Only one province – the Free State – is using a case management system designed to help provincial Health Departments defend themselves against potentially crippling medical negligence claims, a situation verging on fruitless and wasteful expenditure, the Auditor-General told Parliament this week.
While only a fraction of the legal claims levelled against provincial Health Departments are paid out, the sums the government hands over to victims of medical negligence are nevertheless significant, reports BusinessLIVE. The case management system is one of several government efforts to rein in spending on medico-legal claims, and should have delivered quick improvements while other processes unfold.
The government has spent R1.2m on the system for all provinces, but only four have imported data into the system and the Free State is the sole province that is using it.
The Health Department’s 2021/2022 performance plan says the scheme should have been implemented in at least seven provinces by the end of March.
The AG also highlighted the department’s irregular expenditure of R1.3bn the past financial year – an increase of 42% from the year before.
To put that into perspective: according to the department’s annual report, the total expenditure for employee compensation in 2021/22 was R848m. That means the department could have completely eradicated the personnel shortages if it simply rooted out corruption and implemented effective monitoring systems, said Michele Clarke, DA Shadow Minister of Health, in a statement.
She said by far most of the wasted money was due to a variety of issues pertaining to the non-compliance of procurement processes, supply-chain management (SCM) prescripts and contract monitoring controls.
The AG also highlighted the lack of consequence management within the Department and its entities, which are unable to properly manage projects in a legally compliant way and when the projects inevitably cross into dodgy territory, the officials responsible are not held accountable, she pointed out.
Clarke added that the public health sector had steadily declined – infrastructure is not maintained or updated, equipment is outdated or broken, severe staff shortages continues to persist despite annual empty promises, and corruption thrive. When these issues are raised, whistleblowers are callously persecuted and some pay with their lives, like Babita Deokaran.
The AG’s report, she said, is the clearest indication yet that if the NHI were to be implemented, it would lead to a total systematic collapse of the health system and a human rights crisis.
Dodgy claims
In a separate process, the SA Law Reform Commission is considering public comments in response to a discussion paper released last November recommending the replacement of lump-sum settlements with a structured schedule of annual payments.
The government will then draft legislation updating the 2018 State Liability Amendment Bill, which was rejected by Parliament’s Justice Committee this year.
At the same time the Special Investigating Unit (SIU) is investigating dubious claims in a probe authorised by President Cyril Ramaphosa in July.
Contingent liabilities for medico-legal claims stood at R120.3bn in the 2021/2022 fiscal year, constituting 96% of the total R125.3bn in legal claims levelled against provincial health departments.
A total of 15 148 claims were lodged against provincial Health Departments in 2021/2022, with the Eastern Cape leading the way with 4 443 claims against its health department, followed by Gauteng (3 783) and KwaZulu-Natal (2 915).
Most claims are for severe birth injuries like cerebral palsy.
See more from MedicalBrief archives:
SA’s medical negligence Bill ‘unfair’ and ‘endangers patients’
‘Oversight failures and greed’ drive SA’s medical litigation explosion
What needs to be done to reduce rising medico-legal claims
Phaahla vows to close loopholes, end medico-legal claims