Background: How the Dispute Started
In October 2019, Dr. Ganes Anil Ramdhin, an obstetrics‑and‑gynecology specialist, made an informal, unwritten deal with Dr. Nisar Moosa, the sole owner of Rondebosch Medical Center (Pty) Ltd (RMC). The agreement let Dr. Ramdhin admit and treat his private patients at the hospital.
What Went Wrong: The HPCSA Suspension
In June 2023, Dr. Ramdhin pleaded guilty to two counts of unprofessional conduct before the Health Professions Council of South Africa (HPCSA). The charges stemmed from:
- Performing surgery that offered no benefit to the patient
- Carrying out procedures without proper preoperative checks
- Failing to give appropriate postoperative care
As a penalty, the HPCSA suspended him from the practitioner register for three years. One year was active (he had to stop practicing immediately), while the remaining two years were suspended on the condition that he avoid further misconduct and work only under strict supervision.
Policy Shifts at Rondebosch Medical Center
While Dr. Ramdhin’s suspension was in effect, RMC underwent major changes:
- Ownership and management structures were reshuffled.
- By May 2024, the hospital set up a Physicians Advisory Board (PAB).
- A formal, strict policy for admitting privileges was introduced, requiring:
- Peer reviews
- Proof of active HPCSA registration
- Assessments of commercial viability and reputational risk
Dr. Ramdhin’s Attempt to Return
On >
On 3 June 2024, Dr. Ramdhin successfully asked the HPCSA to lift the active part of his suspension, allowing him to resume supervised practice. He then applied to RMC for the restoration of his admitting privileges, arguing that his 2019 agreement was merely “paused” and should automatically resume.
The hospital’s PAB refused, citing:
- No medical or financial need for another gynecologist
- Concerns that hiring a doctor whose disciplinary case was widely reported would damage the hospital’s reputation
- Potential increase in professional insurance premiums
When Dr. Ramdhin filed a formal application in July 2024, the PAB again denied it, prompting him to seek an urgent injunction in the High Court.
The Legal Battle: From High Court to Supreme Court of Appeal
High Court Decision
Dr. Ramdhin first went to the Western Cape Division of the Supreme Court, asking for an order to stop RMC from blocking his access. He argued that the 2019 agreement stayed alive because a suspension only interrupted performance, not ended the contract. The High Court dismissed his request.
Appeal to the Supreme Court of Appeal (SCA)
Undeterred, Dr. Ramdhin appealed. His lawyers introduced a new argument on appeal: the doctrine of “temporary impossibility of performance,” claiming the contract survived the suspension.
The SCA judged that:
- Raising a brand‑new legal point on appeal would be unfair to RMC, which never had a chance to contest it earlier.
- The impossibility doctrine cannot protect a party whose own wrongdoing created the barrier to performance.
How Section 44 of the Health Professions Act Decided the Case
The core of the dispute turned on the interpretation of Section 44 of the Health Professions Act 56 of 1974.
Dr. Ramdhin’s team argued that a suspension merely “maintains the status quo” and is different from being struck off the register.
The SCA rejected this view. Judge PA Koen clarified that under Section 44:
- Both suspension and removal disqualify a person from practicing medicine.
- A suspended doctor’s registration certificate is expressly “deemed canceled” for the duration of the sentence.
The court held that the right to practice medicine is an implied, essential term of any hospital admission contract. Because Dr. Ramdhin was legally barred from practicing for a year, the contractual foundation vanished. When he returned, he was no longer an independent specialist but a practitioner limited to supervised work—a substantially different arrangement.
Consequently, the 2019 agreement terminated automatically by law when the suspension took effect. RMC was under no obligation to hold a spot for him or to accept a higher‑risk, changed professional relationship.
Outcome and What It Means for Dr. Ramdhin
The SCA dismissed the appeal with costs. Dr. Ramdhin now has two options if he wishes to work at Rondebosch Medical Center again:
- Go through the hospital’s updated credentialing process, meeting all peer‑review, HPCSA‑status, and risk‑assessment requirements.
- Seek admitting privileges elsewhere, where his current supervised status satisfies the institution’s policies.
Conclusion
The case underscores a clear legal principle: a suspension by the HPCSA cancels a doctor’s legal right to practice, and any contract that depends on that right ends automatically. Hospitals can therefore adjust their staffing policies without being forced to reinstate privileges that were based on a now‑invalid legal status. For medical professionals, staying in good standing with the regulatory body is essential—not only for patient safety but also for maintaining the contractual basis of their work arrangements.
