Call to hold healthcare workers accountable for negligence claims

Opposition parties want Eastern Cape healthcare workers to be held accountable for the province’s ever-ballooning medico-legal claims, which may cost taxpayers R29bn by the time they are settled.

In most cases, pregnant women attending a clinic or hospital and experiencing a difficult labour have been on the receiving end of poorly performing doctors and nurses, leading to the birth of a child suffering from cerebral palsy.

It appears that little to no disciplinary action has been taken against any doctor or nurse employed by the department whose action or inaction led to a claim for damages.

Asked if he knew of any healthcare worker being held accountable for their negligence, UDM MPL Mncedisi Filtane said: “That is never done.”

Filtane was among MPLs on the legislature’s standing committee on public accounts who grilled health officials last week on a strategy document setting out how they were addressing negligence claims.

His assertion was echoed by DA MPL Jane Cowley, who said that, as far as she knew, in the two years she had been on the committee no doctor or nurse was disciplined for an act of negligence that led to the birth of a child with cerebral palsy.

Filtane said the health department continually failed “to do the right thing”.

Failure to perform clinical services and negligence were the two fundamental factors in the medico-legal claims.

A secondary factor was poor patient record management.

He said: “Sadly, the department’s strategy, while it identifies these weaknesses in its systems, only refers to training. It doesn’t state that the existing staff who, by the way, are the ones who have contributed to the existing claims, are the ones to be retrained. So we are likely to remain with some incapable staffers.”

He said unless there was close supervision of healthcare workers, “we are still likely to see more cases arising from negligence”.

Cowley said the department perennially failed to hold healthcare workers accountable, with “an appallingly low percentage” of staffers being held responsible for incurring wasteful expenditure.

The strategy document has again raised the prospect of specialist treatment and care for cerebral palsy babies being provided in dedicated health centres at Nelson Mandela Academic, Cecilia Makiwane, Dora Nginza, Frontier, St Elizabeth and Butterworth hospitals.

Department superintendentgeneral Thobile Mbengashe has previously shared with the Dispatch plans to have centralised resource centres to remove the need for huge damages payments intended for future care of these babies.

Bhisho is on record blaming unscrupulous lawyers who target the health department, allegedly sometimes colluding with staffers who steal documents for them, making it difficult for the state to defend some cases.

Former health MEC Dr Phumeza Dyantyi told the Dispatch in 2016 that plans were afoot for the digitalisation of patients records. Four years later, this has not happened.

According to the strategy document, “the recording of obstetric management is often very poor from most hospitals”. Such information includes poor or no foetal heart records, and the failure to record why delays in treatment may have been unavoidable.

Among the omissions of hospital staff was the “worrying” failure to comply with national guidelines on labour and delivery, delays in assisted delivery when this was required, and the failure to get early secondary opinions from referral doctors or hospitals.

Department officials failed to respond to further queries submitted on Wednesday.

Failure to perform clinical services and negligence were the two fundamental factors in the medico-legal claims