JOHANNESBURG - The controversy that surrounds medical certificates submitted to the Madlanga Commission has sparked conversations about the use of sick notes.
This extends not only to legal proceedings but also beyond, including the workplace.
Vice-chairperson of the Unity Forum for Family Practitioners, Dr Angelique Couttsier, said concerns about the misuse of medical certificates should be taken seriously.
Couttsier said no statistics show that fraudulent medical certificates are widespread, and if they are, they would likely be isolated cases.
In the case of the Madlanga Commission, there is intense scrutiny following a list of key witnesses who have handed over sick notes to the Commission, forcing it to postpone their appearance.
From the CEO of Medicare24, Mike van Wyk, to North West businessman Suliman Carrim and now recently the head of the Investigating Directorate Against Corruption (IDAC), Advocate Andrea Johnson.
Madlanga sick note
The medical certificate booked her off until 15 July but provided so little information that the chair of the commission, Justice Mbuyiseli Madlanga, described it as another ‘useless medical certificate'.
READ | Expert urges scrutiny of sick notes after Andrea Johnson's no-show
In the workspace, an article by Labour Guide South Africa dated unpacked fraudulent sick note exposed.
In a case dating back to 2025, an engineering assistant employed at a gold mining company was dismissed after she had submitted a fraudulent sick note.
According to the case, the doctor denied issuing it and confirmed the inconsistencies.
Couttsier explained that a medical certificate is a professional medical opinion, and it's not simply a note requested by a patient.
“It's a legal and ethical document,” she said, further adding that doctors may only issue a medical certificate after an appropriate consultation.
This certificate, she said, should accurately reflect the doctor's clinical findings and opinion.
“Medical certificates should have the date of the examination, confirm indeed whether the patient was examined, whether the patient is medically unfit, the period of your incapacity, and then the doctor's details, as well as the Health Professions Council of South Africa (HPCSA) number and the signature.
"Importantly, the diagnosis doesn't have to be disclosed unless the patient consents,” she added.
Couttsier notes doctor's dilemma is that they are often caught between respecting confidentiality, advocating for their patient and meeting legal or employee requirements.
READ | One sick note after another | Expert says Madlanga Commission's irritation valid
In matters relating to court or commissions, and one needs to be booked off, it is important or the medial certificate to determine whether the person is medically incapable of participating, whether the incapacity is temporary and when the reassessment is expected, provided the patient gives consent.
“We do see those vague sick notes. But in the case of a court the judge can ask for an opinion, whether this is indeed a sick note that, in this case, is appropriate," she said.
Where medical certificates are issued or used inappropriately, she said those cases should be investigated and, where necessary, referred to the Health Professions Council of South Africa (HPCSA).
However, in the same breath, she warned that the issue should not undermine the thousands of doctors who uphold the integrity of the medical field.
“We believe that most doctors are ethical. And one controversial case should not tarnish the profession going forward,” she said.