Ramdhin v Rondebosch Medical Centre (Pty) Limited

The applicant, a specialist obstetrician and gynecologist, was granted admission privileges at the respondent's private hospital in 2019 under an unwritten agreement. In June 2023, the Health Professions Council of South Africa (HPCSA) suspended the applicant from practice for one year after he pleaded guilty to two counts of unprofessional conduct. The HPCSA lifted the suspension on 3 June 2024. During the suspension, the hospital's ownership changed and a Physicians' Advisory Board (PAB) was established. The respondent advised the applicant he needed to reapply for admission privileges. On 18 June 2024, the respondent's board resolved not to reinstate the applicant's admission privileges. The applicant applied for privileges on 1 July 2024, but received no response. After correspondence from his attorneys, the respondent advised on 2 August 2024 that the applicant's admission privileges were terminated when the HPCSA removed him from the register in June 2023. The applicant launched an urgent application for an interim interdict to restore his admission privileges.

• Whether the agreement granting the applicant admission privileges contained a term implied by law that admission privileges would terminate if the medical practitioner was suspended from practice by the HPCSA.
• Whether the applicant's admission privileges were terminated by operation of law upon his suspension from practice.
• Whether the respondent's decision to terminate (or not reinstate) the applicant's admission privileges constituted administrative action reviewable under the Promotion of Administrative Justice Act 3 of 2000 (PAJA).

The application is dismissed with costs, such costs to include the costs of counsel to be taxed according to scale C.

An agreement granting hospital admission privileges to a medical practitioner contains a term implied by law (derived from the Health Professions Act 56 of 1974) that the admission privileges will terminate if the practitioner is suspended from practice and their registration is deemed cancelled under the Act. Upon such suspension, the admission privileges terminate by operation of law. The termination is not dependent on any decision by the hospital; the contract simply comes to an end.

The court stated, for the sake of completeness and on the assumption that there was a decision by the respondent to terminate the admission privileges, that such a decision was not of an administrative nature: it was not performed as part of the daily functions of government bureaucracy, nor was it the application of policy translated into law. The decision would not have been taken in the exercise of a public power or the performance of a public function as required by section 1(i)(b) of PAJA.

This case clarifies that admission privileges granted to medical practitioners at private hospitals are subject to an implied legal term that such privileges terminate automatically when the practitioner is suspended from practice by the HPCSA, even where the suspension is temporary. It also confirms that decisions by private hospitals regarding doctors' admission privileges do not constitute administrative action under PAJA, as they are not exercises of public power or public functions. This has implications for the contractual and regulatory framework governing private healthcare in South Africa.