Health considers fund to deal with medical claims

Health considers fund to deal with medical claims


Cape Town – The Health Department is mooting a fund that will deal with the medical claims that are forever ballooning in all the nine provinces.

This was revealed by Health Minister Zweli Mkhize when he briefed the health portfolio committee this week.

The matter was brought up by Freedom Front Plus leader Philip van Staden when he asked what the department was doing to eradicate the problem of medical claims in the Eastern Cape.

The National Treasury revealed in the budget this year that medical claims rose from R97 billion in the 2018/19 financial year to R111bn in the 2019/20 period.

Addressing MPs, Mkhize said the issue of medical claims was a problem not only in the Eastern Cape but in the entire country.

“We are working out a mechanism on how to deal with litigation in general. Actually, we are looking at a future just like other countries to start developing a compensation system that will be able help us to deal with medical claims,” he said.

The minister also said he has had a long discussion with the Eastern Cape.

He said, however, the issue of medical claims was a major problem for the whole country.

“No province can deal with it alone. We all have to deal with it.”

Mkhize also said a fund similar to the newly-formed No Fault Compensation Fund for Covid-19 vaccination would be set up to take care of the medical claims.

“We can budget for it and cap it at a particular level. Right now medical legal costs are a runaway horse that no one can control,” he said.

There was a lot of exploitation of government resources, which has to stop at a certain point, the minister said.

“The only way we can do is to actually create a framework which allows us to curb the cost and expenditure and make sure there is an easier way for people to get protection in cases of mismanagement, negligence or any kind of problems.

“If they suffer any harm, they can go through that process without having to face exorbitant charges by lawyers and a lot of extortion that we see happening to this fund. This is something the government really must reign in and stop.”

Mkhize said the medical claims bill was way above what the government could afford and was causing a huge dent to the service.

“Nevertheless, because it goes through the courts and you can’t do much. Quite often the problem has to do with the fact that records are lost and a doctor who was there is no longer in the area so nobody remembers what happened.

“All of those things are things that can be cured and sorted out. We are to work on that and make sure it does not become a problem.”

In its 2019/20 annual report, the department said six provincial departments were not implementing the claim management system to manage medico-legal claims.

This prompted the health portfolio to recommend last December that the department should reduce the number of medico-legal cases and costs.

It also said the department should ensure there was appropriate and adequate professional staffing in health establishments.

“National and provincial treasuries should assist provincial departments in dealing with accruals and medico-legal claims which are depleting departments’ budgets,” the committee said in the December 2020 report.

Political Bureau

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