Gauteng’s medical payouts soar 36%

• Province’s health services hobbled by crises and corruption scandals

The scale of medical negligence claims paid out by the scandalridden Gauteng health department soared 36% in the past year, rising to R696m in 2023/24, from R512m the year before, according to figures provided to parliament by health minister Aaron Motsoaledi.

Gauteng is home to a quarter of SA’s population. It has four teaching hospitals that serve as referral sites for complex cases, but its public health services have been hobbled by continuing crises and corruption scandals.

As payouts for medical negligence claims are not budgeted for, they reduce the money available for essential supplies, medicines and equipment, and further limit the capacity of public hospitals and clinics to meet patients’ needs.

The health ombudsman criticised Gauteng’s health department last year for poor care provided by the Rahima Moosa Mother and Child Hospital. The department was taken to court in June for its failure to spend an extra R784m budget allocation set aside for tackling its cancer treatment backlog. Three years after whistle-blower Babita Deokoran exposed graft at Tembisa Hospital her murderers have yet to be brought to book.

Business Day’s analysis of the data provided by the minister to parliament in response to questions posed by EFF MP Vuyani Pambo shows Gauteng’s trajectory is in sharp contrast to most of the other provinces, which — with the exception of Limpopo and the Northern Cape — paid out less in medical negligence claims in 2023/24 than they did the year before.

Payouts fell 41% in KwaZuluNatal to R119m in the period, halved in Mpumalanga to R82.7m and dropped 27% in the Western Cape to R120m. Gauteng accounted for almost a third of the R7.6bn paid out to successful medical negligence claimants by all the provinces in the past five years, and accounted for almost half the R1.51bn paid out by provinces in 2023/24. Provincial health departments paid out altogether R1.57bn in 2022/23.

Pambo’s questions homed in on payouts to the legal fraternity, which is the focus of an investigation by the Special Investigating Unit (SIU).

Referring to a joint statement issued by the health department and the SIU in August, the minister said there was evidence of collusion between attorneys, touts, nurses and doctors in the public and private healthcare sectors, but not all fraudulent claims involved healthcare professionals.

The majority of the claims against the state are for birth

injuries such as cerebral palsy. President Cyril Ramaphosa issued a proclamation in 2022 authorising the SIU to investigate allegations of corruption, fraud and maladministration related to medico-legal claims within the public health sector.

This was triggered after the SIU uncovered extensive medico-legal fraud in Eastern Cape and Gauteng, centred on claims for cerebral palsy.

Provincial health departments paid out claims to 410 law firms in the past five years, said the minister. The largest amount was R465m, paid by the Eastern Cape to law firm Dayimani Sakhela, followed by R357m paid by the KwaZulu-Natal health department to Justice Reichlin Ramsamy Attorneys.

These payouts were for multiple claims over the fiveyear period, but no details were provided about the nature of the claims or size of individual payouts.

GAUTENG PAID OUT NEARLY A THIRD OF THE R7.6BN ALL PROVINCES PAID FOR MEDICAL NEGLIGENCE CLAIMS