‘No private gynaecologists left by 2020’

Insurance costs forcing doctors out

MEDICAL negligence claims are forcing maternity doctors out of private practice – so much so that the gynaecologist society has warned there will not be any left in the private sector by 2020.

The SA Society of Obstetricians and Gynaecologists said about 50 obstetricians had quit this year, leaving about 450 in the private sector.

There are currently 140 000 babies delivered in private hospitals a year.

But the society is expecting between 50 to 100 obstetricians and gynaecologists to stop working in private practice next year because of the high insurance rates, which they say makes it impossible to stay in business.

“There are going to be about 200 to 350 obstetricians left next year,” Johan van Waart, head of the society, said.

“If things continue as they are, by 2020 we will not have a private-practice obstetrician in this country.”

Already there are no paediatric neurosurgeons left in private practice as it is too specialised and expensive to insure, leaving them working in the overburdened state sector.

Unlike doctors working in the state sector, private practitioners have to cover their own medical insurance.

This year, each obstetrician paid R650 000 in medical insurance and this is expected to reach between R850 000 and R1-million next year.

This is paid to the British non-profit organisation, the Medical Protection Society.

Because of the high rates, South African doctors were looking at a model of insuring themselves at cheaper rates, gynaecologist and society member Chris Archer said.

The insurance is used to cover any negligence claims against the doctor.

While no data on negligence cases in the private sector exists, the Department of Health owes at least R35-billion in claims since 2010, many of which relate to maternity negligence.

Payouts can be between R10-million and R21-million a claim.

Professor Ames Dhai, who is part of a team working on reducing medical negligence under instruction of Health Minister Aaron Motsoaledi, said the reason claims were so high was that the payouts covered the expected lifespan of the infant injured at birth into adulthood.

In addition, a child patient has 21 years in which to bring a claim against a doctor.

Another problem is the contingency law which sees lawyers take on cases for no charge but then claim 25% of the payout.

The society has approached Motsoaledi to intervene and asked him to:

ý Cap the amount to be paid out;.

ý Structure the payout so that it could be done monthly or annually;

ý Make lawyers liable for the legal costs if doctors are found not to have been negligent; and

ý Institute a mediation process before the claim goes to court.

Speaking to Times Media yesterday, Motsoaledi said medical litigation was out of control.

He said plans were under way to put a cap on the amount to be claimed.

But Dhai said this would be difficult legally.