Urgent action required to tackle 9 700 medico-legal cases and strengthen public health
3 October 2024
In light of the escalating medico-legal crisis affecting our healthcare system, the DA will write to the Chairperson of the Parliamentary Portfolio Committee on Health, Dr. Sibongiseni Dlomo, to request that the Western Cape’s medico-legal team present their proven approach to the committee.
In response to a written parliamentary question from the DA, Health Minister Dr. Aaron Motsoaledi revealed that there are currently 9 721 active medico-legal cases in the country, with nearly a third of them concentrated in the Eastern Cape (3 014).
KwaZulu-Natal, Limpopo, Gauteng, and Mpumalanga also face significant caseloads of 1 817, 1 553, 1 300, and 958 cases, respectively.
A DA report from March 2024 highlighted that between January 2020 and December 2023, medico-legal claims have cost the provinces a staggering R23.6 billion, with R1.3 billion spent on legal costs alone. The Auditor-General noted last September that the dramatic rise in claims is placing immense pressure on the public health sector, comprising 78% of the appropriation.
Should all 9 721 cases go to court, the financial implications could reach nearly R108.4 billion—an average of R11.1 million per claim. Alarmingly, five provinces currently lack any permanent clinical medico-legal advisors, despite evidence that the Western Cape's advisors have saved the Department of Health millions annually.
Dr. Motsoaledi has advocated for a Scandinavian-style no-fault mediation system as a solution to expedite case resolution and reduce costs. However, the necessary legislation has yet to be introduced to Parliament.
It’s essential to acknowledge that many current claims arise from a beleaguered public health service that demands significant and systematic reform. This transformation requires meritocratic leadership, sound management, and a cultural shift prioritising patient care. The time for action is now; it cannot be postponed in hopes of a miraculous fix through the National Health Insurance (NHI).
To address the overwhelming medico-legal caseload, the DA urges a broader adoption of the Western Cape’s successful model, where two permanent clinical advisors - medical doctors with legal expertise - have effectively collaborated with legal advisors in the Office of the Premier, saving the province millions.
Expanding the use of clinical advisors across all nine provinces could save billions in the coming years, allowing for increased investment in healthcare for the vulnerable.
Issued by Karl le Roux, DA Deputy Spokesperson on Health, 3 October 2024
