Mpumalanga faces negligence claims

Mpumalanga’s health department faces medical negligence claims of more than R7.6bn, of which more than 40% centre on children allegedly born with cerebral palsy.

Mpumalanga’s health department faces medical negligence claims of more than R7.6bn, of which more than 40% centre on children allegedly born with cerebral palsy, Parliament was told on Tuesday.

This figure represents more than half of its budget allocation for the 2018-19 fiscal year, which stands at R13.3bn.

The figures cast the spotlight on the province’s weak public health service, which has seen its institutional maternal mortality ratio deteriorate in the past four years from 108 per 100,000 live births in 2014-15 to 120 per 100,000 in 2017-18.

The mortality ratio is considered a key indicator of the strength of a health system.

In Italy it was four per 100,000 live births in 2015.

Parliament’s health portfolio committee has asked provincial health departments to report on the state of their hospital services. Last week Gauteng and Western Cape briefed MPs and both provinces highlighted the growing pressure they faced to provide service.

On Tuesday it was the turn of Mpumalanga and Eastern Cape.

Mpumalanga’s head of health, Savera Mohangi, said the province faced 158 medicolegal claims of R3.3bn, which related to obstetrics and gynaecology cases. “A single claim can cost between R12m and R40m,” she said. There were also many claims relating to orthopedic cases, partly because of the province’s shortage of orthopedic specialists, she said.

She told MPs that while there had been some improvements in care, such as better immunisation coverage, the provincial health department nevertheless faced huge challenges, which included a shortage of ambulances, an ageing fleet and staff shortages. This had led to a deterioration in the department’s emergency response time in the past three years. Only 71% of urban cases had been responded to within 15 minutes in 2017-18 compared with 75.5% in 2015-16.

In the same period the proportion of rural cases responded to within 40 minutes fell to 68%, from 71%.

Mpumalanga is not alone on huge medicolegal bills. The Eastern Cape faces claims of R24.3bn, according to documents presented to the committee. It has to date paid out R1.1bn and R433m in legal fees. Both provinces are attempting to use mediation to resolve claims more efficiently. Mohangi said seven cases, totalling almost R2bn had been finalised since mediation started in 2016-17.