Interdict, Appeal, Review: Dissecting The Limits Of Interim Relief In HPCSA Matters

On 4 November 2025, the Pretoria High Court delivered an important judgment on the nature and limits of the statutory framework governing the internal processes of the HPCSA. The judgment is significant for medical and healthcare professionals and, to an extent, for professional indemnity insurers and other stakeholders

Summary of facts:

The applicant, the medical practitioner, a specialist endocrinologist, faced seven counts of unprofessional conduct relating to alleged sexual misconduct toward female patients during 2013–2014. Complaints were lodged in 2020, and the Health Professions Council of South Africa (HPCSA) initiated a professional conduct inquiry.

The inquiry was marred by multiple postponement requests, urgent applications, and a recusal bid. Despite these, the inquiry proceeded, and on 3 June 2025, the medical practitioner was found guilty on two counts and acquitted on five counts. On 24 July 2025, his name was removed from the register under section 42(1)(c) of the Health Professions Act, effectively preventing him to practice.

The medical practitioner launched an internal appeal, a review application, and indicated an intention to pursue a statutory appeal under section 20 of the Act. Pending these processes, he approached the High Court for an interim interdict to suspend the sanction and allow him to resume practice.

Issues for determination:

1. Whether the applicant demonstrated exceptional circumstances to justify an interim interdict suspending the sanction pending appeal/review.
2. Whether section 42(1A) of the Health Professions Act permits such suspension.
3. Whether the applicant established a prima facie right and prospects of success in the main proceedings.
4. Whether the balance of convenience favoured granting interim relief.

Court's findings and reasons:

Interpretation of Section 42(1A):

The court emphasised that section 42(1A) expressly states that a penalty of erasure or suspension remains effective until the appeal is finalised. This provision overrides the usual principle that noting an appeal suspends execution. Its purpose is to protect the public from practitioners found guilty of serious misconduct, even while exercising appeal rights.

Exceptional circumstances requirement:

Given the statutory framework, the applicant had to show exceptional circumstances to justify deviation. Financial hardship and inability to earn an income, while serious, did not constitute exceptional circumstances.

Prospects of success:

The review was based on alleged bias and a failed recusal application, while the appeal challenged evidentiary handling and sanction severity. The court found no strong prospects of success, noting that the inquiry allowed representation, cross-examination, and submissions. The charges involved sexual misconduct, not medical negligence, and the sanction was not "shockingly disproportionate."

Balance of convenience:

The court held that public protection under section 42(1A) outweighed the applicant's financial prejudice. Sexual exploitation concerns in South Africa heightened the need for strict enforcement. Thus, the balance of convenience favoured the HPCSA.

Separation of powers:

The judgment reiterated that courts must respect statutory discretion and avoid interfering with regulatory bodies' mandates unless decisions are unreasonable or unconstitutional.

Significance for Medical and Healthcare Professionals:

This case underscores critical principles for practitioners for various reasons. First, it highlights the stringent nature of the statutory regime – Section 42(1A) creates a mandatory suspension of practice rights following erasure or suspension, even during appeals. Practitioners cannot assume that noting an appeal will allow continued practice. Second, the public protection priority—the HPCSA's role as guardian of professional integrity and public interest—means that misconduct, especially involving sexual exploitation, triggers uncompromising measures.

Third, the exceptional circumstances standard – courts will only intervene where extraordinary factors exist. Financial hardship alone is insufficient; compelling grounds such as procedural irregularities or constitutional violations must be demonstrated. Fourth, professional accountability, the judgment reinforces that ethical breaches, even outside clinical negligence, can lead to the ultimate sanction—removal from the register—and courts will defer to disciplinary bodies unless decisions are irrational.

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