Netcare, which also runs hospitals in Britain, took part in an international scam that allegedly saw poor Brazilians and Romanians paid $6,000 (£3,840) for their kidneys to be transplanted to wealthy Israelis.
At the Durban regional court yesterday, Netcare KwaZulu (NKZ) pleaded guilty on 102 counts relating to illegal operations between June 2001 and November 2003. It was fined R7,820,000 (£704,000).
Police said these included five counts of "unlawfully acquiring and transplanting human kidneys by acquiring kidneys from five minors in law at the time the kidneys were transplanted". Netcare admitted that some of the kidney donors were "minors" but there were no details of the children's ages or nationalities.
The group made a plea bargain in which criminal charges against the parent company, Netcare, and its chief executive, Richard Friedland, were unconditionally withdrawn.
The transplants took place at one of South Africa's top hospitals, Netcare St Augustine's in Durban. In September the Times of South Africa cited a charge sheet that read: "Israeli citizens in need of kidney transplants would be brought to South Africa for transplants at St Augustine's hospital. They paid kidney suppliers for these operations."
Kidneys "were initially sourced from Israeli citizens, but later Romanian and Brazilian citizens were recruited as their kidneys were obtainable at much lower cost than those of the Israeli suppliers."
The charge sheet said documents related to surgeries were forged to make it appear that the recipient and the donor were family members, a requirement of South African law. Israeli kidney suppliers were paid $20,000 while Brazilians and Romanians were paid $6,000, it said.
Colonel Vishnu Naidoo, a spokesman for the South African police service, was today unable to confirm these details, but said he was aware of "at least one Israeli" recipient and a number of donors from South America. Naidoo added: "It has emerged that the conviction of a hospital in respect of human tissue cases such as this one may be the first conviction in the world. Law enforcement agencies around the world have already started to take these matters seriously."
In court yesterday, NKZ was fined R20,000 for contravening the Human Tissues Act by allowing minors to donate kidneys. It received a further R4m fine for receiving money and participating in an illegal kidney transplant scheme. It will also have to pay R3.8m – "the benefit derived by NKZ from the illegal operations" – to South Africa's asset forfeiture unit.
Summonses were served on four surgeons, a doctor, two employees of Netcare and one translator to appear in the Durban regional court on 23 November.
Netcare, which for the past seven years has strongly denied any wrongdoing, issued a statement in which it admitted "criminal activities".
Jerry Vilakazi, chairman of Netcare's board of directors, said: "It became evident to Netcare and its legal counsel that certain employees of NKZ must have been aware that some kidney donors were not related to kidney recipients, that payments must have been made to the donors for their kidneys and that certain of the kidney donors were minors at the time that their kidneys were removed."
A Netcare statement said: "Dr Friedland commented that none of the employees who had participated in the criminal activities were still in the employ of Netcare or NKZ. Dr Friedland pointed out that the employees concerned had not only contravened the law but they had also disregarded Netcare's own internal policies, which expressly stipulated that ministerial permission in cases of transplants between non-related persons was to be obtained and that donations could only be done for altruistic purposes."
It added: "The last of the illegal operations was performed at the end of 2003. Since then Netcare and its subsidiaries have devoted considerable time and attention to ensuring that the law, the guidelines issued by the Department of Health and Netcare's own internal guidelines are meticulously adhered to and enforced in order to ensure that the conduct of deviant employees does not again cause harm to Netcare and its stakeholders."