Medical claims probe almost done

Suspects will be arrested soon, says health department

A“HIGH-LEVEL” investigation into ballooning medicolegal claims against the provincial health department is close to finalisation.

As a result, roleplayers – including lawyers and health practitioners who were investigated for suspected collusion in stealing medical records in order to institute claims – will soon be arrested.

This was revealed by health department superintendent-general Dr Thobile Mbengashe yesterday.

His comments were relayed to the Daily Dispatch by departmental spokesman Sizwe Kupelo.

Kupelo, however, refused to divulge who was conducting the investigations or when the arrests would be executed.

He said they did not want to jeopardise the process.

This comes after provincial auditor(AG) Sithembele Pieters revealed in his latest report that the financial sustainability of the department was at risk as a result of the mountain of claims.

Pieters found that the claims were then standing at R16.7-billion.

The provincial health department, led by MEC Dr Phumza Dyantyi, revealed that in 2016-17 they had paid out over R224-million in medico-legal claims.

The department reported that the “scourge” of medico-legal claims “continued to place financial pressu on the department, which had to shell out a further R13.3-million to the state attorney who assisted in defending the department from numerous negligence claims made by patients or their relatives after death or permanent injury or disability.

In July Dyantyi said 151 out of a total of 155 medico-legal claims against her department in the past three financial years were settled. They won only four cases.

In his latest report tabled in the Bhisho legislature recently, the AG said no money was budgeted to settle the R16.7-billion health claims bill.

“The payments in respect of the contingent liability are unfunded and [paying them] may have a negative impact on the financial sustainability of the department,” the auditor-general said.

The department’s annual budget for 2016-17 financial year was R20billion, meaning a R16.7-billion negligence payout would eat 83.5% of budget.

In the department’s 2016-17 annual report, Mbengashe said they were focusing on improving clinical, administrative process and would be buying more equipment to monitor foetal distress.

They would also put in more resources to cope with the need to conduct Caesarean section surgery.

Security around patient records would be tightened up.

“Furthermore, a panel of medicolegal experts has now been appointed to assist with the defence of these cases in court,” he said.

A “consortium of lawyers” was appointed by the department recently “to assist with capacity in dealing with such cases which are currently over 500”.

He said 300 cases were referred to the consortium and that “of the 40 cases they have already dealt with so far, 26 were found to be duplicated as you will find four lawyers making a claim for one patient”.

“Those 26 cases have since been returned to the lawyers who instituted them as they did not meet the standards.

“This shows that there are a lot of fraudulent claims. Through this investigation, we will be targeting those hell-bent on milking the state as this not only affects the department, but the entire province,” said Mbengashe. —