2014-04-08 15:08:37 - Managing clinical negligence and medical error in South African hospitals: Implications for the National Health Insurance Scheme
“Accurate statistics on clinical negligence and medical error, and a non-adversarial cost-effective system for managing medical negligence claims are critical factors that will need to be tackled before introducing the National Health Insurance Scheme in South Africa”, says Professor Sylvester Chima of the College of Health Sciences at the University of KwaZulu Natal ahead of the Africa Health Exhibition & Congress 2014, in which he will be presenting on the topic.
Africa Health 2014 is the fourth edition of an event that has been growing in stature and popularity since it was first held in South Africa in 2011. Conference organizers, Informa Life Sciences Exhibitions will host the event at Gallagher Convention Centre in Midrand from the 29 – 31
Professor Chima, whose paper is entitled ‘’ says that the current lack of definitive statistics is playing havoc on an already compromised healthcare service in Africa.
Medical negligence occurs when a professional in the health services sector provides care that is below standard. Negligence may occur for many reasons including delay or failure to diagnose a condition, delay or failure to treat a condition, when a treatment goes wrong, use of the wrong treatment, or failure to obtain informed consent.
“The incidence of clinical negligence and medical error in African countries including South Africa is unknown as there are no accurate statistics. This has a huge impact on healthcare services delivery. For example, the use of fake drugs in other African countries such as Nigeria is a huge cause for concern. In South Africa there have been many cases of clinical negligence and medical error which lead to Court cases reported in the media,” explained Professor Chima.
In addition, the high cost of clinical negligence and medical error claims is adding to the challenges impeding the delivery of an effective and efficient healthcare delivery system.
“The cost of unregulated medical negligence claims may likely impact on the National Health Insurance (NHI) scheme if funds needed to run the programme are diverted to pay for medical negligence claims. For example, such excessive claims almost ruined the National Health Service (NHS) in England until the government introduced the Clinical Negligence Scheme for Trusts (CNST) which assists in managing medical negligence claims.
“Essentially what was done was to remove the clinical negligence compensation system from strict liability and adversarial court litigation, whereby to receive compensation, the injured person was required to prove that there was a failure by a healthcare professional to follow established standard of care or exercise reasonable skill in carrying out their duties. Here most of the inflated costs from medical negligence claims were due to excessive charges by lawyers and expert witnesses. The African continent, with particular reference to South Africa may need a no-fault compensation scheme similar to the Road Accident Fund (RAF) in order to limit the costs of medical negligence and its impact on the NHI,” he said.
Statistics that have been referred to in the media include reports that Gauteng province alone faces R3.7billion in legal claims for clinical negligence whilst in Kwazulu-Natal the Department of Health has legal claims against it in excess of R2billion. With regards to common errors, reports from the Eastern Cape tell of how medical professionals left surgical sponges or instruments inside patients after surgery. The patients are now suing for damages and compensation. Avoidable medical errors include the 22 HIV-positive women who were involuntarily sterilized in South Africa without their informed consent. The patients later sued the government and were awarded for damages in compensation by a South African Court of Law.
Professor Chima pointed out that healthcare professionals in Africa need to be better trained in Medical Law and Ethics in order to have a full understanding of the implications of medical negligence and its impact on healthcare services.
“Unfortunately, not much is being done by the medical fraternity in Africa to minimise the incidence of clinical negligence and medical error within medical practice. However, what we are trying to do in South Africa is to teach medical students and doctors to be ethical in their practice. Courses in Medical Law and Ethics need to be introduced in all medical and nursing schools in Africa,” he said.
Africa Health 2014 is dubbed as the continent’s premier medical showcase. The event comprises a three-day conference and exhibition which features the latest medical innovations from 400 international and local manufacturers. This year, over 5000 delegates are expected to attend the medical showcase.
For more information about Africa Health 2014, please visit www.africahealthexhibition.com
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