The Eastern Cape Health Department claims to be instituting “extraordinary interventions” to limit the R30bn contingent liability it’s facing from negligence claims, and taking several “special measures” to tackle the decades-old crisis.
The Auditor-General’s office told Parliament last week that the Eastern Cape was one of eight provinces that had not yet fully implemented a mandatory case management system designed to help provincial Health Departments defend themselves against financially devastating negligence claims.
However, provincial health spokesperson Mkhululi Ndamase said the steps being taken by the department and its multi-pronged approach would stem the tide of the multimillion-rand court-ordered negligence payouts, reports Daily Dispatch.
He admitted that the department’s contingent liability still stood at about R30bn as a result of the cases.
Provincial Treasury head Daluhlanga Majeke predicted in 2021 that the debacle would cause the department’s collapse and heap more financial misery on the already overburdened Treasury.
Many of the cases involve babies born with lifelong disabilities, including cerebral palsy, due to medical negligence during childbirth.
The department’s strategy includes preventing future cases through better and safer healthcare, deploying a tactical and co-ordinated legal defence strategy with medico-legal cases, some of which are fraudulent, and strengthening the chaotic administration of medico-legal matters.
It will require ambitious investment in “clinical, administrative and forensic” interventions, as well as a sustained bid to generally improve healthcare in the province.
These include:
• Revising standard operating procedures and referral patterns, and improving EMS capability;
• Filling of critical vacancies;
• Training clinicians and nurses on medico-legal risk identification and management, with a focus on how to avoid medical negligence;
• Addressing record management challenges through placement of additional human resources in “highly litigated facilities”; and
• Mobilising the province’s medical specialists as an internal resource to provide expert advice and identify opportunities to promote safer and better care.
Ndamase said the provincial government had already established a specialised litigation unit under the Office of the Premier and procured an additional legal panel to “supplement” the state attorney’s office to address the deluge of negligence claims.
The department was also already rolling out its in-house health management system, known as HMS².
“This is an electronic medical record system aimed at recording the patient’s journey from point of registration to discharge. The system is already operational at 10 hospitals and will be implemented in our 28 most litigated facilities over the next three years.”
He said the HMS² would, in the long run, save time and money and improve the turnaround time for services.
Ndamase did not indicate if this were the same as the case management system mandated by the national department.
He said all of these measures had already started to benefit the province, with medical claims decreasing “year on year” after peaking a few years ago.
A health specialist with the Auditor-General’s office, Clothilde Oliphant, recently revealed to Parliament’s Portfolio Committee on Health that the Eastern Cape remained the worst provincial offender over the past financial year. In 2021/2022 alone, it had been hit with 4 443 new negligence claims, which accounted for almost 30% of the 15 148 claims lodged countrywide.
She said the government had spent R1.2m to roll out the case management system in all provinces, but only the Free State was actually using it.
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