Department of Health looks to new system to curb medico-legal claims

Published Aug 27, 2024

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Health Minister Dr Aaron Motsoaledi says they are exploring introducing a Scandinavian system as part of curbing fraudulent medico-legal claims in the country.

Motsoaledi told a national broadcaster that different systems were necessary as the Special Investigating Unit (SIU) probed medico-legal claims lodged against the Department of Health (DoH) across the country.

The SIU began their work in 2017, specifically looking into medico-legal claims by targeting provinces with the highest share of claims.

Motsoaledi revealed that more than R100 billion in medico-legal claims had been laid against provincial health departments in KwaZulu-Natal (R29bn), Gauteng (R24bn) and the Eastern Cape (R22.3bn). He said more than R30bn in claims is under investigation.

There are 2 440 claims in KZN in total and the SIU is currently investigating 713 of these claims which are worth R8bn alone, he said.

“We want to change the legal process where a lawyer represents a claimant because we believe that as long as there is an incentive to lawyers, we will have more cases of fraudulent claims.

“I can give an example of what is happening in Scandinavian countries, where instead of a shoot-out in court between lawyers, they put up a tribunal that consists of retired judges, retired nurses and advocates.”

Motsoaledi used the Road Accident Fund as an example and said a tribunal would decide on fair compensation, whereas lawyers benefit from the current system.

Professor Alex van den Heever from the University of the Witwatersrand said it was good that the department was trying to implement strategies to fight corruption.

“Corruption in the department is rife and we saw it in the previous administration. If the tribunal method will help to fight corruption, then more details must be shared.

“Corruption needs to be fully addressed so that our health system can fully function, you have fraudulent medico-legal claims because of corruption,” he said.

Dr Imran Keeka, DA spokesperson on health, said it is no surprise that KZN ranks among the provinces with the highest medico-legal claim contingent liability in the country.

“The reality is that we have a broken healthcare system and scapegoating unscrupulous legal practitioners and staff is cringe worthy.

“While the undoubted reality is that there is collusion, racketeering and unscrupulous behaviour, it is a slice of the pie.

“There are not enough ambulances, staff or medicines, resulting in delays in getting to patients and not providing the correct treatment certainly worsens people’s health while waiting.

“Not having proper record-keeping in place, lost files, illegible writing and of course people who make money from selling files to crooked legal practitioners, are all truths that form slices of the same pie,” said Keeka.

The Mercury