Skyrocketing medico-legal claims threaten to cripple SA’s public and private health sectors as specialists face exorbitant litigation. Without drastic intervention, experts warn, healthcare could soon become unaffordable – or unavailable. Meanwhile, legal experts say mediation could be a solution hiding in plain sight, notes a Bhekisisa report.

‘Something’s got to give,’ says David Campbell, MD at medical indemnity insurance company MPLA. He says SA’s laws allow for medico-legal claims to haunt health workers up to 19 years after an incident. The possibility that healthcare workers will have to pay for mistakes made years ago is forcing insurance companies to increase medical indemnity rates radically, he says.

Bhekisisa previously reported that in 2009 obstetricians and gynaecologists paid R78 000 for insurance.

In 2017, the Medical Protection Society’s insurance costs around R800 000 – an increase of 925%.

Campbell explains: ‘High-risk specialists like obstetricians and neurosurgeons will either become unaffordable or unavailable. Obstetricians are already leaving the field – and rightfully so. A 50-year-old obstetrician would be right to worry about a summons of however many zeros arriving at their door at age 69.’

President of medical professional body, the SA Society of Obstetricians and Gynaecologists, Johannes van Waat says the organisation’s records show about 50 obstetricians left the field in 2016 – almost 7% of their members. He says the society expects to lose 100 more this year if the litigious trend persists.

The Health Department, legal experts and professional bodies are waking up to the benefits of mediation before litigation, says the Bhekisisa report. Mediation starts with accepting that something went wrong, says Health Minister Aaron Motsoaledi. ‘But instead of fighting in court, let's sit down and talk about what you as a patient will regard as justice.’ He says the Health Department has requested the SA Law Reform Commission(SALRC) to provide legislation that mediation will precede any litigation against the state.

Researcher at the SALRC Ronel van Zyl confirmed receipt of a joint request from the departments of Health and Justice. Van Zyl says the commission will release issue papers on the application towards the end of the month. Van Waat says the body strongly supports mediation. He says the prospect of mediation has already enticed some of his members to stay in the field: ‘We are closer to a solution than we’ve ever been. Since mediation has come onto the scene, a number of obstetricians are hanging around to see what happens.’

Full Bhekisisa report