Medical Certificates, Clinics and Nurses

Have you ever wondered what the legal requirements are for issuing and accepting medical certificates? Or how to deal with employees who claim to have a calling from their ancestors to become traditional healers? If so, this article will provide you with some useful insights and guidance.

 According to the Health Professions Council of South Africa (HPCSA), medical certificates are legal documents that must adhere to certain guidelines. Medical doctors can be found guilty of unprofessional conduct if they fail to comply with these guidelines. For example, a medical certificate must state the name, address and qualification of the practitioner, the name and employment number of the patient, the date and time of the examination, the diagnosis based on the professional opinion of the practitioner, the period of recommended sick leave, and the date of issue of the certificate. The medical certificate must also be an original document and not a copy.

 The Basic Conditions of Employment Act (BCEA) stipulates that an employee is obliged to furnish a legitimate medical certificate if they are absent from work for more than two consecutive days or on more than two occasions during an eight-week period. The medical certificate must state that the employee was unable to perform their normal duties because of illness or injury. The BCEA also recognises that a medical certificate can be issued and signed by a person who is certified to diagnose and treat patients and who is registered with a professional council established by an act of Parliament. This includes a professional nurse who holds an additional qualification in clinical nursing science, health assessment, treatment and care and is registered as such by the South African Nursing Council (SANC). However, the SANC recommends that such a nurse should only issue a medical certificate for a period not exceeding two days and should refer the patient to a medical practitioner or to the next level of care if their condition does not improve. 

 Employers have a right to investigate the validity of a medical certificate to confirm that the patient did indeed visit the medical practice on the date stated on the certificate, as well as the actual dates booked off. Employers also have a legitimate expectation that their employees will act with honesty and integrity. Fraudulent or questionable medical certificates are not acceptable and can lead to dismissal. However, dismissals for misconduct must be substantively and procedurally fair.

 In some cases, employees may request leave or remain off work for reasons related to their cultural or religious beliefs, such as training as a traditional healer. In such cases, employers should consider the employee’s right to freedom of religion and try to accommodate their request as far as possible. The Supreme Court of Appeal (SCA) has ruled that the dismissal of an employee who failed to obey an instruction to resume work because she had a calling from her ancestors to train as a traditional healer was unfair. The SCA also held that the traditional healer’s certificate was to be equated with a medical certificate for purposes of sick leave.

In conclusion, medical certificates, clinics and nurses are important aspects of the employment relationship that require careful attention. Employers and employees should familiarise themselves with the relevant laws and ethical rules that govern these matters and seek legal advice if in doubt.