UNIVERSITY OF SOUTH AFRICA (UNISA)
College of Law
⋄
LCR4802 Assignment 01
Law of Contract and Delict Relating to Medical Practice — Semester 2, 2026
⋄
Module Code: LCR4802
Module Name: Law of Contract and Delict Relating to Medi-
cal Practice
Assignment No.: Assignment 01
Semester: Semester 2, 2026
Submitted in partial fulfilment of the requirements for LCR4802
at the University of South Africa.
,UNISA | LCR4802 Law of Contract and Delict Relating to Medical Practice
Question 1: Sipho’s Refusal of Admission to Ubuntu Health Centre
Sipho’s claim rests on the proposition that a healthcare provider may not turn a patient away
purely because that patient cannot pay immediately. This is not merely an ethical aspiration;
it is anchored in specific constitutional provisions, statutory duties and a body of case law
that together define when refusal of treatment becomes unlawful.
1.1 The Constitutional Foundation
Section 27 of the Constitution of the Republic of South Africa, 1996 governs access to health
care.1 Section 27(1)(a) affords everyone the right to have access to health care services, in-
cluding reproductive health care, but this right is subject to progressive realisation within
available resources under section 27(2).2 Section 27(3), by contrast, is not qualified by re-
source availability at all: it provides simply that “no one may be refused emergency medical
treatment.” 3 This distinction is decisive to Sipho’s case. If his admission was refused in cir-
cumstances amounting to a medical emergency, section 27(3) applies in unqualified terms,
and neither Ubuntu Health Centre nor Mr Khumalo may lawfully invoke a lack of immediate
payment as a ground for refusal.
The Constitutional Court settled the meaning of “emergency medical treatment” in Soobra-
money v Minister of Health, KwaZulu-Natal.4 Soobramoney suffered from chronic renal failure
and sought ongoing dialysis at a state hospital that could not accommodate every patient
with his condition. The Court held that his was not an emergency within the meaning of sec-
tion 27(3), because his was “an ongoing state of affairs” resulting from incurable chronic
illness, not a sudden, unforeseen crisis requiring immediate intervention to stabilise the pa-
tient.5 Chaskalson P explained that the purpose of section 27(3) is to ensure that a person
in a sudden crisis is not turned away by bureaucratic formalities or administrative delay, and
that this purpose does not extend to guaranteeing indefinite access to scarce ongoing treat-
ment.6 Critically, the Court gave a hypothetical example directly on point: where a person
requiring urgent treatment following a sudden motor accident is turned away from more than
one hospital because he cannot pay, and treatment is available but denied, that is precisely
1
Constitution of the Republic of South Africa, 1996, s 27.
2
Constitution, s 27(1)(a) read with s 27(2).
3
Constitution, s 27(3).
4
Soobramoney v Minister of Health, KwaZulu-Natal 1998 (1) SA 765 (CC).
5
Soobramoney (n 3) para 20–21.
6
Soobramoney (n 3) para 19.
Page 1 of 16
, UNISA | LCR4802 Law of Contract and Delict Relating to Medical Practice
the situation section 27(3) is designed to prevent.7
Sipho’s position must therefore be tested against this distinction. If his admission followed a
sudden, unforeseen medical crisis, unrelated to a chronic condition requiring rationed ongo-
ing care, his situation falls squarely within the Soobramoney example of unlawful refusal. If,
however, his need was for ongoing management of a chronic condition, section 27(3) would
not assist him and his claim would instead have to be assessed under the qualified right in
section 27(1) and (2), which is subject to resource constraints and a rationality standard of
review.8
1.2 Statutory Reinforcement: The National Health Act
Section 27(3) is given legislative teeth by section 5 of the National Health Act 61 of 2003,
which provides that a health establishment may not refuse a person emergency medical
treatment.9 This duty binds both public and private establishments, and applies irrespective
of the patient’s medical scheme status or ability to pay.10 Ubuntu Health Centre, whether
public or private, therefore carries a statutory duty independent of the Constitution itself, and
a breach of section 5 exposes the institution to liability distinct from any constitutional claim.
This statutory duty is reinforced at the level of professional ethics. Rule 27 of the Ethical
Rules of Conduct for practitioners registered under the Health Professions Act 56 of 1974
obliges a practitioner to render emergency treatment to any person requiring it, regardless
of the person’s ability to pay, and permits the practitioner to arrange payment or referral only
once the patient has been stabilised.11 Mr Khumalo, as the individual practitioner who refused
Sipho, is personally bound by this rule in addition to whatever institutional obligations rest on
the health centre.
1.3 Application to Sipho’s Facts
Applying this framework, Sipho’s view has merit only to the extent his admission was refused
during a genuine emergency. Three consequences follow. First, if his condition met the Soo-
bramoney threshold of sudden onset requiring immediate stabilisation, both the health centre
7
Soobramoney (n 3) para 22, discussing the facts of Cape Metropolitan Council v Graham and analogous
scenarios of sudden traumatic injury.
8
Soobramoney (n 3) para 29.
9
National Health Act 61 of 2003, s 5.
10
National Health Act, s 5, read with s 1 defining “health establishment” to include private facilities.
11
Health Professions Council of South Africa, Ethical Rules of Conduct, r 27, made under the Health Professions
Act 56 of 1974.
Page 2 of 16
College of Law
⋄
LCR4802 Assignment 01
Law of Contract and Delict Relating to Medical Practice — Semester 2, 2026
⋄
Module Code: LCR4802
Module Name: Law of Contract and Delict Relating to Medi-
cal Practice
Assignment No.: Assignment 01
Semester: Semester 2, 2026
Submitted in partial fulfilment of the requirements for LCR4802
at the University of South Africa.
,UNISA | LCR4802 Law of Contract and Delict Relating to Medical Practice
Question 1: Sipho’s Refusal of Admission to Ubuntu Health Centre
Sipho’s claim rests on the proposition that a healthcare provider may not turn a patient away
purely because that patient cannot pay immediately. This is not merely an ethical aspiration;
it is anchored in specific constitutional provisions, statutory duties and a body of case law
that together define when refusal of treatment becomes unlawful.
1.1 The Constitutional Foundation
Section 27 of the Constitution of the Republic of South Africa, 1996 governs access to health
care.1 Section 27(1)(a) affords everyone the right to have access to health care services, in-
cluding reproductive health care, but this right is subject to progressive realisation within
available resources under section 27(2).2 Section 27(3), by contrast, is not qualified by re-
source availability at all: it provides simply that “no one may be refused emergency medical
treatment.” 3 This distinction is decisive to Sipho’s case. If his admission was refused in cir-
cumstances amounting to a medical emergency, section 27(3) applies in unqualified terms,
and neither Ubuntu Health Centre nor Mr Khumalo may lawfully invoke a lack of immediate
payment as a ground for refusal.
The Constitutional Court settled the meaning of “emergency medical treatment” in Soobra-
money v Minister of Health, KwaZulu-Natal.4 Soobramoney suffered from chronic renal failure
and sought ongoing dialysis at a state hospital that could not accommodate every patient
with his condition. The Court held that his was not an emergency within the meaning of sec-
tion 27(3), because his was “an ongoing state of affairs” resulting from incurable chronic
illness, not a sudden, unforeseen crisis requiring immediate intervention to stabilise the pa-
tient.5 Chaskalson P explained that the purpose of section 27(3) is to ensure that a person
in a sudden crisis is not turned away by bureaucratic formalities or administrative delay, and
that this purpose does not extend to guaranteeing indefinite access to scarce ongoing treat-
ment.6 Critically, the Court gave a hypothetical example directly on point: where a person
requiring urgent treatment following a sudden motor accident is turned away from more than
one hospital because he cannot pay, and treatment is available but denied, that is precisely
1
Constitution of the Republic of South Africa, 1996, s 27.
2
Constitution, s 27(1)(a) read with s 27(2).
3
Constitution, s 27(3).
4
Soobramoney v Minister of Health, KwaZulu-Natal 1998 (1) SA 765 (CC).
5
Soobramoney (n 3) para 20–21.
6
Soobramoney (n 3) para 19.
Page 1 of 16
, UNISA | LCR4802 Law of Contract and Delict Relating to Medical Practice
the situation section 27(3) is designed to prevent.7
Sipho’s position must therefore be tested against this distinction. If his admission followed a
sudden, unforeseen medical crisis, unrelated to a chronic condition requiring rationed ongo-
ing care, his situation falls squarely within the Soobramoney example of unlawful refusal. If,
however, his need was for ongoing management of a chronic condition, section 27(3) would
not assist him and his claim would instead have to be assessed under the qualified right in
section 27(1) and (2), which is subject to resource constraints and a rationality standard of
review.8
1.2 Statutory Reinforcement: The National Health Act
Section 27(3) is given legislative teeth by section 5 of the National Health Act 61 of 2003,
which provides that a health establishment may not refuse a person emergency medical
treatment.9 This duty binds both public and private establishments, and applies irrespective
of the patient’s medical scheme status or ability to pay.10 Ubuntu Health Centre, whether
public or private, therefore carries a statutory duty independent of the Constitution itself, and
a breach of section 5 exposes the institution to liability distinct from any constitutional claim.
This statutory duty is reinforced at the level of professional ethics. Rule 27 of the Ethical
Rules of Conduct for practitioners registered under the Health Professions Act 56 of 1974
obliges a practitioner to render emergency treatment to any person requiring it, regardless
of the person’s ability to pay, and permits the practitioner to arrange payment or referral only
once the patient has been stabilised.11 Mr Khumalo, as the individual practitioner who refused
Sipho, is personally bound by this rule in addition to whatever institutional obligations rest on
the health centre.
1.3 Application to Sipho’s Facts
Applying this framework, Sipho’s view has merit only to the extent his admission was refused
during a genuine emergency. Three consequences follow. First, if his condition met the Soo-
bramoney threshold of sudden onset requiring immediate stabilisation, both the health centre
7
Soobramoney (n 3) para 22, discussing the facts of Cape Metropolitan Council v Graham and analogous
scenarios of sudden traumatic injury.
8
Soobramoney (n 3) para 29.
9
National Health Act 61 of 2003, s 5.
10
National Health Act, s 5, read with s 1 defining “health establishment” to include private facilities.
11
Health Professions Council of South Africa, Ethical Rules of Conduct, r 27, made under the Health Professions
Act 56 of 1974.
Page 2 of 16
