High costs of indemnity leaves SA's obstetrics in crisis

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The fear of being sued for medical negligence and the high cost of indemnity cover from legal claims has resulted in a countrywide trend of obstetricians leaving the child delivery profession, reports the Sunday Tribune.

It notes that in the past six months, five obstetricians practising privately in the northern areas of Durban gave up the speciality in medicine. And, the report says, doctors believe the number leaving will be significantly higher, nationally, in 2017.

By the end of this year, the majority of South African obstetricians in private practise would have paid R650,000 for indemnity cover, as members of popular UK-based non-profit organisation Medical Protection Society (MPS). However, MPS’s fees for protection cover in 2017 is set to cost approximately R1m, paid in 10 monthly instalments.

The average cost of cover for obstetricians was almost R4,000 a year in 2000, Dr Siva Moodley, a council member of the Durban Obstetrics and Gynaecological Society is quoted in the report as saying. “Obstetrics is in a state of crisis. More doctors will leave this profession,” Moodley said.

He said that while experienced obstetricians were bowing out, at the same time, fewer registrars at universities were choosing obstetrics as their field of speciality. Moodley said he had heard rumours that 58 registrars had filled posts at the University of KwaZulu-Natal in 2014, but only 24 were specialising in obstetrics at present.

However, the report quotes UKZN’s executive director, Lesiba Sheshoka, as saying their numbers of registrar applications remained consistent.

The report says that Moodley claimed that lawyers were largely to blame for obstetrics becoming unpopular, as well as the sharp increase in insurance costs. “Medical malpractice is now the niche market lawyers are focused on because of the large lump sum payouts that could be collected. They offered to do legal work on a contingency basis and usually pocketed as much as a third of the payout.

He said the greater number of claims against obstetricians had caused the steep rise in indemnity costs. “Doctors can’t afford the cover that is why they prefer to specialise in other fields.’

The report quotes Dr Graham Howarth, head of MPS Africa, as saying that their tariff increases were justified. “As a responsible, not-for-profit organisation, we need to reflect the increasing cost of negligence claims in our membership subscriptions. The estimation of the long-term average claim frequency for doctors in 2015 is around 27% higher than in 2009. Our concern is that this trend may continue, with increasing claim sizes forcing us to raise subscription costs,” explained Howarth.

Full Sunday Tribune report

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