A groundbreaking ruling on medical negligence in South Africa has mandated hospitals to provide treatment instead of financial compensation to victims.
Introduction
In a significant legal development, an Eastern Cape court has issued a ruling directing that a young victim of medical malpractice receive comprehensive medical care at the state’s expense instead of a one-time compensation payment.
The decision, handed down by the Bisho High Court, represents a departure from the traditional approach of providing lump-sum settlements “once and for all” through a trust in medical negligence cases.
Judge Rob Griffiths’ ruling specifies that two hospitals in the Eastern Cape must offer the 11-year-old patient a range of specific medical services, surgeries, supplements, and equipment at no cost.
The Eastern Cape Department of Health has acknowledged the ruling as a potential shift away from the practice of making large lump-sum payments for future medical needs, paving the way for ongoing care without financial burdens.
“We are incredibly pleased with this positive outcome. The court’s judgment is a humbling validation, and we are committed to providing the necessary care to the patient,” stated Dr. Rolene Wagner, the provincial head of health.
Dr. Wagner emphasized the significant impact of this case on the department’s financial situation and its ability to deliver healthcare to all those reliant on the public sector.
The ruling has been warmly received by the province’s MEC for Health, Nomakhosazana Meth. She noted that while the department is responsible for addressing medical negligence cases, the new ruling will make it more challenging for “unscrupulous lawyers” to claim a disproportionate share of the compensation, thereby protecting litigants from being cheated.
According to reports, provincial health departments collectively paid R1.76 billion in medical negligence claims for the fiscal year ending in March 2021. The Eastern Cape province had the highest number of outstanding cases, potentially costing up to R4 billion in total.
Calculating Costs
The province’s health service faced a lawsuit from the child’s mother, who contended that negligence during his birth led to the development of cerebral palsy, intellectual impairment, and epilepsy.
Acknowledging negligence on the part of its staff, the department’s focus shifted to determining the most appropriate method for calculating damages to cover the child’s future medical requirements.
Judge Griffiths observed that courts typically award lump-sum payments in similar cases.
The plaintiffs sought damages amounting to R35 million, with approximately R2.78 million (equivalent to around 8.5% of the total award) allocated for the administration of a trust responsible for managing the patient’s healthcare needs.
The department had already resolved matters related to general damages and loss of earnings, agreeing to a settlement of R2.1 million. Additionally, they committed to paying R650,000 for an adapted vehicle to transport the child to the hospital.
The remaining issue focused solely on determining damages for the child’s future medical necessities. While the plaintiff advocated for a lump sum, the defense argued that two nearby public sector hospitals could adequately provide the required care. Moreover, if needed, the patient could be referred to the private healthcare sector.
In oral hearings between April and September last year, the court heard expert opinion for the defendants that the awarding of lump sums was causing health departments to run up large contingent liabilities. And “unreasonable” negligence payouts meant public hospitals were struggling to provide services to other patients.
The defence also argued that it was very difficult to predict a patient’s future medical needs. Once-off lump sums could not adapt to unpredictable health needs over time.
In addition, the defendants said that lawyers’ fees were eating into the damage payments.
On the other hand, the defense raised concerns about the ability of the public health sector to deliver the same standard of care that the plaintiff could receive in the private sector.
Griffiths ruled that the state must provide all future healthcare requirements for the 11-year-old, including physiotherapy, surgeries, consultations with neurologists, and other necessary treatments, free of charge.
By Jan Cronje
Reference:
Cronje, J. (no date) Landmark Medical negligence ruling orders SA hospitals to treat – not pay – victim, Business. Available at: https://www.news24.com/fin24/companies/landmark-medical-negligence-ruling-orders-sa-hospitals-to-treat-not-pay-victim-20230213 (Accessed: 15 March 2024).
