SA's shocking medical malpractice crisis

SA's shocking medical malpractice crisis
South Africa is experiencing an explosion in medical malpractice litigation in the public
and private sector, according to Health Minister Aaron Motsoaledi.
Litigation against healthcare providers has reached crisis levels causing practitioners to
shun medical specialities, including obstetrics and gynaecology, Health Minister Aaron
Motsoaledi said on Monday.
"The nature of the crisis is that our country is experiencing a very sharp increase -
actually an explosion in medical malpractice litigation - which is not in keeping with
generally known trends of negligence or malpractice," Motsoaledi said in Pretoria.
"The cost of medical malpractice claims has skyrocketed and the number of claims
increased substantially."
Addressing a medico-legal summit in Pretoria, Motsoaledi said when the trend was
initially observed, doctors in public service were blamed for rendering shoddy service.
"Let me make it very clear, the crisis we are faced with is not a crisis of public
healthcare. It is a crisis faced by everybody in the healthcare profession - public and
private. It does not matter where you are," said Motsoaledi.
Specific medical specialities were targeted.
"There are four medical specialities that are continually, persistently, and mercilessly
being targeted for litigation," said Motsoaledi.
"These are obstetrics and gynaecology, neurosurgery, neonatology, and orthopaedics."
He said the trend was significantly detrimental to the healthcare system.
Motsoaledi said the cost of indemnity insurance for private specialists in neurosurgery
has increased by "a whopping 573%" within a period of eight years between 2005 and
2013.
"The cost of indemnity insurance for private specialists in obstetrics increased by 382%
within a similar period and still growing. All these issues have devastating
consequences to the healthcare system of a country," he said.
Motsoaledi said young doctors were now reluctant to specialise in obstetrics and
gynaecology.
"Those who are too old to change are resorting to procrastinating gynaecology and
refuse to see the woman once she falls pregnant," he said.

Motsoaledi said lawyers leading the litigation against medical practitioners were not
doing it for the love of patients.
"They are driven by this pocket-lining phenomenon. They are simply in hospitals
because the platform from which they have been lining their pockets, and not that of the
wronged patients, has now changed."
"Yes, the RAF [Road Accident Fund] has changed. It has been bankrupted by this
pocket-lining behaviour," said Motsoaledi.
He said numerous countries had faced similar problems.
"It is the same crisis that occurred in the United States in the early 1970s which was
described as a crisis of insurance availability as many insurers exited," he said.
"The second [crisis] in the mid-1980s was a crisis of affordability with price hikes that
meant doctors found they could not afford to pay for cover."
He said the problem had also been experienced in the United Kingdom and Australia.
http://www.health24.com/News/Public-Health/SAs-shocking-medical-malpracticecrisis-20150309
Don't blame lawyers for medical malpractice suits – LSSA
The Law Society of SA (LSSA) has raised serious concern over what it describes as
'sweeping statements' by the Minister of Health, Dr Aaron Motsoaledi, and healthcare
organisations 'regarding the possible limitation of the right to fair compensation of
medical malpractice victims and the role of lawyers in these claims' notes Legalbrief.
In a statement yesterday, the LSSA said: ‘It cannot be that victims of medical
malpractice – who are often the poor and vulnerable – should be expected to have the
specialist knowledge, money or power to take on the state through an “administrative
process” if they have suffered life-changing and critical damage at the hands of the
healthcare system and healthcare practitioners. Such victims have the right to legal
representation and to be compensated
fairly for their losses.'
The LSSA co-chairpersons Max Boqwana and Ettienne Barnard say victims must have
'parity or arms' if they are to challenge the very institutions that caused their loss in the
first place. 'That is the duty of lawyers.' The LSSA leaders urged the Minister to focus
on addressing the dire skills shortages and poor conditions, as well as the duty of
care owed by healthcare professionals and medical facilities to patients, rather

than on removing the right to fair and legitimate compensation from victims of
malpractice.
They add: ‘Legal practitioners cannot “manufacture” malpractice injuries – these are
substantiated by experts. If there is alleged collusion between medical professionals and
legal practitioners as well as a downgrading of standards to create an opportunity for
collusion, this must be reported to the relevant statutory provincial law society and to
the law enforcement agencies. If attorneys are found to be over-reaching or overcharging,
the law societies have assessment committees that investigate the allegations
and assess the fees charged. This is regarded as serious misconduct by the profession
and by the courts.’
Lawyers pointed out the Health Department was in an abysmal state.
‘The entire system is riddled with corruption and maladministration and he (the
Minister) then has the temerity to blame the legal profession for his woes,’ Andre Calitz,
chief operating officer for Joseph’s Inc, which is the largest medical malpractice law
firm in SA, is quoted as
saying in a report on the Health24 site. Calitz said a major problem in the Health
Department is not having a budget for malpractice judgments. He said this meant
that funds had to be taken out of the budgets of hospitals and clinics which led to a
shortage of money for drugs and other essentials services. DA health spokesperson,
Jack Bloom also took a swipe at Motsoaledi. He said the Minister must focus at fixing
the ailing health system, which was in crisis, rather than blame the legal profession.
‘Medical malpractice lawyers render an invaluable service, especially to poor people
who do not have the resources to pursue legal action against medical professionals who
have harmed them.’ Bloom said by criticising attorneys, Motsoaledi is also blaming the
courts for not acting in an ethical manner because all the cases had been adjudicated by
the courts.
legalbrief.co.za/diary/legalbrief...lawyers...medical-malpractice.../pdf

Gauteng medical negligence claims up
Gauteng pays R276m for medical negligence
Gauteng health dept pays R7.5m for negligence
Gauteng dept tackles health issues
Johannesburg - Claims lodged against the Gauteng health department due to medical negligence
were increasing, the department said on Tuesday.
"The reasons for such an increase in the number of claims are numerous and include - an
increased awareness of rights by patients, a worldwide trend, better litigations, a legal profession
that is actively touting patients in hospital wards and a concerning culture of unprofessional
conduct that seems to be on the rise," the department said. The department was concerned by the
increasing number of payouts, and would investigate together with the Health Professions Council
of South Africa (HPCSA).
"Given that these happen while people are performing their duties, the employer is one to respond.
There are various interventions that are in place in all our facilities," the department said.The cases
took a period of more than a year, and it was difficult to determine how much the department has
paid until court judgments were available.
"The department waits for the matters to be put on the court's roll and for all the necessary
processes to be followed before it is informed if or how much should be paid out."
http://www.news24.com/SouthAfrica/News/Gauteng-medical-negligence-claims-up-
20150304
Hospital horrors costing SA plenty
A child's penis was amputated by mistake. Babies are born brain-damaged after their
mothers are not properly cared for during labour and an infant went blind after doctors
failed to diagnose a problem at birth.

These are examples of the medical negligence that is costing provincial health
departments millions in malpractice claims.
Cases of medical negligence are increasing nationwide:
The Gauteng health department is facing negligence claims amounting to R1.28-billion
for the 2012/2013 financial year. In 2005, the department expressed concern about
complaints of malpractice, which had led to lawsuits of R216-million in the previous
five years.
Eastern Cape faced claims of R876-million last year, up from R4.5-million in 2006.
North West paid out R13.3-million in November for negligence at a state hospital in
Witbank that resulted in a baby becoming blinded. Medical negligence attorney Adele
van der Walt said she was contacted daily by people from across the country who had
suffered negligence at both private and government hospitals.
The most common complaint, say lawyers, is about babies born with cerebral palsy, a
form of brain damage that often occurs when mothers have difficulty giving birth.
Some 68 of the 86 claims against Chris Hani-Baragwanath Hospital in Soweto are for
babies who have cerebral palsy.
DA Gauteng health spokesman Jack Bloom said the provincial department should
prevent lengthy and costly legal battles by settling cases in which its hospitals were
clearly in the wrong.
He said judges were awarding much higher amounts to victims than six years ago.
Lawyer Karen Vermaak said babies suffered brain damage because of poor monitoring
of women in labour. If nurses did not detect a baby was in distress and react fast enough,
the infant was deprived of oxygen.
Much negligence in both the private and public sectors was caused by nurses' poor
training and attitudes.
Van der Walt said under-qualified nurses were working in intensive care units in private
hospitals. "Sometimes there is only one specialised nurse monitoring four babies,
instead of one."
Van der Walt was approached this week by a woman who had given birth in a private
hospital in Gauteng a month ago. "The patient had told the nurse: 'My water broke. I
am in labour.' The nurse would not help her despite the mother insisting she was having
contractions. Eventually she stood up and the baby fell onto the floor, hitting his head.
It is too early to determine whether there is brain damage."
The spokesman for the Gauteng health department, Simon Zwane, said: "Considering
the number of 200000 babies born in the province annually, the number of claims
arising on what is alleged to be negligent behaviour is minimal."

He said: "The department admits that hospitals should be places of healing, hence
quality assurance measures have been instituted and more nurses were trained,
especially midwives and neonatologists."
Malpractice cases include misdiagnoses, the supply of the wrong medication, surgical
swabs or instruments left in people during surgery, and hip replacements that are not
done properly.
Health Minister Aaron Motsoaledi has set up a team to investigate the increasing
number of medical negligence cases. He has suggested a cap on payouts to help health
departments avoid bankruptcy.
The minister's spokesman, Joe Maila, said Motsoaledi was determined to solve the
problem.
Van der Walt said: "There were a number of changes in the law that led to the higher
incidence of malpractice. Changes to the Road Accident Fund in 2008 resulted in less
work for personal-injury lawyers. This means they have moved into medical
malpractice."
A Constitutional Court ruling in 2008 that allowed lawyers to attach assets of the state
if it failed to pay has also led to more lawyers suing the state.
Lawyer Gary Austin said payment for nearly every case he won against the Gauteng
health department was delayed so after a month he issued a warrant of execution
showing his intention to attach assets of the state.
The growth in negligence claims has led to an increase in the cost of insurance for
doctors. A gynaecologist can pay as much as R300000 a year, leading to higher costs
for patients and making work as a gynaecologist unsustainable.
Motsoaledi has complained about a shortage of gynaecologists and the SA Private
Practitioners' Forum has warned the shortage is becoming severe.
http://www.timeslive.co.za/news/2014/01/17/hospital-horrors-costing-sa-plenty
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