An appeal by obstetrician and gynaecologist Dr Ganes Anil Ramdhin that sought to legally force Rondebosch Medical Centre (RMC) to restore his hospital admission privileges after his suspension in 2023 has been dismissed by the Supreme Court of Appeal – with costs – reports IOL.
Ramdhin has been suspended four times over the course of his career and also received multiple fines. He was also struck off the British roll in 2006 after the General Medical Council said he had shown “a flagrant disregard for his responsibilities”.
The recent judgment confirms that a medical practitioner’s contract for admission privileges automatically terminates by operation of law if he or she is suspended by the Health Professions Council of South Africa (HPCSA).
The current legal battle dates back to October 2019 when Ramdhin entered into an informal, unwritten agreement with RMC’s then-sole shareholder Dr Nisar Moosa, granting him admission privileges to treat and admit his private patients at the facility.
The arrangement fell apart in June 2023 when Ramdhin pleaded guilty to two charges of unprofessional conduct before the HPCSA, stemming from his treatment of two patients in 2020, and including performing a futile operation, performing procedures without an adequate pre-operative work-up, and failing to provide adequate post-operative care.
The HPCSA suspended Ramdhin from the register of practitioners for three years, ordering him to cease practice immediately. One year of the penalty was active, while the remaining two years were suspended on condition he commit no further misconduct and practice only under the strict mentorship of an HPCSA-approved supervisor.
Policy shifts and reapplication rejection
During his year-long operational absence, however, ownership and management structures of RMC changed, and by May 2024, the hospital had established a Physicians Advisory Board (PAB) and instituted a formal, rigorous policy governing admission privileges.
This new framework required peer reviews, proof of active HPCSA status, and evaluations of commercial viability and potential reputational risk.
Though Ramdhin successfully petitioned the HPCSA to lift his active suspension to resume supervised practice on 3 June 2024, RMC’s board refused to automatically reinstate his privileges, citing multiple shifting factors, and saying there was no medical or financial necessity for another gynaecologist.
Management also expressed concerns that accommodating a doctor labelled “at risk” – whose disciplinary sanctions had been widely reported in the media – would cause the hospital severe reputational damage and inflate its professional insurance premiums.
When Ramdhin submitted a formal application in July 2024 insisting it was for a “continuation” of his old rights, the PAB declined to approve it, prompting his legal team to launch an urgent High Court application.
Ramdhin initially turned to the Western Cape High Court, seeking an interim interdict to restrain RMC from blocking his access to the facilities, arguing that his 2019 agreement remained valid and that a temporary suspension merely paused his ability to perform his duties as opposed to destroying the underlying contract.
But the High Court dismissed his application, prompting an appeal to the SCA.
At the appellate level, his legal counsel used the doctrine of “temporary supervening impossibility of performance” as argument, suggesting the contract survived the disruption.
Rejection – and highly prejudicial
Writing for a unanimous SCA Bench, Judge PA Koen rejected this argument on both procedural and substantive grounds. The court noted that raising a brand-new legal foundation on appeal was highly prejudicial to RMC, which had never been given a chance to evidentially challenge it in the lower court.
The SCA said that the doctrine of impossibility cannot be used as a shield by a party whose own culpable and admitted professional misconduct created the performance barrier in the first place.
The appeal ultimately hinged on the statutory interpretation of Section 44 of the Health Professions Act 56 of 1974. Ramdhin’s legal team said a temporary suspension preserves the status quo of a practitioner’s career, making it fundamentally different from total removal from the medical register.
But the judge clarified that under Section 44, both suspension and removal disqualify an individual from practising medicine, and a suspended practitioner’s registration certificate is explicitly “deemed to be cancelled” for the duration of the penalty.
The court ruled that an independent practitioner's legal qualification and entitlement to practise constitute an essential, implied term of any hospital admission contract. As Ramdhin was legally disqualified from practising for a year, the underlying contractual foundation completely evaporated.
When he returned, he was no longer an autonomous specialist but a heavily restricted practitioner bound to mandatory oversight.
The 2019 agreement dissolved automatically by operation of law the moment the suspension took effect, concluded the SCA, meaning RMC was under no obligation to reserve his spot or accept a fundamentally altered, higher-risk professional arrangement.
The SCA dismissed the appeal with costs. Ramdhin now has no option but to formally clear RMC’s modern credentialing processes if he wishes to secure new privileges at the institution.
See more from MedicalBrief archives:
New charges for thrice-suspended Cape doctor
Fresh criticism of ‘dysfunctional’ HPCSA after Ramdhin debacle
Court denies Cape gynae’s plea to restore hospital privileges