Cape Town - Escalating insurance costs are putting more pressure on obstetricians and gynaecologists, mainly in the private healthcare sector, and may lead to many large hospital chains shutting down their maternity wards.

Legal Risk Adviser at Aon South Africa, Sam Baleson said the risk and costs currently far outweighed the reward and benefit of practising in an “ever evolving industry”.

“A combination of the high-risk nature of obstetric and gynaecological disciplines, an increased and heightened awareness of potential litigants of their rights, and lawyers offering services on a contingency or no-win, no-fee basis are all factors that contribute to a high pressure pot that is bubbling over at an alarming rate.”

He said damages claimed for were either patrimonial loss, which is a reduction in a person’s financial position, and non-patrimonial damage, which is unrelated to finances but compensations for matters like pain and suffering.

“The mother can bring a claim of medical malpractice if the doctor’s carelessness caused her injury prior to or during birth. For example, if the doctor fails to note the mother’s high blood pressure prior to delivery, a sign of a condition known as pre-eclampsia, and the mother has a seizure during delivery, the mother may have a claim for medical malpractice to recover for injuries caused by the seizure.”

Baleson said medical malpractice of this nature, on average, can easily be in excess of R10 million.

The South African Society of Obstetricians and Gynaecologists (Sasog) said the cost of insurance was expected to climb to R800 000 next year, because of the drastic increase in the number of legal claims since 2009.

Sasog proposed a solution and has urged new legislation place a cap on the limit of liability, ensuring insurance premiums for doctors do not drastically increase.

The Western Cape health department’s spokesman Mark van der Heever said they were aware gynaecologists and obstetricians were finding it difficult to cover their medical insurance, and that public sector specialists had a heavily subsidised rate for insurance.

“There is concern many of those patients who previously made use of private delivery units may add extra pressure to existing government services, but there is no indication at the moment what the situation may be.”

He said currently around 82 percent of the citizens in the Western Cape relied on government health services, including emergency care as well as pre- and post-natal care.

“No patient requiring assistance with their pregnancy and birth will be turned away.”

Mediclinic South Africa said it believed the decision to continue to practice in private hospitals should rest with the doctors themselves.

“At this point we have not identified any significant trends in this regard across our hospitals. However, we have requested our hospital general managers continue to monitor the matter and we will then assess the situation once additional information becomes available,” the private hospital group said.

[email protected]

Cape Argus