Gauteng's R18bn medical liability headache

2018-03-25 06:00
There were many health news events in 2017.

There were many health news events in 2017.

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It is the flesh-eating thorn in the Gauteng department of health’s backside – and an estimated R18bn headache its new legal head has to find her way around.

At the time advocate Mpelegeng Lebeloane was appointed in January there were about 2 317 cases against the department with a contingency liability of R21bn – R18bn of which was for medical negligence.

Fortunately for the department, the biggest bill incurred after that – damages relating to the Life Esidimeni transfers of 1 700 patients to community nongovernmental organisations between 2015 and 2016 – will not be theirs to pick up.

This week retired Deputy Chief Justice Dikgang Moseneke awarded a R1.2m payout for each of the 135 claimants affected by the Life Esidimeni tragedy.

Gauteng government spokesperson Thabo Masebe said: “The MEC for finance will make an allocation to the office of the premier. I’m not in a position to say where the money will come from but it won’t be coming from health’s budget. Obviously an adjustment will have to be made but the premier has committed to paying the money.”

Last year the department was dealt its worst blow when ordered to pay about R30m for a cerebral palsy claim that reached the Constitutional Court. There have been 10 more new claims this year alone.

About her plan to tackle the department’s medico-legal crisis, Lebeloane told City Press: “My initial thoughts were that these cases are too many and quantum amounts claimed are very high. If something drastic was not done immediately, these claims would render the department unable to perform its mandate.”

Since the start of the 2017/18 financial year, the department has paid out over R400m in medical negligence cases – most of which are for maternal, neonatal and surgical negligence.

“Cerebral palsy has the highest claims by far with a total of 50%,” she said.

“This should also be taken in the context that more than 23 million patient visits have been recorded across the department’s health facilities, ambulance services and health programmes in the past financial year,” Lebeloane said.

She attributed the spike in claims to a greater awareness from the public around litigation and their rights as patients, but also to an increase in “touting” by some lawyers who collaborate with department employees.

The sheriff of the court has been a frequent visitor to the department in the past year, attaching 14 bank accounts and furniture to try to recoup money owed to suppliers and for payments of negligence cases.

“This certainly affected the morale of staff because in certain instances, the sheriff attached laptops, computers, photocopiers and chairs, and staff were left with no tools of trade to do their work,” she said.

Lebeloane said she is going to start trying to turn the department’s medical negligence woes around by first holding workshops with hospitals, clinics, state attorneys and medical experts in their internal and external advisory councils, as well as collaborating with hospital chief executives and clinic managers to focus on finding solutions and reducing the incidence of negligence.

“We’ve increased attention on preventing claims reaching litigation by dealing decisively with letters of demand to ensure they do not escalate into litigation; as well as engaging families where serious adverse events have occurred and resolve matters as speedily as possible,” she said.

“Where definite harm has occurred, we’re using mediation to mediate matters.”

The department said it was also working to identify “fraudulent and unpatriotic” legal firms that were “preying” on loopholes in the system to lodge false claims.

“Obviously, the department has been affected in a very negative way by having to pay exorbitant claims and court orders and has had to use money for patient safety to satisfy the judgment orders.

“The situation is not sustainable as it opens the department to more litigation.”

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