answering affidavit, if any, by 7 May 2021;
3.
The first respondent is ordered to pay the
wasted costs occasioned by the postponement, including counsel’s
fees, on the opposed
scale.”
[23]
The COE did not file the answering
affidavit as ordered by the Court and instead it pursued a
“
settlement agreement”
with SAMWUMed, which “
settlement
proposals”
were rejected by
SAMWUMed as early as April 2021.
[24]
Moso filed its intention to oppose the
application on 19 May 2021.
[25]
The matter was again set down on the
unopposed roll on 10 August 2021 as no answering affidavit was
received. In the meantime, Moso
since filed its answering affidavit,
this necessitated the matter to be removed from the unopposed roll.
Also, at this time the
COE had not filed its answering affidavit as
ordered by Moorcroft AJ on 3 May 2021.
[26]
On 29 November 2021 the COE once more
approached SAMWUMed to accept their “
settlement
proposals”
as contained in the
already rejected offer.
[27]
SAMWUMed again rejected the “
settlement
offer”
and the matter was set
down for hearing on 14 February 2022.
[28]
However, on 4 February 2022 the COE
addressed a letter to SAMWUMed informing them that they will file its
answering affidavit
“
during the
course of the next week
”
, it was
further intimated that the matter will therefore have to be postponed
as to enable SAMWUMed to file its replying affidavit.
[29]
The COE filed its answering affidavit only
a day before the hearing. This was followed by an application for
condonation for the
late filing of the answering affidavit.
[30]
On 17 February 2022 the matter came before
Makume J and the following order was made after hearing arguments by
all parties:
“
1.
The application for a postponement is hereby granted.
2.
The application for leave to condone the
late filing of the First Respondent’s Answering Affidavit is
granted.
3.
The Applicant shall file its Replying
Affidavit by the 25
th
of February 2022. Heads of Argument shall be filed by the 15
th
of March 2022.
4.
The parties shall approach the Deputy Judge
President to allocate a Judge to hear this matter as a special motion
matter on a priority
basis.
5.
The First Respondent is ordered to pay the
Applicant and Second Respondent’s wasted costs including
counsel’s fees on
an attorney and client scale.”
[31]
Makume
J made the following remark in his judgment:
[1]
“
I
am mindful of the fact that the Service Level Agreement concluded
between the City of Ekurhuleni and Moso, the second Respondent
will
come to an end in June 2022. However, this does not mean that this
matter should not be ventilated fully in the interest of
justice.”
[32]
Following the above mentioned order by
Makume J, the matter was set down on the opposed roll on 9 June 2022.
Factual Matrix
[33]
On
16 September 2011 a broker agreement
[2]
was concluded between SAMWUMed and Moso, the broker agreement was in
force for a period of 18 months. Following the conclusion
of the said
agreement SAMWUMed forwarded a welcome letter to Moso stating the
following:
“
We
have pleasure in advising that you have been registered as a Broker
of the SAMWU NATIONAL MEDICAL SCHEME effective from 01 October
2011.”
[34]
On 9 September 2015 a Collective Agreement
was concluded in the Bargaining Council between SALGA, IMATU and
SAMWU. (
“
the collective
agreement”
). The Minister of
Labour, in terms of
Section 32
of the
Labour Relations Act, 66 of
1995
, made a determination in terms of which the collective agreement
came into operation in respect of non-parties thereto. Therefore,
in
terms of
inter alia
sections
31
and
32
of the
Labour Relations Act, 66 of 1995
, the COE (which is
a member of SALGA), is bound by the collective agreement.
[35]
During April 2019 SAMWUMed concluded a
further written broker agreement with Moso (
“
the
broker agreement”
) which
agreement commenced on 13 November 2018. The said agreement contained
a “territory clause” pertaining to the
COE.
[36]
Prior to 2020, SAMWUMed was accredited by
the Bargaining Council as one of the five accredited medical schemes
as stipulated in
the collective agreement and as such, hundreds of
employees of the COE become members of SAMWUMed.
[37]
During January 2020, the COE and Moso
concluded a service level agreement (
“
the
SLA”
), wherein Moso was appointed
as the service provider for The Provision of Medical Aid Broker
Services to the City of Ekurhuleni.
This was confirmed in an
appointment letter issued on 17 December 2019. The effective date of
the SLA concluded was from 1 January
2020 to 30 June 2022.
[38]
However, on 13 January 2020, the COE
addressed a letter to SAMWUMed stating the following:
“
Our
letter dated 11 June 2019 refers.
You are hereby informed
that the City of Ekurhuleni Municipality (CoE) has appointed two
Medical Aid Brokerage Service Consultants,
namely Moso Consulting
Services (Pty) Ltd and Alexander Forbes Health (Pty) Ltd to service
all employees and pensioners of the
City of Ekurhuleni Municipality
and to provide consulting services to the CoE with effect from 01
January 2020. The aim being to
provide a professional, efficient and
consistent service to CoE.
CoE has concluded a
service level agreement with the appointed medical aid brokers and
their contract will effectively run for the
period 01 January 2020
until 30 June 2022.
Your medical aid Scheme
has been allocated to Alexander Forbes Health (Pty) Ltd.
An appeal is made to you
to work together with the appointed broker, to support them and
ensure that they are well versed with your
medical aid scheme rules
so that they can be able to service the CoE, its employees and
pensioners in a professional way. Also,
it will be appreciated if you
can ensure that these brokers are paid broker fees for the services
rendered in terms of the Medical
Aid Schemes Act No131 1996 or as
amended.
It would be appreciated
if you can rescind all existing medical aid brokerage contracts that
are currently in place for CoE with
immediate effect to make way for
Alexander Forbes Health (Pty) Ltd to take over. No other medical aid
consultants will be allowed
to service employees of CoE unless they
are contracted to Alexander Forbes Health (Pty) Ltd.”
You are hereby informed
that the City of Ekurhuleni Municipality (CoE) has appointed two
Medical Aid Brokerage Service Consultants,
namely Moso Consulting
Service.”
[39]
SAMWUMed was opposed to the COE’s
appointment of two brokers to exclusively render services to
all
the COE's employees, including SAMWUMed’s
own existing members and prospective members.
[40]
Alexander Forbes Health (Pty) Ltd (
“
AFH”
),
however relinquished or somehow fell out of the picture, and Moso
remained as the only exclusive broker “appointed”
by the
COE to, on the one hand, act as broker for all the COE employees and
pensioners, and on the other, for all five schemes.
[41]
Notwithstanding,
SAMWUMed’s dissatisfaction of Moso being appointed as broker,
it applied for accreditation as medical scheme
in terms of the
collective agreement for the 2021 period, which application was
granted in September 2021. The accreditation afforded
SAMWUMed the
right to market its scheme and its benefit options to COE’s
employees and pensioners during the window period
of 1 October 2020
to 30 November 2020, for the year 2021. It also granted SAMWUMed the
opportunity to render ongoing services to
its members thereafter.
[3]
[42]
On 2 September 2020, Lungile Mtwana (
“
Mr
Mtwana”
), employed by SAMWUMed as
business development specialist, attended an online meeting with
Moso, represented by Lehlohonolo Mokgethi
and Young Lethakha, during
which it was contended by Moso that:
(a)
AFH had been appointed as broker on behalf
of SAMWUMed by the COE, but that AFH relinquished their appointment,
and as such, SAMWUMed
would be represented by Moso; and
(b)
In terms of guidelines released by the COE
ahead of the “freedom of association” period, the COE had
advised that going
forward only applications stamped by Moso would be
processed by the COE.
[43]
On 3 September 2020, in anticipation of the
October to November window period, the COE directed further
correspondence to the five
accredited medical aid schemes which read
as follows:
“
1.
Only COE appointed brokers are to facilitate YER roadshows supported
by Medical Schemes.
2.
All New-applications, additions and terminations should be processed
by COE appointed brokers
Only.
3.
Only application forms submitted by COE appointed brokers, will be
stamped by payroll.
4.
All Application forms should have the mandatory Record of Advice of
the COE appointed brokers.
5.
Appointed brokers and Medical Schemes should not use marketing and
promotional items during
the YER.
6.
Key Account Officers are to Inform appointed brokers of servicing
schedules.
7.
Medical Schemes and appointed brokers are required to follow COE
COVID-19 protocols.
8.
COE will issue permits for a specific number of YER representatives
from the Medical Schemes
and appointed brokers.”
[44]
Following the said correspondence, on 12
October 2020, Ms Stefanie Storbeck (
“
Ms
Storbeck”
) of the human resources
department (payroll office) of the COE directed an email with the
following content to SAMWUMed:
“
Good
day
Moso is now the Sole
Broker for all the medical funds.
Their stamp must be on
all the documents.
I can’t even accept
an application from the medical funds
Kind regards
Stefanie Storbeck
Bonitas, Key Health, SANWUMED”
[45]
The COE also indicated that the window
period for new applications and enlisting of new dependents would
open on 1 October 2020
and will close on 30 November 2020, and that
the window period for change of benefit options would close on 25
November 2020.
[46]
During the window period, SAMWUMed’s
internal consultants were present at the COE’s various venues,
they were allowed
to, freely and unhindered, provide information
about SAMWUMed and its benefit options to members and prospective
members. They
collected new application forms, new dependent forms
and change of option forms from members and prospective members.
[47]
Since 27 November 2020 brokers appointed by
SAMWUMed submitted application forms to Ms Storbeck of the COE, who
accepted a number
of SAMWUMed application forms, but only as a result
of some employees/members having put pressure on her to do so.
[48]
Early December 2020, Ms Storbeck stopped
accepting application forms from SAMWUMed.
[49]
As a result of the above, SAMWUMed launched
the application.
Relief claimed by
SAMWUMed
[50]
SAMWUMed seeks declaratory relief coupled
with interdictory relief, as well as contractual relief in the
context of certain provisions
of the MSA, the collective agreement
and a broker agreement.
[51]
The relief sought is as follows:
“
1.
An order declaring that the first respondent is in breach of the
collective agreement concluded on 9
September 2015;
2.
An order compelling the first respondent to
comply with the collective agreement concluded on 9 September 2015,
more specifically
to allow the applicant to freely market its scheme
and benefit options and to render services to its members and all
prospective
members who are employees of the first respondent,
unhindered and by way of the applicant’s own internal
consultants or independent
brokers appointed by the applicant, should
it so wish;
3.
An order compelling the first respondent to
accept member application forms and other documents and
communications directly from
the applicant, and to duly process such
applications and related documents submitted by the applicant;
4.
An order declaring that the second
respondent is not entitled to payment of broker fees by the applicant
in respect of the employees
of the first respondent,
in
the absence of a written broker agreement having been concluded
between the applicant and the second respondent and in the absence
of
the second respondent having actually rendered broker services;
5.
An order interdicting and restraining the
first and second respondents:
5.1
from taking any steps that would prevent or
hinder the applicant to market its scheme and benefit options and
render services to
its members and all prospective members who are
employees of the first respondent by way of the applicant's own
internal consultants
or independent brokers appointed by the
applicant, should it so wish;
5.2
from holding out that the second respondent
is the exclusive broker for the five medical schemes accredited in
terms of the collective
agreement concluded on 9 September 2015, and
that no other brokers or consultants will be allowed to service
employees of the first
respondent;
5.3
from refusing to accept member application
forms and other documents and communications submitted to the first
respondent by the
applicant, and from refusing to duly process such
applications and related documents;
5.4
from insisting that all medical scheme
member application forms and other related documents and
communications be submitted to the
second respondent, as opposed to
the first respondent;
5.5
from insisting that payment of broker fees
be made by the applicant to the second respondent in the absence of a
written broker
agreement between the applicant and the second
respondent and/or in the absence of the second respondent having
actually rendered
broker services;
5.6
from approaching members of the applicant
and requesting them to execute service notes in favour of the second
respondent, in the
absence of a written broker agreement between the
applicant and the second respondent and/or in the absence of the
second respondent
having actually rendered broker services to members
of the applicant;
6.
That the first respondent be ordered to pay
the costs of this application;
7.
Should any party/person oppose the present
application, ordering such party/person to pay the costs of this
application jointly
and severally with the first respondent;
8.
Alternatively,
to
prayers 1 to 7 above:
8.1
that an interim interdict with immediate
effect be and is hereby issued in terms of prayer 5 above, pending
the final determination
of action proceedings and/or arbitration
proceedings and/or other proceedings between the applicant and the
first and second respondents,
which
proceedings
shall be instituted or commenced with within 20 days from date of
this order;
8.2
ordering the first respondent to pay the
costs of this application; and
8.3
should any party/person oppose the
application, ordering such party/person to pay the costs of this
application jointly and severally
with the first respondent.”
Counter application
– Moso
[52]
On 7 June 2021 Moso filed its counter
application wherein it seeks the following relief:
“
1.
That it be declared that the provisions in the agreement between the
applicant and the second respondent
that limits the area within which
the second respondent can render broking services:
1.1
Does not preclude the second respondent
from rendering services outside the territorial area defined therein;
1.2
The second respondent is entitled to render
brokerage services to the applicant’s members throughout the
Republic of South
Africa;
2.
That the appointment of the second
respondent as a broker by the first respondent was:
2.1
The subject of public procurement; and
2.2
lawful;
3.
Costs against the applicant.”
Condonation
[53]
The delivery of SAMWUMed’s replying
affidavit to the COE’s answering affidavit did not coincide
with the time periods
contained in the order dated 17 February 2022.
The replying affidavit ought to have been delivered on 25 February
2022, but was
delivered six court days later on 7 March 2022. When it
became apparent that SAMWUMed would not be able to finalise and
deliver
its replying affidavit within the said time period, its
attorneys proactively engaged the COE’s attorneys and sought
their
consent to an extension of the time period. The COE’s
attorneys adopted the position that the COE cannot agree to an
extension,
but the COE did not raise any prejudice if condonation is
granted for the late delivery of the replying affidavit.
[54]
The relevant facts and grounds for
condonation have been set out in SAMWUMed’s replying affidavit,
and I am therefore of the
view that, seeing as no prejudice has been
caused by the six-day delay, the application for condonation be
granted.
Common Cause
[55]
In the matter all facts as summarized above
are not in dispute.
[56]
It is also
common
cause
that the SLA concluded between
the COE and Moso came to an end on 30 June 2022.
Issues between
SAMWUMed and COE
[57]
The issues to be decided between SAMWUMed
and COE are:
(a)
Whether the applicant lacks
locus
standi
in that it had derived nothing
more than a “privilege” from the collective agreement.
(b)
Whether SAMWUMED is allowed to freely
market its products and whether it has been denied this “privilege”.
(c)
Whether the SAMWUMED has met the
prerequisites for granting of interdicts.
The main collective
agreement
[58]
During September 2015 a collective
agreement was concluded between the South African Local Government
Bargaining Council (
“
the
Council”
), SALGA, IMATU and
SAMWU. The parties agreed that the agreement shall commence of the
date of signature and will remain in force
until 30 November 2020.
[59]
The said collective agreement concluded was
endorsed by the Minister in terms of section 32 of the Labour
Relation Act, Act 66 of
1995 (
“
LRA”),
to the extent that it be binding on all
employees of COE.
[60]
For purposes of the judgment, I quote the
relevant clauses pertaining to my discussion in full below.
[61]
In terms of clause 4 of the objects of the
collective agreement included the following:
(a)
To
establish uniform conditions of service for employees covered by the
collective agreement;
[4]
(b)
To
endeavour to ensure effective and efficient employment relations that
will enhance service delivery;
[5]
(c)
To
promote fair treatment of employees,
[6]
and
(d)
To
promote and maintain industrial peace.
[7]
[62]
Clause
9 of the collective agreement refers to employee benefits,
specifically medical aid; and membership to medical aid
[8]
and of importance in this regard are the following terms agreed upon:
(a)
The
Bargaining Council shall annually accredit medical schemes which
qualify for employer contributions.
[9]
(b)
The
employer shall, on behalf of the employee, make contributions to
accredited medical schemes.
[10]
(c)
Scheme
members will be afforded a choice on an annual basis before 1 January
of each year, to move to a council accredited medical
scheme.
[11]
(d)
An
employee must belong to an accredited medical scheme to qualify for a
medical aid subsidy.
[12]
(e)
An
employee who elects not to belong to an accredited medical scheme,
will not be entitled to a medical aid subsidy.
[13]
[63]
The
collective agreement also made provision for the procedure for
selection and accreditation of medical schemes, which procedure
is
set out in clause 15. The criteria for the recognition of medical
schemes, amongst others, are the following:
[14]
(a)
The medical scheme applying for admission
to the Council (hereinafter referred to as “applicant scheme”)
must be registered
in terms of
Section 24
(1) of the
Medical Schemes
Act (MSA
), and
(b)
The applicant scheme must meet all the
legal requirements as prescribed in the MSA and regulations issued in
terms of the MSA and
determinations of the Registrar from time to
time.
[64]
The selection process of an accredited
medical scheme for purposes of the collective agreement is clearly
set out in clause 15.3
and the following is of importance:
“
The
Council will undertake the implementation of the above agreed to
criteria as follows:
15.3.1.1
Medical
schemes presently accredited shall be notified in writing, inviting
them to apply for accreditation and shall be advised
of the terms of
application and of any other rules applicable;
[15]
15.3.1.2
Medical
schemes will be given until 15 August of each Year to submit their
applications for accreditation, in compliance with the
Council
criteria above. The failure to comply with the submission deadlines
without substantive motivation shall result in the
disqualification
of that scheme… .
[16]
15.3.1.3
The
Executive Committee will be responsible for overseeing the process
and finalizing the accreditation by 30 September and inform
medical
schemes of the outcome of the accreditation process as soon as
possible thereafter;
[17]
…
15.3.1.5
Notification of a decision of the Executive Committee regarding
accreditation
shall be in writing and shall be forwarded at least one
month in advance of any freedom of association campaign.”
[18]
[65]
In
terms of the collective agreement accredited medical schemes may
market their schemes annually between October and November
(“the
window period”
)
of the year proceeding.
[19]
[66]
As appears from clauses 15.3.2 to 15.3.6 of
the collective agreement, scheme members who wish to transfer from
one accredited scheme
to another, have to do so prior to 1 January
of each year.
[67]
Clause15.6 (Code of conduct) of the
collective agreement stipulates the following:
(a)
An
accredited medical scheme shall at all times present its own scheme
and its benefits in a fair and reasonable manner,
[20]
(b)
An
accredited medical scheme shall not misrepresent or discredit another
accredited medical scheme or its benefits in any way,
[21]
(c)
All
presentations to members and prospective members shall be based on
the benefit structure and contributions levels of that accredited
medical scheme that will apply as at 1 January in the following
year,
[22]
(d)
Accredited
medical schemes may only present benefits as contained in their
approved rules. Scheme representatives may not engage
in the sale of
any other non-medical scheme product whilst conducting marketing as
contemplated in the collective agreement.
[23]
[68]
Clause 15.7 addresses any breach of the
Code of Conduct in that any breach of conduct or any terms of the
agreement may be reported
to the General Secretary of the Council. On
receipt of the complaint, the General Secretary shall submit the
complaint to an ombudsperson
selected from the Council’s
National Panel of Arbitrators for adjudication.
Question of locus
standi of SAMWUMed raised by COE
[69]
COE argued that SAMWUMed lacks the
necessary legal standing to rely upon the terms of the collective
agreement for the relief sought
in the application.
[70]
In support of its argument counsel on
behalf of the COE raised the following points regarding SAMWUMed’s
locus standi
:
(a)
SAMWUMed is not party to the collective
agreement and it was not a signatory to it;
(b)
SAMWUMed is not a member of any employee or
employer organisation as envisaged in the LRA, and it does not act on
behalf of either
the employees or the employers falling within the
organisations recognised by the collective agreement;
(c)
The collective agreement does not give
SAMWUMed a right to enforce its terms against any member of the
employer organisation; and
(d)
the COE does not have any obligations and
duties contained in the collective agreement dischargeable in favour
of SAMWUMed.
[71]
The contention was made that SAMWUMed’s
averments are lacking in order to sustain a cause of action against
COE based on contract.
[72]
COE further argued that SAMWUMed has not
specifically pleaded any term of the agreement giving rise to the
COE’s obligation
towards it; this argument was based on the
following:
(a)
SAMWUMed has failed to identify a term of
the agreement the COE is alleged to have breached;
(b)
SAMWUMed has failed to plead a term of the
agreement entitling it to a specific remedy contained in the
collective agreement in
the event of any breach of the agreement
occurring.
Broker services, embarked upon
by the COE, have no direct relation to the applicant’s
privilege to market its services as
provided for in the collective
agreement. Therefore, there is no co-relation between the actions of
the COE to procure broker services,
and the alleged breach of the
applicant's right to market its services.
[73]
The COE contended that it has not breached
the terms of the collective agreement, but in fact, has always acted
within the confines
of the agreement, particularly when marketing of
medical aid schemes takes place during window periods.
[74]
SAMWUMed placed huge emphasis on the fact
the during the postponement application on 16 February 2022, COE
stated that it had conceded
the
“
material
remedies”
sought by SAMWUMed.
This was furthermore recorded in a letter by COE’s attorneys
dated 29 November 2021, where the following
was stated;
“
The
proposed terms of settlement by our client records the material
remedies your client seeks in the notice of motion.”
[75]
Furthermore, it argued that the draft order
attached to its postponement application, confirmed the material
parts of the relief
sought by SAMWUMed. This was confirmed in the
COE’s founding affidavit in the postponement application dated
11 February
2022.
[76]
SAMWUMed argued that the COE seeks to make
a 180 degree turn by contending that SAMWUMed has no rights as an
accredited medical
scheme, but only “a privilege”. The
assertion was made that SAMWUMed was granted a “right” in
terms of
the collective agreement and such “right” should
be honoured. It further contended that SAMWUMed has the necessary
legal standing in terms of the collective agreement concluded in
2015.
[77]
It
is evident that the COE has placed SAMWUMed’s
locus
standi
in
dispute.
The
test is whether the applicant has a direct personal interest in the
suit to be considered “his cause”
.
[24]
In
Minister
of Safety and Security v Lupacchini and Others
[25]
two connotations of the expression were aptly identified. It was said
that in its primary sense, it refers to the capacity to litigate
or
that it has the capacity to sue or to be sued.
[78]
Locus
standi
is
thus an issue which needs to be determined preliminarily in a
judicial process.
[26]
In other
words, the issue of
locus
standi
has
to be decided
in
limine
before
the merits.
[27]
That the
parties have the necessary legal standing or
locus
standi
must
accordingly appear
ex
facie
the
founding pleadings.
[79]
It
is trite that our courts will not be unduly technical with regard
to
locus
standi
as
each case should be considered on its own merits. And whilst the
issue of standing is always determined in light of the factual
and
legal context of each case, it is also true that there is no rule of
law that allows a court to confer
locus
standi
upon
a party who otherwise has none, on the ground of expediency or to
obviate impractical and undesirable procedures.
[28]
[80]
The
question of
locus
standi
in
a sense is procedural, but it is also a matter of substance. It
concerns the sufficiency and directness of a person’s
interest
in litigation in order for that person to be accepted as a litigating
party. Generically, it is for the party instituting
proceedings to
allege and prove its
locus
standi
.
The
onus
of
establishing the issue rests on that party. It is thus necessary for
a party in all cases to allege in its pleadings facts
sufficient to
show that it has
locus
standi
to
bring an action. This applies to all proceedings, whether brought by
way of application or summons.
[29]
[81]
It is clear from the
facts and circumstances of this case that SAMWUMed seeks to perform
an act and/or seeks something to be performed
or rectified in terms
of the collective agreement concluded between COE and its employees.
[82]
In
order to establish whether SAMWUMed has
locus
standi
one has to answer the question as to what the purpose of collective
bargaining is. Collective bargaining is a crucial form of social
dialogue. It’s true nature recognizes “the desirability
for joint decision making, joint problem solving and joint
responsibility in conducting relations between employers and
employees.”
[30]
In
addition, it is a key method used to regulate the relationship
between employers and employees in the workplace and a means
to
settle disputes through joint decision making. The true value of
collective bargaining is that it generally produces peace within
the
working environment, also to provide a level playing field between
employers and employees and furthermore, it preserves the
essence of
freedom of association.
[31]
[83]
The
LRA aims
inter
alia
to
promote orderly collective bargaining and to advance the
democratization of the workplace.
[32]
This is in keeping with the right of trade unions, employers and
employers’ organisations to bargain collectively as enshrined
in section 23(5) of the Constitution of South Africa, 1996.
[33]
[84]
In
Medihelp
v Minister of Finance NO
[34]
the Supreme Court of Appeal said:
“
[5]
The nub of the appellant's case was pleaded as follows:
‘
The
defendant, despite the granting by the plaintiff of membership to the
affected civil servants (and their surviving spouses)
and in breach
of its obligations in terms of the Agreement and General Notice,
deducted from the monthly subscription payments
the total sum of R9
997 256.75 being the subscriptions of the 94 affected civil servants
listed in Annexure “MH3” in
respect of past subscriptions
paid.’
In
the result it was alleged that the respondent was indebted to the
appellant in the amount of R9 997 256.75, as well as
mora
interest
thereon.
[6]
In the special plea the respondent pointed out that, on its own
pleadings, the appellant was not
a party to the Agreement and the
General Notice was directed to the affected civil servants. It thus
concluded that ‘there
being no privity of contract between the
Plaintiff and the Defendant, the Plaintiff has no
locus standi
to assert any rights or obligations which attach to an agreement to
which it is not a party.’
[7]
A person might lack standing to sue or be sued in either of two
circumstances. The first is where
the person is in law not capable of
suing or being sued, such as an unassisted minor or a person
suffering from a mental disorder.
The second is where the person
indeed has such capacity, but has insufficient interest in the
proceedings. See
Lupacchini NO and Another v Minister of
Safety and Security
[2010] ZASCA 108
;
[2011] 2 All SA 138
(SCA);
2010 (6) SA 457
(SCA) para 13.
[8]
In respect of the latter circumstance the general rule is that a
party claiming relief in respect
of any matter must establish a
direct interest in that matter. A direct interest is one that is not
academic, abstract or hypothetical.
An interest which all citizens
have, would generally be too remote to found standing. An actual and
existing interest in the matter
is required. See
Cabinet of
the Transitional Government for the Territory of South West Africa v
Eins
[1988] ZASCA 32
;
[1988] 2 All SA 379
(A);
1988 (3) SA 369
(A) at 388B-H
and
Jacobs en ‘n Ander v Waks en Andere
[1991] ZASCA 152
;
1992
(1) SA 521
(A) at 534B.
[9]
Standing is thus determined without reference to the merits or
demerits of the claim in question.
A contract or administrative
decision may, for instance, patently invalid, but a party may have
insufficient interest in the matter
to rely thereon for relief. A
finding that a party has no standing to sue or be sued generally
brings an end to the action or defence.
It follows that it is not
correct to find a lack of
locus standi
where a party is
of a class of persons that may in principle obtain the relief
claimed, but fails to plead a cause of action in
law.
[10]
What the special plea raised, was that the appellant’s alleged
right to receive payment from the respondent
was solely based on the
Agreement and the General Notice. But, on its own showing, the
appellant was not a party to the Agreement
and the undertaking
contained in the General Notice was not directed to it. In terms of
these documents the respondent was bound
to the affected civil
servants and not to the appellant.”
[85]
Significantly,
the Supreme Court of Appeal noted that the Minister’s special
plea of
locus
standi
was
based on an Agreement and General Notice, it found that the Agreement
and undertaking contained in the General Notice was not
directed to
Medihelp. Van der Merwe AJ stated that in terms of the Agreement and
the General Notice the Minister was bound to the
affected civil
servants and not Medihelp.
[86]
Additionally,
the doctrine of privity of contract
[35]
should be taken into consideration in this matter. In
Capital
Alliance Life Ltd v Simonsen
,
[36]
the court held that the doctrine of privity of contract states that
parties who have no connection to a contract cannot sue or
be sued on
the contract. Furthermore, in
Cosira
Developments (Pty) Ltd v Sam Lubbe Investments CC t/a Lubbe
Construction & Others
[37]
the court found that in the absence of privity of contract between
two parties, the applicant did not have the necessary
locus
standi
to demand specific performance of alleged contractual obligations
from the respondent.
[87]
In
Solidarity
v South African Rugby Union and Others
[38]
the following was said:
“
A
second preliminary point raised by the respondents challenged the
applicant's
locus standi
to
bring the application.
The
locus standi
of
a trade union is clearly stated in
section 200
of the
Labour
Relations Act. It
enables a union to act in its own interest in any
dispute to which any of its members is a party. The applicant failed
to establish
that the employees referred to in the application were
its members. It therefore failed to establish that it had
locus
standi
. The second point
in limine
was therefore upheld.”
[88]
I
n
accordance with the provisions of
section 23
of the LRA, collective
agreements are binding on the parties. The purpose of
section 24
of
the LRA is to resolve disputes where a party to an agreement is
alleged to have been in breach of the provisions of that agreement
by
failing to interpret or apply its terms either correctly or at
all.
[39]
The principles
applicable to the resolution of such disputes are trite as restated
in
Western
Cape Department of Health v MEC Van Wyk & Others
.
[40]
These are that:
“
i.
When interpreting a collective agreement, the arbitrator is enjoined
to bear in mind that
a collective agreement is not like an ordinary
contract, and he/she is therefore required to consider the aim,
purpose and all
the terms of the collective agreement;
ii.
The primary objects of the LRA are better served by an approach which
is practical to the
interpretation of such agreements, namely to
promote the effective, fair and speedy resolution of labour disputes.
In addition,
it is expected of the arbitrator to adopt an
interpretation and application that is fair to the parties.
iii.
A collective agreement is a written memorandum which is meant to
reflect the terms and conditions
to which the parties have agreed at
the time that they concluded the agreement.
iv.
The courts and arbitrators must therefore strive to give effect to
that intention, and when tasked
with an interpretation of an
agreement, must give to the words used by the parties their plain,
ordinary and popular meaning if
there is no ambiguity. This approach
must take into account that it is not for the Courts or arbitrators
to make a contract for
the parties, other than the one they in fact
made;
[41]
…
vi.
Collective agreements are generally concluded following upon
protracted negotiations, and it is
expected of the parties to those
agreements to remain bound by their provisions. It therefore follows
that such agreements cannot
be amended unilaterally.”
[42]
[89]
It
is incumbent on the basis of the
stare
decisis
that
this Court to be guided by the Supreme Court of Appeal and the LRA
and I am unable to deviate from the principles laid down.
The primacy
of the collective agreement concluded between COE and its employees
cannot be ignored in terms of the LRA.
[43]
The question of
locus
standi
must
be interpreted in terms of the terms of the collective agreement. The
collective agreement will be applicable to all issues
between the
employer (COE) and its employees.
[90]
In the present matter, SAMWUMed may have a
direct interest in this matter (given their claim that their right to
freely market their
scheme has been impacted), but attempting to
enforce these interests through the collective agreement, which they
were not party
to, is misplaced.
[91]
I am of the
view that SAMWUMed was not a party to the collective agreement
between COE and its employees. The collective agreement
clearly
states the obligations and rights pertaining to medical scheme
benefits between COE and its employees which are as follows:
1.
The Council
shall annually accredit medical schemes which qualify for employer
contributions;
2.
The employer
shall on behalf of the employee make contributions to the accredited
medical scheme;
3.
An employer
who elects not to belong to an accredited medical scheme will not be
entitled to the medical aid subsidy.
[92]
It is crystal
clear that SAMWUMed was not a party to the said agreement. This is
further strengthened by Clause 15 of the collective
agreement, which
set out the criteria and requirements in selecting accredited medical
schemes. It is important to note that the
Executive
Committee is responsible for overseeing the process and finalizing
the accreditation
by 30 September of each year and will furthermore inform the medical
schemes of the outcome of the accreditation process. [Emphasis]
[93]
Furthermore,
any breach of the Code of Conduct or any terms of the collective
agreement may be reported to the General Secretary
(“
GS”
)
of the Council and the GS of the Council shall submit the complaint
to an ombudsperson selected from the Council’s National
Panel
of Arbitrators.
[94]
Thus, when a
medical scheme is accredited in terms of the collective agreement,
the choice of membership vests in the employee.
The chosen accredited
medical scheme and the member/employee concludes the terms and
conditions of the members’ benefits.
Therefore, SAMWUMed
accepts a mandate from the employee and as such, act on behalf of the
employee. In return, the COE pay a subsidised
amount, as per the
collective agreement, on behalf of its employee to the medical
scheme, appointed by the employee. It is evident
that SAMWUMed has a
financial interest which rests on the employees’ decision to
appoint it as his/her medical scheme. The
mere fact that SAMWUMed has
a financial interest in its obligations towards the employee, clearly
points to an indirect interest.
[95]
The
position would have been totally different if
SALGA,
IMATU or SAMWU
launched
the said application.
The
legislative provision which deals with a Trade Union’s
locus
standi
to
act in its own interest is contained in
section 200
of the LRA and
expressly provides that a registered Trade Union may act in its own
interest in any dispute to which any of its
members is a party.
[44]
[96]
In
National
Education Health and Allied Workers Union obo Adeyoka v Central
University of Technology: Free State and Others
[45]
it was held:
“
It
is therefore clear that a registered trade union or registered
employers' organization is only entitled to be a party to any
Court
proceedings if one or more of its members is a party to those
proceedings. This section does not purport to vest the registered
trade union with the authority to act on behalf of its members in any
proceedings in any Court.”
[97]
All boils down to the
fact that SAMWUMed was not a party to the collective agreement and as
such, has no direct or substantial interest
in the matter and
therefore has no
locus
standi.
[98]
On this basis
the application stands to be dismissed.
Has SAMWUMed been
denied its right to freely market its products and benefits to
employees of COE.
[99]
SAMWUMed does not dispute that it was able
to exercise the rights afforded to it pursuant to its accreditation
in terms of the collective
agreement. Counsel for SAMWUMed
acknowledged that it was allowed to freely market the scheme and the
benefit options to the employees
of COE during the window period. It
was furthermore able to render the ongoing services required by its
members.
[100]
Thus, SAMWUMed was allowed to freely market
the scheme and its benefit options therefore the COE was not in
breach of the procedures
contained in the collective agreement.
Issues between
SAMWUMed and Moso
[101]
The issues to be decided between SAMWUMed
and Moso are:
1.
Whether Moso’s appointment by the COE
was the subject of lawful public procurement;
2.
Whether the written broker agreement allows
Moso to perform broker services to SAMWUMed’s members outside
the defined geographical
area stipulated in the broker agreement, and
whether the broker agreement can circumscribe the territory in which
a broker may
render broking services;
3.
Whether SAMWUMed’s conduct of “broker
noting” members through its own internal consultants, is
unlawful and precludes
the granting of relief;
4.
Whether a case for an interdict has been
made out by the applicant.
Legality of the SLA
concluded between COE and Moso
[102]
Moso contends that its appointment by the
COE was the subject of public procurement, and that it was lawful.
[103]
However, during argument Moso indicated
that the SLA ends on 30 June 2022 which renders the relief sought in
prayer 2 of the counter
claim to be moot.
[104]
Therefore, Moso did not persist with the
said relief and on that basis, it is unnecessary for me to consider
this issue any further.
Broker agreement
between Moso and SAMWUMED and the Territorial Clause
The broker
agreement concluded in April 2019
[105]
SAMWUMed argued that in terms of the broker
agreement, Moso is entitled to render broker services to the members
of SAMWUMed in
the City of Johannesburg’s territory, but not in
the COE’s territory. Furthermore, in terms of clause 6 of the
broker
agreement, Moso is not permitted to render broker services to
members of SAMWUMed outside of the “Territory” agreed
upon with SAMWUMed, save with the prior written consent of SAMWUMed.
[106]
Counsel on behalf of SAMWUMed contended
that the conduct of Moso is not only in breach of the broker
agreement, but it is also in
breach of the MSA. The MSA provides that
no person may be compensated by a medical scheme for acting as a
broker unless such person
enters into a prior written agreement with
the medical scheme concerned.
[107]
SAMWUMed further alleged there is no
provision in the MSA or the Regulations which restricts the
contractual freedom of a medical
scheme to agree to a contractual
provision in terms of which a broker is appointed within a defined
geographical area only. It
asserted that it is important that such
right be honoured and upheld, since medical schemes are guided by
specific needs, demographics
and practices in different areas. By way
of example, a broker cannot be appointed to service members in a
geographical area where
the broker has no or insufficient resources,
support or infrastructure. That would result in sub-standard services
being rendered
to the members. It is incumbent upon the scheme to
regulate the appointment of brokers and to ensure that brokers
appointed are
capable of rendering appropriate services in the areas
concerned.
[108]
SAMWUMed argued that the relief in the
counter application ought to be dismissed.
[109]
Moso on the other hand, argued that the
existence of a broker agreement between SAMWUMed and Moso, for
purposes of payment of commission,
is a statutory requirement in
terms of
Section 65
of the MSA read with Regulation (28). It further
contended that the actual argument of SAMWUMed is that such agreement
only applies
to the territory of the Greater Johannesburg region and
does not apply to Ekurhuleni.
[110]
Moso contended that, despite the fact that
its appointment by SAMWUMed in terms of the written broker agreement
is to perform broker
services within a defined geographical location,
it does not preclude Moso from rendering broker services to
SAMWUMed’s members
outside such area, throughout the Republic
of South Africa.
[111]
Counsel on behalf of Moso argued that
whilst the alleged principle that SAMWUMed purports to uphold and
fight for is employee’s
freedom of choice, the paradox lies in
that its attempts to circumscribe territory is antithetical to that
principle and results
in it actually stifling their very ability to
exercise free choice. This illustrates its stance to be entirely
self-serving. It
is only content to uphold employee’s freedom
of choice of broker when it is the recipient of that benefit.
[112]
Moso argued that the principle of legality
does not empower SAMWUMed to prescribe territory — the
empowering provisions do
not allow for that, and the general scheme
of our law gives clients free choice of broker, which a scheme cannot
override, and
the attempts to do so are unlawful, such that the
“territory” provision cannot be enforced, and prayer 1 of
counter
application must succeed.
[113]
The MSA in
section 1
of Chapter 1 provides
the following definitions:
“
broker
services means-
(a)
the provision of service or advice in respect of the introduction or
admission of members to a medical
scheme; or
(b)
the ongoing provision of service or advice in respect of access to,
or benefits or services offered
a medical scheme;…”.
and
“
broker
means a person whose business, or part thereof, entails providing
broker services, but does not include—
(i)
an employer or employer representative who
provides service or advice exclusively to the employees of that
employer;
(ii)
a trade union or trade union representative
who provides service or advice exclusively to members of that trade
union; or
(iii)
a person who provides service or advice
exclusively for the purposes of performing his or her normal
functions as a trustee, principal
officer, employee or administrator
of a medical scheme,
unless a person referred
to in subparagraph (i), (ii) or (iii) elects to be accredited as a
broker, or actively markets or canvasses
for membership of a medical
scheme”.
[114]
Section 65(6)
of the MSA provides that a
broker may not be directly or indirectly compensated for providing
broker services by any person other
than a medical scheme; a member
or prospective member, or the employer of such member or prospective
member, in respect of whom
such broker services are provided; or a
broker employing such a broker.
[115]
Regulation 28
(1) and (6)-(9) under the MSA
stipulates the payment and compensation of brokers as follows:
“
(1)
No person may be compensated by a medical scheme in terms of
section
65
for acting as a broker unless such person enters into a prior
written agreement with the medical scheme concerned.
…
(6) The ongoing payment
by a medical scheme to a broker in terms of this regulation is
conditional upon the broker—
(a)
continuing to meet service levels agreed to between the broker and
the medical scheme
in terms of the written agreement between them;
and
(b)
receiving no other direct or indirect compensation in respect of
broker services from
any source, other than a possible direct payment
to the broker of a negotiated professional fee from the member
himself or herself
(or the relevant employer, in the case of an
employer group).
(7)
A medical scheme shall immediately discontinue payment to a broker in
respect of services rendered to
a particular member if the medical
scheme receives notice from that member (or the relevant employer, in
the case of an employer
group), that the member or employer no longer
requires the services of that broker.
(8)
A medical scheme may not compensate more than one broker at any time
for broker services provided to
a particular member.
(9)
Any person who has paid a broker compensation where there has been a
material misrepresentation, or
where the payment is made consequent
to unlawful conduct by the broker, is entitled to the full return of
all the money paid in
consequence of such material misrepresentation
or unlawful conduct.”
[116]
It is not in dispute that a broker
agreement was concluded between SAMWUMed and Moso during April 2015
and in terms of Item 5 of
the said broker agreement it was stated
that the agreement commenced on 13 November 2018 and continues until
cancelled by either party with 30 days’
written termination notice. Alternatively, the broker agreement can
be terminated
for reasons of breach as contemplated in clause 10 of
the agreement.
[117]
It is furthermore not in dispute that in
terms of clause 1.2, “The Scheme” means SAMWUMed and
“Territory”
is defined to mean:
“
...
the geographical location or employer group in respect of which the
Broker is authorised by the Scheme, in the Scheme’s
sole and
absolute discretion to market the Services and to obtain remuneration
in respect thereof, the particulars of which Territory
are further
set forth in annexure ‘A’ hereto.”
[118]
In terms of annexure “A” to the
broker agreement, the territory does not include the territory of the
COE.
[119]
In fact, the territory is described as:
“
Greater
Johannesburg Branch — Metropolitan
City of Johannesburg and
its municipal entities namely:
- City Parks and Zoo
- City Power
- Joburg Roads Agency
- Joburg Property Company
- Pikitup
- Metrobus Company
-Joburg
Water”
[120]
The question in this matter is whether a
medical scheme (which SAMWUMed qualifies as) can, in the mandatory
written agreement between
it and a broker circumscribe the territory
within which a broker may offer its services.
[121]
The
question has been the subject of prior disputes before the Council
for Medical Schemes (
“
CMS”)
,
one of which was in the matter of LA Health Medical Scheme and
Moso.
[46]
The dispute arose
when LA Health Medical Scheme refused to pay commission to Moso for
broker noting on behalf of Ekurhuleni because
it was not authorised
to render services in the territory.
[122]
The dispute was adjudicated upon by the CMS
in April 2021, and the CMS ruled in favour of Moso
— that it was allowed to render services in Ekurhuleni and that
LA Health
Medical Scheme could not circumscribe territory. The CMS
held there that a medical scheme may not circumscribe territory in
terms
of an agreement as the
Medical Schemes Act and
its Regulations
do not empower such a course.
[123]
The following paragraphs of the decision
are of importance in this matter:
“
23.
Although the scheme insists that it has the sole and absolute
discretion to prescribe the geographical location
or employer group
in respect of which brokers it operates, it is unclear where the
scheme derives this power as this discretion
is not found anywhere in
the act of the regulations…
24.
The
scheme contends that it is contractually bound to adhere to SALGBC’s
code of conduct for marketing
of accredited medical schemes and that
its failure to do so, could result in its loss of SALGBC
accreditation. While the registrar
accepts that medical schemes are
entitled to enter into various agreements pursuant to the business of
a medical scheme, it is
important to note that the scheme cannot
contract or bind itself to the extent that creates conflict with the
governing legislation.
As stipulated in
section 2
of the act, the
provisions of this act shall prevail where ever there is any conflict
between this act and the provisions of any
other law (save for the
Constitution in relation to matters dealt with in the act. Therefore,
any powers parameters, rights and
obligations exercise in any manner
is regulated by the act, must be done so within the confines of the
act and its regulations,
failing which they become unlawful.
25. The
scheme rightfully accepts that members and/or employees are free to
appoint a broker of their choice,
and that its obligation to pay the
broker commission on behalf of the member subject to the contractual
terms agreed upon with
the broker.
26.
The scheme also argues that CoE has no right to act as agent on
behalf of its employees by appointing and
imposing a broker upon
employee without their consent. This implies that a broker cannot be
imposed on a member once they have
made a decision to be serviced by
a broker of their own choice. In our view, this same principle should
be applied to the scheme
as well.
27. In
conclusion having considered all the evidence before us, the above
stated provisions of the act and regulations,
as well as the terms of
the written agreement between the Scheme and the Complainant, it is
clear that the scheme has no legal
authority to prescribe the
geographical location and/or employer group within which a broker may
render services nor does it have
an entitlement to preclude a broker
from rendering services to members perceived to all outside a
prescribed geographical location
and/or employer group. It is
therefore our ruling that the Scheme’s decision to dishonour
the Complainant’s broker
appointments is unlawful and
unjustified.”
[124]
An
attempt to limit territory is one that very clearly infringes upon
the right of free choice to a broker.
[47]
[125]
The conduct of SAMWUMed in limiting
territory also amounts to a breach of the provisions of the.
Financial Advisory and Intermediary
Services Act 37 of 2002 (
“
FAIS
Act”
) and the Code of Conduct
promulgated in terms of that Act.
[126]
The MSC and the regulations requires that
brokers must be accredited, pay the annual fee, they must be
well-informed (about the
products in question), that they must render
services and that they must maintain an agreed service standard in
the course of doing
so. Provided that they cover those requisites,
they are entitled to be paid commission.
[127]
This is to be considered together with the
principle of free choice of broker (per,
inter
alia
, the authorities above and the
FAIS Act and Code of Conduct to it).
[128]
Be that as it may, the COE was undoubtedly
entitled to appoint or replace a broker on behalf of its employees.
The COE is an organ
of state and is entitled to procure broker
services.
[129]
Furthermore, the COE is responsible for
ensuring that the terms of the collective agreement are adhered to
and to protect the interest
of its employees. Therefore, the
appointment of Moso to enhance service delivery for employees who
contribute towards medical aid
schemes is within the COE’s
purview and qualifies as acting in the best interests of its
employees which is the purpose of
the collective agreement.
[130]
However, had SAMWUMed been doubtful as to
whether Moso was lawfully appointed, it could have lodged a complaint
with the Council.
Furthermore, the COE’s decision to procure
broker services qualifies as an administrative action in terms of the
Promotion
of Administrative Justice Act 3 of 2000 (“
PAJA”
).
As such, SAMWUMed could have sought to challenge the COE’s
decision and have it reviewed and set aside in terms of PAJA.
Prerequisites for
granting of an interdict
[131]
An applicant seeking a final interdict has
to establish on a balance of probabilities that the following
requirements have been
met:
1.
A clear right,
2.
An injury actually committed or reasonably
apprehended, and
3.
The absence of a similar or adequate
remedy.
[132]
Firstly, I have found that SAMWUMed was not
a party to the collective agreement concluded in 2015 between COE and
its employees.
Therefore, SAMWUMed has no
locus
standi
in the application before me.
Thus, SAMWUMed has not demonstrated a clear right giving it power to
enforce the terms of the collective
agreement against the COE and any
signatory party thereto.
[133]
Secondly, SAMWUMed’s application for
interdictory relief is premised on the infringement of its purported
right to market
its products, and that the SLA does not prescribe for
Moso to undertake marketing services of medical schemes. On its own
version,
SAMWUMed conceded that they were provided the opportunity to
market their medical scheme freely during the said window period as
prescribed in the collective agreement. The averments regarding the
apprehension of injury or actual injury suffered by SAMWUMed
has not
been demonstrated on the papers. In fact, it was allowed to submit
membership forms of members to COE, except that the
said applications
had to be submitted through Moso in terms of the SLA concluded.
[134]
It is evident that the appointment of Moso
had no external effect of depriving SAMWUMed of its rights to market
its scheme to the
employees of the COE.
[135]
Furthermore, SAMWUMed does have alternative
remedies if it was of the view that the COE and Moso infringed on its
rights to market
their scheme. These remedies are the following:
(a)
Section 47 of the MSA, which provides as
follows:
“
47.
Complaints
. —
(1)
The Registrar shall, where a written
complaint in relation to any matter provided for in this Act has been
lodged with the Council,
furnish the party complained against with
full particulars of the complaint and request such party to furnish
the Registrar with
his or her written comments thereon within 30 days
or such further period as the Registrar may allow.
(2)
The Registrar shall, as soon as possible
after receipt of any comments furnished to him or her as contemplated
in subsection (1)
either resolve the matter or submit the complaint
together with such comments, if any, to the Council, and the Council
shall thereupon
take all such steps as it may deem necessary to
resolve the complaint.”
(b)
In terms of the collective agreement clause
15.7.1 any breach of the Code of Conduct or any of the terms of this
agreement may be
reported to the General Secretary of the Council.
The General Secretary shall submit the complaint to an ombudsperson
selected
from the Council’s National Panel of Arbitrators.
(c)
Furthermore, had SAMWUMed been adversely
affected by the appointment of Moso as service provider to the COE
and its employees, it
could have challenged the appointment of Moso
in terms of PAJA, which it failed to do.
[136]
Insofar as the
claim for the interdictory relief against COE and Moso goes, in my
view, SAMWUMed failed to establish that the requirements
for
interdictory relief have been met.
[137]
The counter application by Moso is
inextricably linked to the application of SAMWUMed. Once it is found
that SAMWUMed has no legal
standing to launch the application it
follows that there is no need to deal with the counter application.
Cost
[138]
It
remains to deal with the costs of this application. The SAMWUMed, as
the unsuccessful party, must bear the costs of the application.
Much
was made by counsel for the applicant of the council’s change
in stance regarding the discussions pertaining to an order
being made
during February 2022 by consent between all parties. SAMWUMed argued
that COE and Moso’s belated entry into the
fray justifies a
punitive cost order.
[139]
The
contention is not without merit as it resulted in an extended paper
trail including, as I have alluded to, an application for
condonation. It however, did not have any bearing on the hearing of
the matter. In the exercise of my discretion I have decided,
in
fairness to the applicant, that some allowance in respect of the
extra costs resulting from the council’s belated entry
into the
proceedings, should be made.
[140]
The
most practical and just manner of achieving this, in my view, is to
limit the applicant’s liability for the counsel’s
costs
to the costs incurred in respect of the hearing of this matter, as is
reflected in the order I propose to make.
Order
[141]
In the premises of the above, the following
order is made:
1.
Condonation for the late filing of the
replying affidavit by the applicant is granted.
2.
The application is dismissed.
3.
The first and second respondent’s
costs of the application, shall be limited to the hearing of the
matter.
CSP
OOSTHUIZEN-SENEKAL
ACTING
JUDGE OF THE HIGH COURT
This
judgment was handed down electronically by circulation to the
parties’ representatives by email, by being uploaded to
Case
Lines
and by release to SAFLII. The date and time for
hand-down is deemed to be 16h00 on 25 August 2022.
DATE OF
HEARING:
9 JUNE 2022
DATE JUDGMENT
DELIVERED:
25 AUGUST 2022
APPEARANCES
:
Attorney
for the Applicant:
Malatj & Co Attorneys
Counsel
for the Applicant:
Mr E Kromhout
Attorney
for the first Respondent:
BM Kolisi Attorney
Counsel
for the first Respondent:
Mr K Mnyandu
Attorney
for the second Respondent:
Wadee Attorneys
Counsel
for the second Respondent:
Mr Y Alli
[1]
Paragraph
[20].
[2]
Case
lines 031/1.
[3]
The
said accreditation was contained in Circular 12/2020, which was
issued by the Bargaining Council on 2 September 2020.
[4]
Clause
4.1.
[5]
Clause
4.3.
[6]
Clause
4.4.
[7]
Clause
4.5.
[8]
Clause
9.1.
[9]
Clause
9.1.1.1.
[10]
Clause
9.1.1.2.
[11]
Clause
9.1.1.4.
[12]
Clause
9.1.1.6.
[13]
Clause
9.1.1.7.
[14]
Clause
15.2.
[15]
Clause
15.3.1.1.
[16]
Clause
15.3.1.2.
[17]
Clause
15.3.1.3.
[18]
Clause
15.3.1.5.
[19]
Clause
15.3.2.
[20]
Clause
15.6.1
[21]
Clause
15.6.2
[22]
Clause
15.6.3
[23]
Clause
15.6.4.
[24]
per
Searle,
JP in
Rescue
Committee, DRC v Martheze
1926
CPD 300
.
[25]
[2015]
JOL 33825 (FB).
[26]
Watt
v Sea Plant Products
[1998]
(4) All SA 109
(C) at 113-114.
[27]
Giant
Concerts CC v Rinaldo Investments (Pty) Ltd and Others
2013
(3) BCLR 251
(CC) at [58].
[28]
Gross
and Others v Pentz
[1996] ZASCA 78
;
1996
(4) SA 617
(A) at 632E-F.
[29]
W
ilson
v Zondi
1967
(4) SA 713
(N) at 717B.
[30]
Collective
Bargaining and Labour Disputes Resolution; is SADC Meeting the
Challenge? Fumane Malebona Khabo. ILO Sub- Regional
Office for
Southern Africa, Harare: ILO, 2008 (Issue Paper No. 30)
https://www.ilo.org/africa/information-resources/publications/WCMS_228800/lang--en/index.htm
(accessed
26 June, 2019).
[31]
Freedom
of association is “a basic human right with universal scope
enabling the enjoyment of other rights, a process with
substantive
content, and opens the door to participatory actions against forced
labour, the protection of children from abuses
and responsive
measures based on non – discriminatory and equality beneficial
to all.”
Giving
Globalization a Human Face
.
International Labour Conference 101st Session, 2012. Report III
(Part 1B). ILO: Geneva
https://www.ilo.org/wcmsp5/groups/public/---ednorm/---.../wcms_174846.pdf
(accessed
13 June 2019).
[32]
Section
1of the LRA states:
“
The
purpose of this Act is to advance economic development, social
justice, labour peace and the democratisation of the workplace
by
fulfilling the primary objects of this Act, which are—
(a)
to give effect to and regulate the
fundamental rights conferred by section 23 of the Constitution of
the Republic of South Africa,
1996;
…”
.
[33]
Section
23(5) of the Constitution states:
“
Every
trade union, employers’ organisation and employer has the
right to engage in collective bargaining. National legislation
may
be enacted to regulate collective bargaining. To the extent that the
legislation may limit a right in this Chapter, the limitation
must
comply with section 36(1).”
[34]
[2020]
ZASCA 29.
[35]
See
Christie
The
Law of Contract
4ed
at 298:
“
The
basic idea of contract being that people must be bound by the
contracts they make with each other; it would obviously be
ridiculous if total strangers could sue or be sued on contracts with
which they were in no way connected. The doctrine which prevents
this ridiculous situation arising is usually known as the doctrine
of privity of contract. Parties who are not privy to a contract
cannot sue or be sued on it.”
[36]
[2005]
8 BPLR 640 (N).
[37]
[2011]
JOL 27763 (GSJ).
[38]
[2019]
JOL 41780 (LC).
[39]
Public
Servants Associations on behalf of Liebenberg v Department of
Defence & Others
(2013)
34 ILJ 1769 (LC), at paragraph 2.
[40]
(2014)
35 ILJ 3078 (LAC) at para 22
[41]
See
Natal
Joint Municipal Pension Fund v Endumeni Municipality
(2012)
2 All SA 262 (SCA).
## [42]Dioma
and Another v Mthukwane NO and Others[2020]
ZALCJHB 138 at [36].
[42]
Dioma
and Another v Mthukwane NO and Others
[2020]
ZALCJHB 138 at [36].
[43]
In
National
Bargaining Council for the Road Freight Industry and Another v
Carlbank Mining Contracts (Pty) Ltd and Another
(2012) 33 ILJ 1808 (LAC) the Court held that section 199 of the LRA
must be read together with section 23(3) of the LRA and that
the
purpose of the two provisions together aim at “advancing a
primary object of the LRA, namely the promotion of collective
bargaining at sectoral level and giving primacy to collective
agreements above individual contracts of employment.” Section
199 provides,
inter
alia
,
in essence, that “contracts of employment may not disregard or
waive collective agreements”.
[44]
“
(1)
A registered trade union or registered employers' organisation may
act in any one or more
of the following capacities in any dispute to
which any of its members is a party
(a)
in its own interest;
(b)
on behalf of any of its members;
(c)
in the interest of any or its members.
(2)
A registered trade union or a registered employers' organisation is
entitled to
be a party to any proceedings in terms of this act if
one or more of its members is a party to those proceedings.”
[45]
(2009)
30 ILJ 1261 (O) at paragraph [7].
[46]
See
Complaint Ruling dated 1 April 2021 and the erratum thereto dated 6
April 2021.
[47]
See
Hlela
and Others v SA Taxi Securitisation (Pty) Ltd and Others
[2014]
ZASCA 112
at paragraphs [18] [20] and [31].
sino noindex
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