The Auditor-General has raised alarm bells over the ballooning medical claims against the Department of Health, saying this was unsustainable.
The AG’s office said the medical claims have now risen to R125 billion and the department was under severe pressure to pay out some of the claims.
Officials from the Office of the Auditor-General on Wednesday told members of the Select Committee on Appropriations in the National Council of Provinces that despite all measures taken to reduce medical claims for negligence, the number has increased.
Acting Business Leader in the AG’s office Thabelo Musisinyani said they started monitoring the issue of the claims a few years ago when they noticed large payouts made by the department.
Musisinyani said in 2018 the department had said it would reduce claims by 2024, but in fact the cases of negligence have risen sharply.
In the report that was tabled before the select committee, it was found that the claims have affected service delivery.
“As at the end of March 2022, there were 15,000 claims that had been lodged against the department and were valued at R125 billion. Ninety-six percent of the claims are attributed to medical legal claims. We also indicating that during the 2021/22 financial year the department paid just paid over R800 million towards medical claims.
“What is important here is that the majority of the provinces did not budget for claims. In some cases, additional funds were requested from relevant Treasury to cover these claims.”
The report also said the claims have had an impact on the provision of quality healthcare services.
“These medical claims have a negative impact on the funding of the public healthcare sector and ultimately on service delivery,” said the report.
Musisinyani said they were concerned about the fact that the situation has not improved.
The department is forced to divert funds meant for goods and services to pay claims.
Additionally, the report also found in some cases the provincial departments were in a shambles, as they did not have medical records to defend medical claims in court.
They instead choose to settle these cases out of court.
The provincial departments did not have a proper tracking system for some of the files of patients.
siyabonga.mkhwanazi@inl.co.za
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