The Eastern Cape is implementing a multi-pronged strategy to help tackle medico legal claims that have cost the province just over R1bn over the past few years.
Eastern Cape Health MEC, Helen August-Sauls
In a presentation to the portfolio committee on health, Dr Thobile Mbengashe, the Eastern Cape Health HOD, said that while the province has cumulatively paid R1.1bn on medico claims since the 2010/11 financial year to date, R432m has been paid during the current financial year. An additional R44.5m was paid to the state attorney in legal fees.
He said as a result of the medico claims bill, coupled with an additional demand in health services, health services were under pressure.
One of the first things that the province has already done is to deal with the areas where we are getting medico legal claims, and that is primarily is OR Tambo district.
About 90% of the legal claims are stemming from the maternity section. The province is in the process of deploying capable professionals into the maternity units after the province’s executive committee gave the department a budget to make the appointments.
Dysfunctional patient records
On the administrative side, the provincial leadership has also identified the issue of dysfunctional patient record systems in the OR Tambo region.
The provincial department is currently tackling the capturing of medical records with the use of an online system and the “vigorous campaign” has resulted in the OR Tambo district recording the highest number of online health records.
While the Special Investigating Unit has been roped in to root-out corrupt elements in medico legal claims, the provincial department strives to go the mediation route before going to court in order to minimise costs.
Province must acknowledge its challenges to improve
While the provincial health system was under pressure, it was still able to deliver health care services to the rural province. “… It must be acknowledged that the Eastern Cape, with the financial duress that we are experiencing due to legal medial claims, is still able to at least run a system… [However] we need to acknowledge that we should be doing far better,” Helen August-Sauls, Eastern Cape Health MEC said.
Some of the challenges that have been identified include the geographical coverage due to the terrain in the rural areas, for which 4X4 vehicles were being used as replacement ambulances.
To address the scarcity of skills, the department is working with the University of Fort Hare to establish a training programme for emergency medical services practitioners.
The province is also prioritising the appointment of 30 forensic pathologists by the end of September to deal with a skills shortage in this area, which has resulted in the overuse of overtime, which has exceeded the 30% of the basic salary cut-off that is allowed by the Department of Public Service and Administration.
“Rapidly, we have increased our Ideal Clinics, making sure that norms and standards are introduced in the clinics.
“… We [must] acknowledge that there are inefficiencies in the way that we have run our [health services]. If we want to run a qualitative healthcare service, which our people expect from us, we need to immediately deal with the inefficiencies that are within the system.
“We understand that we are a rural province but we need to start dealing with [our challenges]. We can’t just do things because they’ve been done for 20 or 30 years in that manner and I think in that way, people will begin to respect us. They will respect government and the service that we bring to them as government,” said August-Sauls.
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