The first question is whether Dr G can be considered impaired in her ability to practise as a dentist. Section 1 of the Health Professions Act 56 of 1974 defines impairment as “a mental or physical condition which affects the competence, attitude, judgement or performance of professional acts by a registered practitioner”. It is down to Dr A’s judgment whether this fulfils the description of Dr G’s condition.
If Dr A considers Dr G to be impaired in her ability to practise, then section 25 of the Act obliges him to report Dr G to the HPCSA.
It says: “Reporting of impairment or of unprofessional, illegal or unethical conduct (1) A student, intern or practitioner shall – (a) report impairment in another student, intern or practitioner to the board if he or she is convinced that such student, intern or practitioner is impaired.”
In addition, the HPCSA’s guidance Confidentiality: Protecting and Providing Information (2007) – in its section “Disclosures to protect the patient or others”, sections 9.3.1 to 126.96.36.199 – says:
“Disclosure of personal information without consent may be justified where failure to do so may expose the patient or others to risk or death or serious harm. Where third parties are exposed to a risk so serious that it outweighs the patient’s right to confidentiality, health care practitioners should seek consent to disclosure where practicable. If it is not practicable, they should disclose information promptly to an appropriate person or authority. They should generally inform the patient before disclosing the information.
“Such circumstances may arise, for example: A colleague who is placing patients at risk as a result of illness or some other medical condition (eg. an impaired colleague): If health care practitioners are in doubt about whether such disclosure is justified they should consult an experienced colleague, or seek advice from a professional organisation. The safety of patients must come first at all times.”
Dr A discussed his concerns with Dr G. As an impaired practitioner, Dr G had an obligation to self-report to the HPCSA and Dr A was advised to give her that opportunity. However, Dr A was advised that he had to be satisfied that this self-reporting had occurred, and to remember his own obligations to report.