- Cancer Alliance and SECTION27 express disappointment after the High Court overturns an order addressing the radiation oncology backlog.
- The court finds no exceptional circumstances or irreparable harm, resulting in delayed treatment for patients on the backlog.
- Despite the setback, Cancer Alliance and SECTION27 pledge continued advocacy and hope for a resolution in the Supreme Court of Appeal.
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Cancer Alliance and SECTION27 have expressed grave disappointment after the High Court in Johannesburg set aside a previous order that would have compelled immediate action to address the backlog of radiation oncology patients in Gauteng.
The decision has suspended enforcement of critical relief for cancer patients, but both organisations remain committed to fighting for timely and equitable care, with the matter now set to proceed to the Supreme Court of Appeal.
On 5 December 2025, the court overturned an August order, previously granted by Judge D Dipenaar, which had compelled urgent compliance with a March 2025 judgment ensuring timely care for patients on a critical treatment backlog.
The March judgment, which mandated the Gauteng Department of Health and hospital CEOs to update the list of patients in need, provide treatment, and report to the court, remains valid but is now suspended pending appeal to the Supreme Court of Appeal.
Ongoing Commitment to Patients Despite Setback
Despite this significant setback, Cancer Alliance and SECTION27 reaffirmed their unwavering commitment to fight for timely, equitable access to life-saving treatment. The organisations pledge to continue advocacy until the Supreme Court of Appeal hears the case.
Cancer Alliance emphasised that the work of compiling an accurate backlog list had been done in close collaboration with clinicians and officials at the Gauteng Department of Health, ensuring that the needs of patients were clearly represented. In their joint statement, the organisations said they remained steadfast despite the High Court ruling.
“We note the judgment with disappointment, but we remain steadfast in our commitment to securing improved access to healthcare for cancer patients. While the ruling delays the implementation of critical relief, it does not diminish the urgency of the crisis faced by patients on the radiation oncology backlog,” the statement said.
They added, “Our collaboration with clinicians and officials at the Gauteng Department of Health has been central to compiling an accurate list of patients in need of treatment. The matter will now proceed to the Supreme Court of Appeal, where we hope it will be heard in the first term of 2026. Until then, we will continue to advocate for transparency, timely treatment, and the protection of patients’ lives.”
The High Court case involved Cancer Alliance as the respondent and the MEC for Health in Gauteng, the Head of Department, Health Gauteng, and the CEOs of Charlotte Maxeke and Steve Biko Academic Hospitals as appellants.
The appeal was filed under Section 18(4) of the Superior Courts Act 2013, against the entire judgment and order granted by Judge D Dipenaar on 20 August 2025. The appeal questioned whether the appellants should be compelled to comply with Judge Van Nieuwenhuizen’s March 2025 judgment while their appeal to the Supreme Court of Appeal was still pending.
A Decade of Delays in Radiation Oncology
The background to the case reveals a long-standing crisis in radiation oncology services in Gauteng. Since 2013, when Gauteng Provincial Treasury allocated R784 million to the Health Department to address backlogs in surgical and radiation oncology services at Charlotte Maxeke and Steve Biko Academic Hospitals, Cancer Alliance had been raising concerns that the Health Department’s approach was insufficient.
The department awarded tenders only for planning-stage treatment rather than providing immediate radiation oncology services, which risked delaying life-saving treatment for patients. Cancer Alliance argued that any time delay was dangerous, as cancer is a progressive disease that worsens over time. On 27 June 2024 the organisation approached the High Court urgently, seeking relief for the provision of radiation oncology services at Charlotte Maxeke Academic Hospital for patients on the backlog list.
Judge Van Nieuwenhuizen delivered the Part A judgment on 27 March 2025, ordering the Health Department and hospital CEOs to update the backlog list within 45 days, maintain compliance with Protection of Personal Information Act, provide radiation oncology treatment to patients on the backlog list, and file progress reports within three months.
Although leave to appeal this judgment to the Supreme Court of Appeal was granted on 7 May 2025, suspending the order’s operation, Judge D Dipenaar in August 2025 had ordered immediate execution under Sections 18(2) and 18(3) of the Superior Courts Act, citing exceptional circumstances and irreparable harm.
High Court reasoning and overturning of relief
Judge NA Makume, Judge NP Mali, and Judge S Meersingh overturned Judge Dipenaar’s order. They found that exceptional circumstances had not been sufficiently demonstrated, that prospects of success on appeal weighed against immediate execution, and that the evidence provided by Cancer Alliance regarding the backlog list lacked credibility.
The court highlighted that waiting lists are dynamic and the situation is fluid, and there was no evidence presented that patients had died while awaiting treatment. The judges emphasised the importance of respecting executive expertise in healthcare administration and warned against judicial interference in operational decisions. The High Court ultimately upheld the appeal, set aside Dipenaar’s order, and dismissed Cancer Alliance’s application with costs.
“Waiting lists are dynamic, and the situation is fluid. There is insufficient evidence to show that immediate execution of the order is warranted,” the judgment stated.
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