While the Act defines healthcare professions as “any profession for which a professional board has been established in terms of section 15 and includes any category or group of persons provided for by such a board”, section 15 does not specify which health and allied professions are included. The Act has created a Health Professions Council (the Council), which supervises the various professional boards in the training, examination and continued supervision of the healthcare practitioners who fall under their control.
Section 17 provides that no-one may practise their healthcare profession unless registered with the Registrar, and deals with the procedure to obtain registration. This prerequisite is reiterated in sections 34 and 39 of the Act, which prohibits healthcare practitioners from performing certain actions unless they are registered in terms of the Act. Contravention of this provision can result in a fine, imprisonment, or both.
Section 18 of the Act requires the Registrar of the Council to maintain a register of all practising healthcare practitioners. An important practical requirement is contained in section 18(3), namely that all registered persons who change their contact details must notify the registrar in writing within thirty days after such change. This requirement is mentioned again in section 19A(1)(a).
The Registrar may from time to time make necessary alterations to the entries in the register, including the removal of deceased practitioners and persons who have been removed from the register in terms of the Act. Section 19 sets out the grounds for removal, which may occur if a practitioner is found guilty of unprofessional conduct, was registered fraudulently or in error, had their degree revoked, and for various other serious misdemeanours. However, another ground for removal from the register is for what the general public would consider a much lesser breach – a failure to pay their annual registration fee, three months after it has become due!
In order to maintain their registration with the Council, all healthcare practitioners must pay annual fees. Should a healthcare practitioner fail, or refuse, to pay their annual fees to the Council within the specified time, the Council may recover the fees by instituting legal action in terms of section 62(2). Section 19 of the Act allows the Registrar both to remove a practitioner’s name from the register, and to restore it on the register. Specifically, section 19(1)(d) allows the professional body or committee to remove the name of any person who has failed to pay their annual fees, which are due by 1 April of each year. A practitioner may be suspended or removed from the register even if partial, rather than full, payment of the annual fees has been made. Unfortunately, neither the Act nor the regulations make a distinction between removal from the register and suspension.
It appears to be the Registrar’s prerogative whether to remove or suspend a practitioner for non-payment or partial payment of annual fees.
The Registrar must provide the healthcare practitioner with a notice of their removal from the register. This is given by way of certified mail address (i.e. registered mail), fax, or electronic transmission to the practitioner, at the address appearing in respect of that particular practitioner on the register.
Where a practitioner has been removed from the register due to non-payment, he or she must pay all outstanding fees before their name may be restored on the register.
The Council penalises practitioners for non-payment of annual fees and, if a practitioner wishes that their name to be restored on the register, the penalties are calculated as follows:
- If a practitioner has been suspended or removed from the register for less than 6 months, they will have to pay the equivalent of twice the applicable fee for the current year plus the outstanding fee;
- If a practitioner has been suspended or removed from the register for more than 6 months, but less than 12 months, they will have to pay the equivalent of four times the applicable fee for the current year plus the outstanding fee;
- If a practitioner has been suspended or removed from the register for more than 12 months, they will have to pay the equivalent of five times the applicable fee for the current year plus the outstanding fee.
Practitioners who are specialists, sub-specialists or have an additional qualification are required to pay an additional fixed fee for their name to be restored. Where a practitioner is in arrears, any monies paid will be allocated first to the oldest debt.
The implication of removal or suspension due to the non-payment of annual fees is enormous. The practitioner’s registration certificate is deemed to be cancelled and the practitioner must cease to practise until such a time that his or her name is restored on the register. Another implication of removal or suspension is that the practitioner concerned will be blocked by medical aid schemes and as a result claims by patients might not be paid out. This also means that claims submitted by the practitioner will not be paid. Additionally, he or she will be at risk should he or she be subject to a civil claim or a complaint, either to the Council or to the healthcare facility where they practise as they will, in principle, be practising and rendering services while not permitted to do so.
It may happen that a practitioner is removed or suspended from the register without being provided with appropriate and proper notice. This usually happens in situations where the Registrar issues the notice of suspension or removal and it is delivered by way of registered post. The Registrar then proceeds to remove or suspend the practitioner without satisfying himself or herself that the practitioner has actually received the notice.
A practitioner who finds himself or herself suspended as a result of non-payment of annual fees should fact-check that the correct procedure has been followed, i.e. -:
- Have three (3) months passed since the day on which payment became due (i.e. 1 April of that year);
- Has a Notice of Suspension or Removal been received either by registered post, e-mail, or fax;
- If not, was the Notice forwarded to the correct address or e-mail address as it appears on the register?
As mentioned above, the Act requires healthcare practitioners to update their personal and professional details with the Registrar. The practical implications of any failure to do so, apart from the sanctions that the Registrar may impose (section 19), are apparent. But, provided that these details have been updated and are correctly recorded, should the Council fail to satisfy any of the abovementioned three steps, a practitioner who finds himself or herself suspended or removed may challenge their suspension or removal.
Various practical amendments to the Act are required. The provisions allowing for notices to be forwarded by registered post and fax are no longer feasible. These modes of communication have become superannuated and are no longer effective. Should a practitioner find themselves removed from the register or suspended by the Registrar due to partial or non-payment of annual fees, we recommend that he or she seek advice from their legal representative.
Read the article on pages 18-19 in the February 2023 Edition of the SAMA Insider here.
