Kirland Investments applied to establish two private hospitals in the Eastern Cape (a 120-bed hospital in Port Elizabeth and a 20-bed hospital with operating theatres in Jeffreys Bay) under the Health Act 66 of 1977. The Superintendent-General, Mr Boya, decided to refuse the applications based on advice that the area was over-serviced, but before the refusal letters were signed, he was involved in a motor accident and took sick leave. During his absence, the Acting Superintendent-General, Dr Diliza, approved both applications on 23 October 2007, allegedly under political pressure from the MEC, Ms Jajula, who instructed her to grant the approvals despite the advisory committee's recommendations to refuse. Upon Boya's return, and after receiving legal advice, he purported to withdraw the approvals by letter dated 20 June 2008, claiming the area was over-serviced. Kirland Investments appealed to the MEC, Ms Majodina, who dismissed the appeal, holding that Boya was entitled to withdraw Diliza's decision and was not functus officio. Kirland Investments then brought review proceedings.