A recent High Court judgment (Welkovics v HPCSA) has reaffirmed the principle that doctors in private practice are under no legal obligation to accept every patient seeking care, reported MedicalBrief (30 July 2025).
In Welkovics v HPCSA, the High Court considered whether Dr Norbert Welkovics, a private intensivist, was obliged to accept a self-funded patient for admission to the ICU.
“This ruling highlights why it is essential for clinicians to understand when a doctor-patient relationship begins and when they can lawfully decline to enter into one, wrote Dr Volker Hitzeroth, medico-legal consultant, Dr Yash Naidoo, dento-legal consultant, Dr Blesset Nkambule, medico-legal consultant and Dr Shivani Chirkut, medico-legal consultant, for Medical Protection.
Private practitioners are generally free to decide whether to accept a patient unless an emergency exists or refusal would amount to discrimination on unconstitutional grounds (e.g, race). Covering doctors designated to provide care in a colleague’s absence assume immediate responsibility for those patients, while on-call specialists contacted about a new patient are not automatically obliged to accept them unless they agree to do so.
“In the public sector, doctors are employed by the state, which has a constitutional duty to provide healthcare. This limits their discretion to refuse care, and refusal to treat is generally only acceptable in exceptional circumstances, such as when resources are exhausted.”