Our health department is sick

As a court reporter I see tragedies unfold just about every single day of my working life, but the biggest tragedy must surely be the increasing number of claims for botched births on which our provincial health departments spend staggering amounts every year.

The facts contained in court papers in these cases are cold and clinical, but they read like a horror story. Mothers are being left battling for hours or even days to give birth. Caesarian sections are either not performed at all or far too late. The oxygen levels of premature babies are not being properly monitored.

The results of these botched procedures are tragic not only for the babies who are left blind or severely brain damaged, but also for the mothers on whom the burden falls to care for their disabled children for the rest of their lives.

The amounts needed to take care of a disabled child are massive: nappies, feeding tubes, special apparatus, multiple medical procedures, various forms of therapy, special schooling and caregivers to name a few. And all this must be paid from the negligent hospital’s ordinary budget, taking away money urgently needed for better medical equipment.

In its 2017 report on medical-legal claims, the South African Law Commission expressed concern about the explosion in medical malpractice litigation, saying the impact of these claims was reaching dire proportions, especially in the public health sector, which services 80% of our population.

Although claims are instituted against the MEC for health in the province, the money to pay for the claims, which could run into millions of rands in each case, was in most instances derived from the budget of the hospital concerned.

The increase in claims means money has to be diverted from the delivery of healthcare services, which further reduces the funding for an already severely burdened system.

“The more damages paid, the less money is available for service delivery, the poorer the quality of the service rendered by the hospital, the more room for negligence and error, the more the claims,” the commission pointed out.

It described medical malpractice claims as a vicious circle which, if not urgently addressed, could cause the entire health system to implode.

Figures released by the minister of health paint a bleak picture of just how many claims are instituted against the health departments, with the vast majority being for botched births.

In 2014-15, more than R391 million was paid out for 1 562 medical-legal claims across all provinces, with Gauteng in the lead with payouts of more than R154 million. In 2015-16, over R730 million was paid out in 1 732 claims with Gauteng once again in the lead with payouts of over R433 million.

Payouts increased to R1.2 billion in 1 934 cases across all provinces in 2016-17 of which Gauteng hospitals paid out over R566.9 million. The amount so far paid out for 2017-18 already stands at R247 million.

It’s easy to blame lawyers for the increasing number of claims, but I believe the source of the problem should be tackled, which includes lack of supervision and accountability, under-staffing and, in many instances, lack of proper training.

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