Question NW3279 to the Minister of Health

Reply:

a) (i) According to the Gauteng Provincial Department of Health, the top 10 (Ten) healthcare facilities which account for the most specified claims are as follows:

Health facilities:

• Chris Hani Baragwanath Hospital
• Thelle Mogoerane Regional Hospital
• Tembisa Hospital
• Dr. George Mukhari Hospital
• Charlotte Maxeke Academic Hospital
• Sebokeng Hospital
• Rahima Moosa Mother and Child Hospital
• Bertha Gxowa Hospital
• Pholosong Hospital
• Mamelodi Hospital

(ii) According to the Gauteng Provincial Department of Health, the Department is taking the following steps to intervene in the Gauteng Healthcare facilities:

• The Department is conducting root cause analysis at clinical level of cases that result in medico-legal claims and adverse incidents and also working at eliminating the challenges at the root cause level i.e the shortage of staff & medical equipment, theatres and generally improved service delivery;

• Improving clinical care as part of the clinical risk management process, based on specific clinical audits of adverse events;

• Implementing intervention strategies with the CEO’s of the Hospitals and implementation of consequence management;

• Increasing in the number of Doctors to enhance the patient to Doctor ratio and improving midwifery training of nurses;

(b) It is difficult to say that the intervention steps have improved the situation as the Department is currently undertaking these interventions.

(c) (i) According to the Gauteng Provincial Department of Health, the majority are Cerebral Palsy.

(ii) According to the Gauteng Provincial Department of Health, these matters would be resolved by intervention from clinical services through an intensive training of the clinicians dealing with patients at the healthcare facilities.

It is critical to note that not all medico-legal cases that have been laid against Provincial Departments are as the result of negligence as some are fraudulent.

The following are clinical interventions coordinated from the national level as the result of the Medico-Legal Summit Declaration where Provincial Departments are encouraged to implement:

• A culture of patient safety and medical accountability must be enforced by the Head of the institution i.e. in the case of hospitals, the Chief Executive Officer (CEO);

• All hospital managers must implement the Patients’ Rights Charter;

• Clinical governance must be uniformly implemented;

• Morbidity and Mortality (M&M) reviews and clinical audits of all adverse events must be implemented immediately;

• There must be a compulsory multidisciplinary approach in ward rounds, M&M and other peer review meetings;

• Continuous patient safety campaigns must be conducted;

• The referral of patients must occur at an early and appropriate time; and

• There must be strict adherence to standard operating procedures (SOPs) and scope of practice at all times to avoid preventable safety failures.

Furthermore, the Provinces are also encouraged to have facilities that are properly equipped to provide future medical treatment to address the issue of future medical expenses which normally constitute 80% Medico-Legal claims quantum.

The abovementioned interventions are assisting in reducing the actual amounts payable to the Plaintiffs.

END.