Motsoaledi: Negligence claims affect healthcare, hike doctors’ fees

2015-03-09 14:33

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Health Minister Aaron Motsoaledi has warned that South Africa is facing a major crisis of doctors, in particular obstetricians and gynaecologists, being reluctant to perform surgeries in fear of medical negligence lawsuits.

“Some gynaecologists are refusing to see women who are pregnant because they fear medical negligence claims,” he said.

In the same breath, Motsoaledi lambasted some doctors, lawyers and state employees who collude to defraud the state through bogus medical negligence claims.

Speaking at the Medico Legal Summit in Irene, Centurion, this morning, Motsoaledi warned that the spate of increased medical negligence claims has reached a crisis point where government institutions, such as the Road Accident Fund, had been left bankrupt by litigation.

Motsoaledi also singled out lawyers, branding them as money-grubbing people only intent on lining their pockets instead of having the interest of patients at heart.

Over the past 13 years, the indemnity insurance paid by doctors to protect themselves against medical negligence claims had increased by 573% – which meant that doctors’ fees also increased.

The fear of litigation among doctors, said Motsoaledi, was also causing many in private practice to consider changing their profession even though they have years of experience under their belts.

“People are working in syndicates to achieve their aim which is one – to line their pockets in the name of patients who might have been victims in one way or the other.

“We are aware that these syndicates consist of lawyers and some within the health profession itself to make as much money from the state and other doctors as possible.

“We are aware that members of these syndicates in the various State Attorneys Offices are mismanaging cases deliberately so that the state must lose at all times.

“We are aware that some hospital chief executives are not doing anything to safeguard the welfare of patients but instead deliberately jeopardise the welfare of patients and immediately report to the legal members [lawyers] of these syndicates to start litigation,” said Motsoaledi, adding the he would like to see a chief executive of a hospital arrested for these actions.

He said the outcome of the summit, together with the outcome on the White Paper on the National Health Insurance scheme and the outcome of Chief Justice Mogoeng Mogoeng’s inquiry into the costs of healthcare, would set the tone on the direction the country’s healthcare system will take.

“In fact these three issues ... are going to change the health system as we know it today and this all depends on how everyone reacts to the outcome. Unfortunately the change they might bring may be either positive or negative, depending on our attitudes as South Africans,” said Motsoaledi.

The four medical specialities that are targeted the most are obstetrics and gynaecology, neurosurgery, neonatology and orthopaedics.

Dr Graham Howarth from the Medical Profession Society, which offers indemnity insurance for medical professionals, said the annual subscriptions members paid were high and would continue to increase as the amount of claims and claims lodged in medical negligence lawsuits increased.

According to Howarth, obstetricians pay R187 000 a year to get indemnity cover against lawsuits.

Howarth said the largest individual settlements paid by the Medical Profession Society were R6 million in 2003, R14 million in 2008 and R33 million in 2013, and the group was currently defending claims worth R10 million, R17 million and R80 million each.

“We are seeing more and more obscene claims,” said Howarth.

Professor Ames Dhai from the Steve Biko Centre for Bioethics said the major reason patients lodged claims was found to be a lack of communication by doctors and nurses with their patients.

She quoted a recent study by the Medical Profession Society that found that 70% of all claims in 2013 were caused by a lack of communication.

Dhai said the problem was compounded by healthcare practitioners who work under stressful conditions.

She cited poor working conditions, lack of resources and staff, low salaries and inadequate security at healthcare facilities as contributing to their stress levels.

“But over the past few decades we’ve seen a gradual decline in health workers caring for their patients. Over the few decades there’s been a change in attitude in practitioners and patients. A huge concern is practitioners who are losing that human touch of putting patients first and caring for them.

There are negative attitudes and health practitioners don’t have time and they don’t understand the process of communication.

“Practitioners are also abusing their roles. Among patients in general, there’s a sense that they are not being cared for. But research shows that patients are less likely to sue if they feel the doctor has communicated to them in a caring manner,” said Dhai.

Motsoaledi said he would soon advertise the post for the country’s first health ombudsman to enforce patient safety and welfare at all healthcare institutions.

The summit, which is being attended by provincial MECs, lawyers, doctors and health sector unions, will conclude its workshop tomorrow with recommendations on how to turn around the sky-rocketing medical negligence claims situation.

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