Can a medical practitioner charge for a cancellation?

The Consumer Protection Act (CPA) addresses cancellations and specifically provides a consumer the right to cancel an advance reservation, booking, or order. This in turn provides the right to a Supplier to charge a reasonable cancelation fee, taking the following into consideration:

1. The nature of the goods or services that were reserved or booked.
2. The time the notice of cancellation was provided by the consumer.
3. The reasonable potential for the service provider, acting diligently, to find an alternative consumer between the time of receiving the cancellation notice and the time of the reservation that was cancelled.
4. The general practice of the relevant industry.

The Health Profession’s Council of South Africa (HPCSA)’s stance on this matter was contradictory: the ethical rules disallowed charging any fees, whilst the CPA and Medical and Dental Professions Board rules acknowledged that some cancellation/late fee was allowed to be levied. 

The issue was, however, not a clear-cut one. The end of 2018 saw the HPCSA finally issuing a public, non-contradictory position on “no shows” appointments and late arrivals.

The HPCSA have publicly clarified its position as follows:

“A patient reserves the right to cancel a medical or dental appointment, and a medical or dental practitioner may not charge a consultation fee or a procedure fee for such a cancelled appointment unless:

1. A cancellation was made less than 24 hours for a specialist appointment and less than two hours for a general practitioner appointment, before the appointment time.
2. A practitioner can provide evidence of failure to find an alternative patient between the time of receiving the cancellation notice and the time of the cancelled appointment.
3. The practitioner can provide sufficient proof that the patient was informed about the cancellation of appointments policy.
4. The practitioner has first established the reasons for the patient’s failure to cancel or honour the appointment”.

This provides much needed relief and clarity for some practitioners, where it is difficult to sustain their practice if patients do not honour their appointments. Practitioners should note that the HPCSA advises those who have a cancellation or no-show policy to inform their patients at the time of booking that there will be charges incurred for failing to arrive for an appointment. This also corresponds with the aim of the CPA to ensure that there is transparent communication with a consumer at all times.