R23.6 billion paid in medical legal claims from 2020 to date – a red herring for NHI

12 March 2024

In response to a parliamentary question, the DA can reveal that R23.6 billion has been paid in medico-legal claims across our provinces from January 2020 to December 2023. Further, R1.3 billion has been spent in legal costs for these cases. This figure is staggering, especially considering the widespread shortages of healthcare funding across our provinces and bodes terribly for the ANC’s National Health Insurance (NHI) pipedream.

A total of 3 522 claims were filed, with sadly, our poorer, more rural provinces taking the lion’s share. Notably, Limpopo alone had a quarter (903) of claims filed, followed by KwaZulu-Natal with over a fifth (779).

Also notable is the omission of the Eastern Cape’s figures, as the province is still verifying its figures, but it is without doubt that the province will continue to have the highest claims filed, the highest legal costs and highest claims paid.

Broken down in claims paid per province, KwaZulu-Natal has paid the most, with an eye-watering R8.67 billion paid. KZN is followed by the Free State, with R2.48 billion, and Gauteng with R1.89 billion. Broken down in legal costs per province, Gauteng spent the most, with R634 million, followed by KZN and Mpumalanga which spent R328 million and R224 million respectively.

In 2022, as medico-legal claim costs had already reached alarming figures, the Auditor-General (AG) warned the National Department of Health, as these figures were significantly taking away from the provision of basic health services. Further, the figures were being exacerbated by fraud, incompetence, and the lack of an electronic case management system (CMS) across the provinces. Despite the AG’s warning, medico-legal claims continue to escalate, while funding for health services continues to decrease.

At the start of this year, 800 unemployed doctors petitioned the Department for a job, and despite the Minister of Health, Dr Joe Phaahla’s promises that the National Budget would provide funding, his claims proved to be baseless. Vacancy rates remain high, while also overtime pay for medical personnel faces drastic cuts. While our healthcare system is already on its knees, there will be further staff shortages, particularly during night shifts, weekends, and public holidays – when casualties tend to increase.

Despite all of this, President Cyril Ramaphosa remains “looking for his pen” to sign the disastrous NHI Bill, which will only worsen our healthcare system. By pooling resources into an already dysfunctional healthcare sector, medical claims will only further increase, alongside fraud. While President Ramaphosa looks for his pen, he should also look over the National Budget, which lowered the provincial national health insurance grant by R239 billion.

The National Budget also shifted grants from their beloved NHI to public health oncology services, as the fiscus no longer has room for new funding for cancer treatments, while 10% of our country’s deaths are to cancer.

The ANC government is sadly focused on electioneering and politicking while the facts on the ground are damning, as South Africans suffer real life consequences from poor governance. It, however, does not have to be this way and change is possible.

Under a DA-led government, we will ensure quality access to healthcare for all South Africans, irrespective of economic circumstances.

We will achieve this by:

Leveraging the strengths of the private health care sector to partner with public health care;

Lowering private health care premiums and out of pocket costs;

Ensuring cheaper, more accessible prescription medicines;

Building the necessary health infrastructure, as well as hiring and training more personnel to deliver effective, quality services;

Ensuring that our healthcare system is administered independently and free from politicisation; and

Establishing watchdogs that supervise our healthcare system and report directly to Parliament.

This can only be achieved once the ANC is voted out of national office, and we are presented with that opportunity on May 29th. South Africans must choose a government that puts their health first.

Text of reply:

[1] Eastern Cape still verify the figures.

ENDS

Issued by Michele Clarke, DA Shadow Minister of Health, 12 March 2024