Where will newly qualified doctors go if provinces are being told to scale back staff under budget pressures?
Equipping our future doctors with the tools to advocate for themselves and their patients should start long before they begin making ward rounds. (AFP)

The escalating “costs of cover for negligence claims” have led to concerns about “problems recruiting new candidates” into high-risk specialities, according to the Medical Protection Society [MPS], the largest indemnity backer of healthcare professionals in South Africa. 

In a recent South African Medical Journal article, MPS writes that specialists in the fields of obstetrics, spinal surgery, neurosurgery and neonatology are the hardest hit. 

“Those specialities where injuries may be the most severe and survival is likely to be the longest are at greatest risk of extremely high claims; thus indemnity costs for this group are the highest,” the article states.

According to Chico Bresler from WordSure, a company that provides digital record keeping services, the current “medical malpractice litigation storm is having a ripple effect on the number of future practitioners, with more medical students choosing not to enter these fields due to the unavoidable costs”. 

MPS says recently qualified specialists “may decide that local private practice is unsustainable and remain in state practice (a positive), or leave the country exacerbating the shortage of doctors”.

Increase in cost of claims
Bresler says indemnity cover with MPS for 2014 R330 000 for obstetricians, R318 190 for neuro- and spinal surgeons, “gynaecologists and orthopaedic surgeons face annual rates of over R130 000”. 

The costs of negligence claims increased by 132% between 2009 and 2011, and according to MPS, the average number of claims from its members increased by 30% between 2007 and 2011. 

“Claims can range anywhere from between R3-million to R30-million – enough to put some practitioners out of business,” said Bresler. “Should the numbers continue their upward trend, medical practitioners will become uninsurable.”

This increase has also been seen in the public sector. In Gauteng, “medical-legal claims arising from alleged negligence in hospitals. These have more than doubled from R3.025-billion as at 1 April 2013 to R6.566-billion as at 31 March 2014”, according to Jack Bloom, the Democratic Alliance health spokesperson in the province.