Treatment Action Campaign and Others v Facility Manager, Yeovile Clinic and Others (2025/181893) [2025] ZAGPJHC 1245 (4 December 2025)

Case Note

Head of Department: Gauteng Department of Health and Others v Minister of Health and Others
[2025] ZAGPJHC 5
Date of Judgment: [Date not provided in the text]

Reportability

This case is reportable due to its significant implications for the enforcement of socio-economic rights in South Africa, particularly in the context of healthcare accessibility for foreign nationals and vulnerable populations. The case addresses systemic issues of xenophobia and the failure of state organs to protect the rights of individuals seeking healthcare services, thus touching on constitutional responsibilities and the legal duties of governmental entities.

The judgment emphasizes the constitutional mandate to ensure access to healthcare services, raising essential questions about how public health policy intersects with human rights. The ruling challenges the passive approach of health authorities in the face of unlawful blockades and vigilante violence, thereby reinforcing the need for active state intervention in protecting rights established under the Constitution.

Moreover, the case highlights the interplay between different branches of government and their designated responsibilities in safeguarding citizens' access to vital services, a crucial aspect for future legal frameworks and public health policies.

Cases Cited

1. National Treasury v Opposition to Urban Tolling Alliance 2012 (6) SA 223 (CC)
2. Government of the Republic of South Africa v Grootboom 2001 (1) SA 46 (CC)
3. Minister of Health v Treatment Action Campaign (No 2) 2002 (5) SA 721 (CC)
4. Webster v Mitchell 1948 (1) SA 1186 (W)
5. Hotz v University of Cape Town 2017 (2) SA 485 (SCA)
6. Eriksen Motors (Welkom) Ltd v Protea Motors Warrenton 1973 (3) SA 685 (A)

Legislation Cited

1. Constitution of the Republic of South Africa, 1996
2. Sections 27(1)(a) and 2
3. Section 205(3)
4. National Health Act 61 of 2003
5. Sections 3(1)(a)(2) and 21(2)(l)

Rules of Court Cited

• Uniform Rules of Court, Rule 6(12)

HEADNOTE

Summary

In this case, the applicants, comprised of organizations focused on healthcare access and anti-xenophobia, sought urgent interim relief against various state respondents to ensure that foreign nationals were not obstructed from accessing healthcare facilities due to xenophobic actions by vigilante groups. The court found sufficient evidence that the state actors had a constitutional duty to facilitate healthcare access and prevent unlawful blockades, ultimately ordering the respondents to take comprehensive measures to secure the clinics.

Key Issues

The court addressed critical legal issues regarding the enforcement of socio-economic rights, the obligations of state authorities to prevent xenophobia, and the responsibilities of different organs of government in ensuring that healthcare services remain accessible to all individuals, regardless of their nationality.

Held

The court held that the respondents have a constitutional and statutory duty to ensure that all persons, including foreign nationals, are granted unhindered access to public healthcare services. The court found no valid opposition to the relief sought, emphasizing the urgent need for action against the ongoing violation of rights through the vigilante blockades.

THE FACTS

The applicants were three organizations advocating for healthcare access in Gauteng, which approached the court on an urgent basis seeking interim relief against state entities responsible for healthcare and policing. They argued that vigilante groups had unlawfully blocked access to clinics, particularly targeting foreign nationals without proper documentation. Despite the state acknowledging the unlawful nature of the vigilante actions, various respondents contended that they bore no duty to intervene, a position the court ultimately rejected.

The court was presented with uncontested evidence detailing the disruption of services at the Yeoville and Rosettenville clinics, where individuals lacking South African identity documents were systematically denied access to medical treatment. Further, there were indications that some security personnel within the clinics were complicit in facilitating these blockades, creating an urgent situation demanding immediate judicial intervention to protect the affected individuals.

THE ISSUES

The central legal questions revolved around the responsibilities of state actors under the Constitution and relevant health legislation to intervene against vigilante actions impeding healthcare access. These included examining whether the health departments had a duty to provide protection against violence targeting healthcare access and whether the police were required to act beyond merely responding to complaints.

ANALYSIS

The court’s reasoning drew heavily from constitutional mandates that aim to safeguard the right of access to healthcare for all. It rejected the notion that health authorities could absolve themselves of responsibility for the clinics based on the alleged outsourcing of duties to local government. Instead, the court underscored that both national and provincial health authorities carry affirmative obligations to mitigate barriers and prevent unlawful actions inhibiting healthcare access.

The judgment also critically examined the role of the police, asserting that their responsibilities extend beyond passive engagement with public complaints. The court highlighted that the police must take proactive steps to maintain public order and assist in ensuring that healthcare facilities remain accessible to all individuals, regardless of their nationality. This broad interpretation of state duties illustrates a robust commitment to protecting socio-economic rights within the framework of the Constitution.

REMEDY

The court ordered the first to fifteenth respondents to take all reasonable measures to ensure safe and unhindered access to the clinics by implementing security protocols and confronting individuals obstructing access. The decision positioned the enforcement of socio-economic rights as not only essential but also enforceable through judicial mandates, thereby reinforcing the state's obligation to act in a coordinated manner across different governmental levels.

LEGAL PRINCIPLES

This case solidified several legal principles, including: 1. State Accountability: The state bears a constitutional obligation to ensure unrestricted access to healthcare services, signifying an overarching duty to act against any barriers affecting such access. 2. Proactive Policing: Law enforcement agencies must actively prevent unlawful activities that impede public health services rather than limiting their efforts to reactive measures. 3. Inter-jurisdictional Cooperation: All levels of government must collaborate to uphold constitutional rights, particularly when systemic issues like xenophobia impact access to essential services.

The ruling serves as a pivotal reminder of the interconnectedness of health rights and the obligations of the state in addressing xenophobia, reinforcing the idea that the enforcement of rights cannot be left solely to individual agencies without mutual cooperation and coordinated action to resolve conflicts affecting vulnerable populations.