This blog is co-authored by Mishka Maharaj, a candidate attorney.

In July 2025, the High Court overturned a decision by the Health Professions Council of South Africa (HPCSA) that an intensivist surgeon on critical care call acted unprofessionally by declining to accept a self-funded patient into his care at a private hospital.

The patient presented at the hospital’s emergency unit where he was diagnosed with heart and kidney failure by the casualty doctor. After the patient was stabilised, the casualty doctor contacted the intensivist to consider accepting the patient under his care for admission to the hospital’s high care unit.

Upon being advised by the casualty doctor that it was not a medical emergency, the intensivist declined to accept the self-funded patient. The intensivist stated that had the case been an emergency, he would have proceeded to the hospital to render assistance to the patient. The casualty doctor contacted several other specialist doctors who also declined to accept the patient. The patient was transferred to a state hospital, where he died the next day.

The patient’s daughter submitted a complaint of unprofessional conduct to the HPCSA for the intensivist’s refusal to admit the patient to the private hospital under his care.

Following a professional misconduct inquiry, the HPCSA found the intensivist guilty of unprofessional conduct in the circumstances.

The court decided that the intensivist had no contract with or clinical responsibility for the patient. He was told that the patient was stable, and he did not accept the patient for treatment. The fact that the patient was self-funded, not formally admitted to the hospital and not presented to the intensivist as an emergency, supported the court’s view that the intensivist did not assume any responsibility for the patient.

The court found that whilst the intensivist’s decision not to examine or admit the patient may, in hindsight, be viewed as regrettable, it does not amount to negligence or a breach of professional or ethical duty within the circumstances of this case. The HPCSA’s decision did not align with the evidence and failed to properly consider the context. The HPCSA erred in deciding that the intensivist acted unprofessionally based on financial reasons.

Welkovics v Health Professional Council of South Africa (A274/2024) [2025] ZAGPPHC 676 (4 July 2025)