In December 2025, the High Court granted urgent relief to civil society organisations after vigilante groups at Yeoville and Rosettenville clinics blocked access for anyone unable to produce a South African ID. While the City later withdrew its objection, national and provincial health authorities argued they bore no responsibility for what happens outside clinic gates, and SAPS contended its role was limited to responding to complaints. The court rejected these submissions, emphasising that even undocumented persons have a right to primary healthcare and that the blockade unlawfully denied services to foreign nationals and citizens alike.
Relying on the Constitution and the National Health Act, the court held that the state has a positive duty to remove barriers to access to healthcare. The service‑level agreement assigning management to the City does not outsource or absolve governmental oversight. It requires co‑ordinated planning, monitoring and standard‑setting. SAPS’s constitutional mandate, reinforced by its own national instruction, extends beyond passive complaint‑taking to restoring lawful access.
The court held that national and provincial health authorities must acquaint themselves with barriers to access, plan and implement reasonable measures to eliminate them, and exercise oversight under the National Health Act and the service‑level agreement. The City and facility managers must ensure safe, unhindered access, deploy trained security, remove unauthorised persons, and report incidents to SAPS. Further, SAPS must prevent and respond proactively to unlawful blockades, assist with investigations, and work with health authorities to re‑establish orderly access.
On the interim relief test, the court stated that the applicants have a prima facie right to the final relief sought. They would suffer, or reasonably apprehend, irreparable harm if interim relief was not granted. There was no effective remedy other than an interim interdict to prevent that harm. The court found that the balance of convenience plainly favoured the applicants. There was no credible opposition to the interim relief. Diligent reporting of unlawful activity to the police, which was the only alternative that had been suggested, had proved ineffective.
The judgment underscores that assignment of service delivery does not negate constitutional oversight. Health authorities, municipalities and SAPS must act jointly to secure access to primary healthcare.
This case also has practical lessons for private hospitals and practitioners. A health establishment or provider may not refuse emergency medical treatment, so private facilities should ensure that triage and stabilisation are not unreasonably delayed by ID checks, payment issues, or other administrative hurdles. Private hospitals and practices should ensure that security staff or third parties do not restrict access at entrances and should have clear protocols to manage intimidation and to call SAPS when access to care is being obstructed.
Treatment Action Campaign & Others v Facility Manager, Yeoville Clinic & Others [2025] ZAGPJHC 1256