Government paid out R23.6 billion in medico-legal claims

Health Minister Joe Phaahla said they have paid out billions in medical claims. File Picture: Henk Kruger / Independent Newspapers

Health Minister Joe Phaahla said they have paid out billions in medical claims. File Picture: Henk Kruger / Independent Newspapers

Published Mar 18, 2024


Minister of Health Joe Phaahla says they have paid out more than R23.6 billion in medical claims, as the department is flooded with medico-legal claims.

Phaahla said the claims were from 2020 until the end of December last year.

The department has faced a number of medico-legal claims, with the Standing Committee on Public Accounts (Scopa) calling for measures to reduce the cases and costs incurred by the department when settling claims.

Gauteng and Eastern Cape Health MECs presented to Scopa a few years ago and explained how they are targeted by law firms and other service providers with massive claims.

Minister of Finance Enoch Godongwana said in his Budget that medico-legal claims posed a risk to the fiscus.

Phaahla said out of 3,522 medico-legal claims they received, 738 claims were paid out and 612 claims were ordered by the court.

He added that 126 claims were paid after a settlement and 130 claims “were awarded based on lost patient files.”

The Auditor-General Tsakani Maluleke also made a presentation in Parliament in which she explained how the filing system in some hospitals and clinics was in complete disarray. The auditor-general said some of the files could not be not traced or found.

Phaahla, who was replying to a written Parliamentary question from Democratic Alliance (DA) Member of Parliament Michelle Clarke, said in total they paid out R23.6bn in medico-legal claims.

The minister said they spent R1.3bn in legal fees.

Phaahla also said the National Health Insurance will be implemented in phases.

President Cyril Ramaphosa has not yet signed the NHI Bill.

The NHI has come under criticism from some parties and healthcare bodies.

The minister said the funding of the NHI will be based on what has been set out in the bill.

“The NHI will be funded as per the provisions outlined in the NHI Bill that was approved by the National Council of Provinces on December 6, 2023. Funding for NHI will be determined in accordance with the estimates of income and expenditure as contemplated in Section 53 of the Public Finance Management Act.

“The source of funds for NHI are outlined in Sections 48 and 49 of the NHI Bill. Section 48 identifies the revenue sources for the Fund as consisting of money to which the fund is entitled in terms of Section 49; any interest or return on investment made by the fund; any money paid erroneously to the fund which, in the opinion of the Minister, cannot be refunded; any bequest or donation received by the fund; and any other money to which the fund may become legally entitled.

“Furthermore, Section 49 of the Bill states that the NHI will be entitled to funding appropriated annually by Parliament. This funding will be from monies collected and in accordance with social solidarity in respect of (i) general tax revenue, including the shifting of funds from national government departments and agencies and the Provincial Equitable Share and conditional grants into the fund; (ii) reallocation of funding for medical scheme tax credits paid to various medical schemes towards the funding of NHI; (iii) payroll tax (consisting of employer and employee contributions); and (iv) a surcharge on personal income tax, introduced through a Money Bill by the Minister of Finance and earmarked for use by the Fund,” said Phaahla.

The minister said the implementation of the NHI will be done in various stages.

But some of the political parties said they will challenge the bill in court as the process was not followed when it was passed by Parliament.

The bill has also been said to be unworkable, unconstitutional and unlawful.

But Phaahla said last year when the bill was adopted by the NCOP that he will defend it in court.