The national health department has taken nearly a year to set up teams of experts to help provincial health departments manage soaring claims  for medical negligence that are placing increasing strain on provincial budgets.

Provincial health departments are grappling with the rapid rise in medical negligence claims, from R28.61bn in 2014-2015 to R80.4bn in 2017-2018, according to figures obtained by Business Day.

While actual payouts are far smaller they more than doubled year on year to reach R2.75bn in 2017-2018. These amounts are not budgeted for, and provincial health departments have to cut services to fulfill their obligations to successful claimants.

Provincial health departments desperately need help to deal with their caseload: they face a backlog of 14,000 medical negligence claims, according to a written response health minister Aaron Motsoaledi gave on Tuesday to questions posed by DA’s Willem Faber in the National Council of Provinces.

In response to questions from Business Day, the Treasury said one of the measures taken by the government to tackle the problem was to allocate R30m to the national health department’s budget over the three-year medium-term expenditure framework to set up expert teams to support the provinces. These teams would help provinces manage, negotiate and prepare for the defence of cases in court, the Treasury said.

However, these teams have yet to start work. 

The health department’s spokesperson, Popo Maja, said the tender specifications for the teams were changed, and the tender had to be advertised again, causing delays.  Altogether 52 bids were received, and five companies were preselected.

“It is important to understand the type of teams we are looking for. These will be multisectoral teams that will include clinicians, lawyers, researchers, investigators, analysts and mediators, as well as IT system specialists. The preselected companies were evaluated last week and those that have been found to be suitable will start work in February 2019,” he said.

The expert teams are just one aspect of the government’s attempts to rein in medical-negligence claims. Some provinces, including Mpumalanga, had contracted professional teams to help attorneys representing the state determine whether to mediate or litigate, according to the Treasury.  

The government also proposes legal reforms, set out in the State Liability Amendment Bill, replacing lump-sum settlements with smaller, scheduled payments. The Treasury said the bill was one aspect of possible legal reform.

“Potentially the most important legal reform in the longer term might be to introduce some form of mandatory mediation or arbitration before going to court or to an alternative administrative review,” said the Treasury.

“There is also a strong case for standardising compensation amounts, instead of the courts determining compensation on a case-by-case basis. This is likely to be more equitable and transparent,” it said.