Medico-legal brief five: Impact of medico-legal claims on service delivery access and quality

Percept
February 2025
Dr Jodi Wishnia, Michelle Flowers and Suhavna Khalawan | August 2023
South Africa is experiencing a substantial rise in the number and quantum of medical negligence claims in its public health sector.[1] If claims are successful, the funding to pay claimants is derived from the public health budget, meaning that claims actively reduce available public health funds for service delivery.[2]
This research brief aims to articulate the impact of this redirection of funds on access to healthcare. We do this by looking at the opportunity cost or what else could have been “bought” with the funding that was paid to claimants. This work brings to life the trade-offs in place within a medical negligence claims environment that has high associated legal fees and no payment ceilings for claims of similar types.
We believe and support the right to justice and compensation for those who have experienced negligent care. This right should be accessed through sustainable legal processes that do not further jeopardise healthcare access and quality for the claimants themselves, as well as future public sector healthcare users. Similarly, the health system has a responsibility to render quality health services that its users can trust and part of this responsibility requires transparent data on the quality of services provided. The system and its users’ needs are deeply intertwined. This research brief aims to clarify the impact of claims payments from the systems perspective.
[1] South African Law Reform Commission. Project 141: Medico-legal claims [Internet]. 2021 [cited 2022 Aug 30]. Available from: https://www.justice.gov.za/salrc/dpapers/dp154-prj141-Medico-Legal-Claims.pdf [2] Whittaker, Gregory. Medical Malpractice in the South African Public Sector [Internet]. Actuarial Society of South Africa; 2021 [cited 2022 Oct 10]. Available from: https://www.actuarialsociety.org.za/convention/wpcontent/uploads/2021/09/Gregory-Whittaker-MedicalMalpracticeInTheSouthAfricanPublicSector-FullReport.pdf