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Huge medical negligence claims due to broken public health, not dodgy lawyers

Bhekikisa Centre for Health Journalism has again run an article about the huge medical negligence claims against the state. And again it's been picked up by other media, Daily Maverick and New24 among them. 

President Cyril Ramaphosa tasked the Special Investigations Unit (SIU) to investigate the large medical negligence claims against provincial health departments in the country. The investigation, which is not yet complete, is concentrating on alleged fictitious medical claims including by patients who never made them. 

The health department has long complained negligence claims are the result of touting by lawyers and the legal profession is abusing the system. But seldom if ever has it admitted they're the result of a dysfunctional and broken public health system. Bhekikisa accepted government's tendentious claim it's mostly the result of "dodgy lawyers", "touting" and allegedly "stolen medical records". 

This makes me really angry. Nowhere do I read the reason for the lawsuits: massive malpractice by public facilities and healthcare workers.

Ironically, from time to time the media publicises negligence and bad practices at these facilities. A Corruption Watch post on their website explains the cause of a large part of the claims: plain negligence, not government's conspiracies theories. But Bhekikisa and media do not put the negligence claims in this context.

I'm a survivor of medical negligence at Groote Schuur Hospital - misdiagnosis and the wrong treatment for an elementary condition that even the hospital's specialists privately agreed should not have happened. The offending registrar, Dr Christopher Hobbs, a British citizen, wasn't even registered with HPCSA at the time of the incident but they unethically and illegally (accessory to fraud) protected him!

But the hospital refused to admit fault. I sued but after over two years of Western Cape Health Department and State Attorney deliberately dragging their feet, a legal strategy, my lawyer bailed. He was appointed on contingency. 

I never received resolution. My permanent physical injury as a result was comparatively small but I suffered a decade of PTSD and I still have flashbacks 20 later. 

A second case was my mother's "unnatural causes" death at the same hospital. Admitted for a broken femur, her lung collapsed the following day - they refused to say how or why but probably nicked during intubation; she was under observation for surgery once she stabilised. Only about 12 hours later - too soon - she was extubated, without our knowledge or permission, by an unsupervised junior doctor, Mikhail Botha, only 27 years old or so. She died as a result of it - respiratory collapse triggered cardiac arrest. For reasons they won't say her anaemia treatment was also discontinued before this which weakened her heart (per post-mortem). 

We received no closure for her case but the hospital's CEO, Bhavna Patel, who was instrumental in the cover up, received flattering media coverage on her retirement a couple of years ago. The head of health Beth Engelbrecht who also was implicated, is now an adjunct professor at North West University. The treating doctors' reputations never suffered. No one investigated, and we tried hard to get them to. 

It's not like we intend suing but negligence and mistakes at multiple levels contributed to her death. 

I've heard other stories too, from a patient herself who was treated for over a year for a misdiagnosed condition, a condition she didn't have. The medication left her diabetic. All the hospital - also Groote Schuur - was concerned about was whether she'd sue. No apology.

Cape Town's inquest magistrate Ingrid Arntzen told me the Woodstock policeman responsible for inquest investigations is the "busiest person at the station" because of Groote Schuur. 

There would be a number of suspect or fraudulent negligence legal cases, apparently around R3 billion (out of R78 billion) but to suggest the majority are merely because government says so - a government we cannot trust - is malicious and inconsiderate to the victims. And poor journalism when repeated without verifying the facts of the claims. The facts about South Africa's poor to bad public health system speaks for itself.

In the rush for headlines Bhekikisa and media forget the victims of medical negligence.

Mia Malan, Bhekikisa editor-in-chief responded to my email. She said they often report on negligence cases in public health and don't imply there isn't negligence - they've held Health Minister Aaron Motsoaledi accountable (see their streaming show Health Beat). Without dismissing traumatic experiences like mine, they "have a responsibility to hold the legal sector accountable for the abuse of the health system [that], as a result, deprive the system of money for better care". 

Malan said they use figures from SIU's Health Sector Anti-Corruption Forum (sic; the forum is not SIU's but a partnership of SIU, NPA, SAPS, Health Ombud, HPCSA and others) and their "goal was to show which provinces have the most pending medical negligence claims and tactics used by dodgy lawyers [sic], [to] help investigators with meaningfully broken data to focus their efforts". She noted abuse in the public health sector often happen with the help of unethical health workers. 

However, Bhekikisa has taken government's word that alleged dodgy lawyers and legal profession as a whole are the cause of the huge claims against the state despite it being an allegation still and the investigation is proceeding. The police are not investigating and there are no court cases pending.

Therefore, media and government spin is less about the victims and more about taking the side of an incompetent, negligent government which cannot be trusted. From what they've been saying for years, that the totality of claims against the state - R78 billion - is almost entirely because of alleged dodgy legal practices is not yet proven.

It's vital the media separates dubious claims from the total. It's a small minority of the outstanding debt - contingent and finalised - government must pay. 

In 2019 I reviewed WCHD's 2018/19 annual report wherein in stated the negligence debt, which the head, Beth Engelbrecht, dismissed as touting. I forget the figure but it was high, a couple of hundred million. But contradictorily WCHD claimed it resolved over 90% of patient complaints. 

Both cannot be true. Which is why government cannot be trusted. I'd believe Bhekikisa's et al reports if they disaggregate genuinely irregular claims ie those possibly criminal, from the total. 

As it is now, it's just an incompetent government trying to deflect and change the story and our attention away from the broken public health system.


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