Medico-legal brief two: Dedicated medico-legal units for better management of claims

Dr Jodi Wishnia, Dr Anke Nitzsche, Dr Mawadda Cassiem-Majal, Suhavna Khalawan and Adv Anele Ngidi | August 2023

Medico-legal claims against South Africa’s public health sector are soaring. Minister of Health, Joe Phaahla, reported that in 2018/2019, the country paid out nearly R2 billion in claims, putting significant strain on an already stretched public health system. The crisis of medical negligence litigation signals a number of urgent imperatives. These include:

• The immediate need to improve the standard of care;

• The need to justly distinguish valid from invalid claims, and bolster mediation; and,

• The need to establish a system of compensation that balances the need for fair compensation with the broader goals of equitable resource allocation.

Ultimately, if we do not find evidence-based, people-centred, ways to manage medico-legal claims, we will enter a vicious cycle in which both public health budgets and quality of healthcare delivery are depleted. The South African Law Reform Commission (SALRC) published its report in November 2021, and one of its recommendations was for the public health sector to consider setting up dedicated medico-legal units to support better management of claims.

The research and policy brief contained herein follow this work and investigates the SALRC recommendation to establish dedicated medico-legal units. This policy brief provides a short summary on how medico-legal claims are treated globally and in South Africa, for context. It then goes on to describe a practical and implementable approach to setting up a dedicated medico-legal unit for South Africa’s context.