Medico-legal claims a high risk to healthcare: health minister Joe Phaahla

Health minister Dr Joe Phaahla says medical litigation is a major challenge in the department.

He was speaking at the presidential health summit in Ekurhuleni on Thursday.

“[The] pressure is on quality in hospitals due to high volumes and poor management. Medical litigation remains a high risk, we are working with provinces to have a co-ordinated response. Basic issues such as proper record keeping and preservation make a difference,” said Phaahla.

He was unpacking the “nine pillars” that are a high priority for the department.

“Develop capacity to resolve medico-legal disputes through alternative dispute resolution (ADR). Establish a task team of experts to develop a framework for voluntary alternative dispute resolution. Develop capacity for ADR,” said Phaahla.

Last year, the South African Law Reform Commission made a proposal to put brakes on spiralling negligence claims.

“It is crucial to cut down on litigation that consumes time and money,” the commission said.

The stakeholders had asked the commission to propose new laws because claims threatened to bankrupt provincial health departments.

Proposals to cut costs and keep a lid on frivolous and abandoned claims include:

• compulsory mediation before litigation can be launched;
• a requirement that a certificate of merit from an accredited medical practitioner accompany court papers;
• independent dispute resolution teams in each province to provide redress out of court;
• compulsory budgeting for legal costs and compensation payments; and
• a possible cap on damages.

“The overall budget allocation to the health sector has been reducing over the past few years, including this financial year.

“The 2018 summit identified areas needing attention to improve financial management, including supply chain management,” Phaahla said.

The management of personal protective equipment during 2020 exposed serious weakness leading to reputational damage, he said.

“A number of cases were investigated by the Special Investigating Unit, leading to disciplinary processes. Incidents of poor financial management are still occurring, leading to non-delivery of essential goods and services.”

An anti-corruption forum in the health sector was launched in 2019 but its affect still had to be felt, he said.

“The overall audit outcomes of the health sector showed slight improvement in 2022/2023. A lot still need to be done to improve quality of management, especially on health facilities.”

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