In the past four years, the National Department of Health has coughed up R23.6bn in medico-legal claims countrywide, with all provinces seemingly unable to stem the unceasing tide of money due to claimants and their lawyers.
Thousands of lawsuits, costing the taxpayer billions, have been brought against the national and provincial Health Departments for gross negligence and misdiagnosis, many involving obstetrics and gynaecology, and infants left with cerebral palsy and women with medical complications after birth.
In the Western Cape, 270 claims were finalised at a cost of R501m between 2020 and 2023. Legal costs amounted to R34m in the province and R1.3bn nationally. Records show of 3 522 claims filed nationally, Limpopo had 903 claims and KwaZulu-Natal 779.
Statistics from the Eastern Cape were not available but officials say it often has the most medico-legal claims. KwaZulu-Natal paid out the most at R8.67bn, the Free State R2.48bn and Gauteng R1.89bn.
In terms of legal costs per province, Gauteng spent R634m, followed by KZN at R328m and Mpumalanga R224m.
Limpopo on thin ice
In Limpopo, the R10bn in medico-legal claims is likely to completely empty the department’s coffers and increase instability in an already precarious provincial system, say opposition parties.
Their comments were in response to a parliamentary revelation that the department had forked out R266.8m in medico-legal claims between January 2020 and December 2023, from 30 claims.
“Our total contingency liability for medico legal is standing at just more than R10bn out of 1 440 cases,” said spokesperson Neil Shikwambana.
The Citizen reports that the province has had an ongoing battle with medico-legal liabilities.
In February 2022, the Vhembe district had 500 cases amounting to R5.251bn, Capricorn district had 330 claims (R2.356bn), Mopani district had 322 cases (amounting to R2.683bn), Sekhukhune district had 305 cases – R3.006bn – and the Waterberg district had 118 cases, amounting to R766.053m.
Between 2014/15 and 2021/22, the department registered 1 773 cases and incurred liabilities of R8.4bn.
The Vhembe district still accounts for the highest number of cases at 594 and the highest medico-legal liabilities at R5bn.
Hospitals worsen
“The root causes of the litigation are critical staff shortages in high-risk areas, as well as clinical errors, poor quality healthcare, lack of professionalism, poor communication and staff attitude, lack of equipment, failure to obtain informed consent, missed diagnosis, failure to conduct basic investigations, and system errors, among others,” DA Limpopo provincial chair Lindy Wilson told The Citizen.
She said the rising number of claims the region proved that hospital conditions were continuing to deteriorate.
“Our health facilities are in an appalling state, and the hundreds of millions spent on medical negligence claims could instead be used to vastly improve the condition of these.”
She said the claims threatened to bankrupt and collapse the health system.
Seun Mogotji, general secretary for the Bolsheviks party in Limpopo, said the department would continue to bleed millions in medico-legal claims until the leadership took charge.
“Serious action is needed …Not tomorrow, not next week, or after the May elections, but now.”
In the Western Cape, 270 claims have been paid with a R501m price tag and R34m for legal costs.
In one case, a 16-year-old girl and her family from Saldanha are seeking damages totalling R9 749 465, claiming she had lost significant hearing, had had to be taught sign language, and will wear a hearing aid for the rest of her life.
Another claimant is Kader September (48) from Elsies River, who became a paraplegic in 2013 and is asking the Health Department for R10 860 000 in damages. His legal team claims inadequate post-operative treatment was to blame for him now being paralysed in his lower limbs and with lack of control over his bowels and urination.
Michele Clarke, DA health spokesperson, told Cape Argus that the R23.6bn was “a staggering figure” for medico-legal claims, “especially considering the widespread shortages of healthcare funding across our provinces.”
Dwayne Evans of the Western Cape Health Department said that between 1 January 2020, and 31 December 2023, 267 claims had been filed, with 124 being settled with a final court order. Legal costs amounted to R34m while claims totalled R501m.
Cape Argus PressReader article – Medical payouts soar (Open access)
The Citizen article – Limpopo health department faces R10bn medico-legal woes (Open access)
See more from MedicalBrief archives:
Limpopo Health has lion’s share of province’s R7.6bn in legal claims
Eastern Cape Health: R920m in negligence payouts and R4bn in unpaid bills
State hospitals owe R21bn in medical negligence claims
KZN High Court rejects 'payment in kind' for medical negligence