Minister Aaron Motsoaledi: SIU investigation into medico-legal claims

My Colleague Deputy Minister Joe Phaahla
MECs present
Head of the SIU Adv Andy Mothibi
Members of the Media
Greetings.

We called this media briefing to provide a progress report on the ongoing investigations by the Special Investigating Unit (SIU) into medico-legal claims made against the Department of Health across the country.

Just to provide a background, around 2015 the Health Sector experienced an explosion of medical practice litigation cases directed against health institutions as well as individual medical practitioners in both the public and private practice.

This explosion happens to have coincided with the Road Accident Fund (RAF) strengthening its systems. It is common cause that RAF had been hollowed out by a multiplicity of claims that brought it down to its knees.

In the aftermath legal practitioners who used to litigate against RAF seem to have migrated en masse to the Healthcare Sector. In response, the Department of Health convened a medico-legal claim Summit in 2015.

The following is the summary of the background of the Summit:
• It was attended by various stakeholders including representatives from both the public and private healthcare sectors, the legal profession itself and other health experts.

Over and above the RAF migration phenomenon mentioned above, delegates deliberated on contributing factors and/or other reasons for the escalation of medico-legal claims, and identified
possible solutions.

The possible solutions were classified in three (3) broad areas:
(i) Patient safety:
It was recognised that adverse events do happen in health facilities and practices the world over, on the one hand. On the other hand incidences of negligence, malpractice or unethical behaviour by health practitioners do also occur.

The Summit then focused on the plans to reduce these incidences.

(ii) Administrative solutions:
This entails proper keeping of good medical records, minimising theft of medical records and proper communication with patients and members of the public.

(iii) Legal solutions:
This entails looking at various legal interventions even before matters went to court. This includes but not limited to mediations, possible review of contingency fees and staggered payment to claimants.

However, the Department of Health noticed several claims which were completely out of synch and made no sense at all. There were claims that were evidently fraudulent.

Just as an example, a claim was submitted in which the claimant demanded R70 million for a supposedly botched circumcision by a doctor in a hospital in Limpopo Province. On investigation of this claim, it was found out that no such circumcision was ever performed. It was found that the patient was actually treated for a very serious genital infection. The hospital actually saved his life.

The SIU was then called in to look into these very suspicious claims. In 2017, the SIU started their work by targeting provinces with the highest share of claims.