In a significant victory for cancer patients across Gauteng, the High Court has ruled that the provincial health department must immediately implement a court order to address the critical oncology treatment backlog, despite ongoing appeal proceedings.
Judge Fiona Dippenaar delivered the urgent judgment on Tuesday, firmly rejecting the Gauteng Department of Health’s attempts to delay compliance with a March court order while pursuing an appeal to the Supreme Court of Appeal.
The legal battle stems from a dire situation facing cancer patients in Gauteng, where delays in radiation oncology services have created a life-threatening backlog. In March 2025, Acting Judge Van Nieuwenhuizen declared the provincial health department’s failure to address this crisis as “unlawful, unconstitutional, and in breach of various sections of the Constitution.”
The original court order required the Gauteng Department of Health to: – Update and maintain a comprehensive backlog list of cancer patients awaiting radiation oncology services within 45 days – Take all necessary steps to provide treatment, whether at public or private facilities – Submit regular progress reports to the court on measures taken and long-term solutions
However, instead of complying, the department appealed the ruling, creating uncertainty about whether the order needed to be followed immediately.
Life-and-death urgency
The Cancer Alliance, represented by public interest law centre SECTION27, returned to court on 5 August seeking urgent clarification that the March order remained enforceable during the appeal process.
Judge Dippenaar’s ruling highlighted the devastating human cost of delays, noting that patients were being denied treatment within the critical windows required for radiation therapy to be effective. The court found this had “dire consequences,” with patients facing “irreversible and permanent harm.”
Tragically, the judgment revealed that some patients had already died while waiting for treatment, while others had seen their cancer spread to the point where they were no longer eligible for radiation therapy.
In her judgment, Judge Dippenaar emphasised that the harm extended beyond individual patients to affect families and create a broader public health crisis. She made it clear that paragraphs 5, 6, and 7 of the March order would not be suspended pending the Supreme Court of Appeal’s decision.
“The operation and execution of (the original order) will not be suspended until the Supreme Court of Appeal’s decision,” Judge Dippenaar ruled, effectively ending the department’s ability to use the appeal process as a delaying tactic.
The court found it “undisputed that the respondents did not take any significant steps to abide by the order” since March.
What this means for the public
This landmark ruling establishes several important precedents for healthcare rights in South Africa.
Cancer patients on the backlog list must receive urgent treatment without further delay – Government departments cannot use appeal processes to avoid constitutional obligations – Private healthcare facilities may be used to clear public sector backlogs when necessary
This strengthens the constitutional right to healthcare, particularly in life-threatening situations – Sets a precedent that urgent medical care cannot be delayed by bureaucratic or legal processes – Reinforces that the state must act with “urgency, transparency, and accountability when lives are at stake”
Other provinces facing similar healthcare backlogs may face similar legal challenges – The ruling could influence how courts approach cases where government inaction threatens lives – Establishes that constitutional rights to life and dignity take precedence over administrative convenience
SECTION27 and the Cancer Alliance have called on the Gauteng Department of Health, the national Minister of Health, and hospital CEOs to immediately comply with the court order.
“Every day of inaction means more families losing loved ones unnecessarily,” the organizations stated, urging authorities to stop using legal processes as delaying tactics.
The ruling serves as a critical reminder that constitutional rights—particularly the rights to life, dignity, and healthcare—cannot be suspended while government departments navigate legal proceedings.
For the hundreds of cancer patients currently on waiting lists in Gauteng, this judgment represents hope that life-saving treatment will finally be accessible within the time frames that could save their lives.
