Claims for medical negligence against the state have almost quadrupled over the past four years, rising to R104.5bn in 2018/19 from R28.6bn in 2014/15, writes MedicalBrief. Actual settlement payments made by provincial health departments increased apace, from R499m to R1.953bn.
The statistics, based on both published and unpublished data from the National Treasury, are contained in the latest edition of the SA Health Review. The review, published by the Health Systems Trust, writes that the trends place “a huge burden on the distressed health system, reducing financial resources available for health-service provision”.
Medical-negligence claims against the nine provinces rose steadily from R28.6bn in 2014/15, to R43.1bn in 2015/16, and then to R56.2bn in 2016/17 and R80.4bn in 2017/18, and then shot up 30% to R104.5bn in 2018/19.
In 2018/19, Eastern Cape and Gauteng contingent liabilities amounted to 56% of the R104.5bn, at R29.1 and R28.9bn respectively — year-on-year increases of 20% and 33%. KwaZulu-Natal was up 20% to R20.7bn. On smaller bases, Mpumalanga was up year-on-year by 35% to R10.1bn, Free State up 36% to R2.5bn and Northern Cape 52% to R2.4bn.
The Treasury analysis of negligence payment trends extended a couple of years further back, to 2012/13, and showed that claim disbursements had increased from R265m to R1.95bn in 2018/19. Over that period, Eastern Cape was up from R63m to R797m; Gauteng from R145m to R586m; KwaZulu-Natal from R21m to R439m; Mpumalanga R14m to R39m; and Western Cape from R7m to R62m.
“With the exception of Limpopo, there has been a massive increase in claims paid by provincial health departments. This means that the provincial health departments conceded the medico-legal claims for a range of reasons,” the review reports.
The review notes that the increased number of medico-legal claims and pay-outs are not limited to the public sector. “The private healthcare sector is also under pressure, with a sharp increase in insurance for private medical practitioners over the past few years.”
The national health department is concerned about the financial pressure that medical negligence pay-outs create for provincial health departments, and welcomes the 2019 Johannesburg High Court ruling, which paved the way for compensation in kind – such as the provision of services at a designated state facility – instead of a lump sum settlement for victims of medical negligence, national Health Department spokesperson, Popo Maja, said in a BusinessLive report.SA Health review chapter Full Business Day report