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Medical malpractice lawsuits are wreaking havoc in South African healthcare system; doctors are bleeding cash in indemnity cover, as they are forced to pay astronomical fees of around R65 000 per month. As a result, specialists in high-risk fields such as obstetrics, neurosurgery, spinal surgery and neonatology are abandoning their professions. This creates a serious shortage of experienced and much-needed skills in the system to the detriment of patients.

The current system is a total rip off for doctors, especially state doctors, who do not get full cover despite paying huge premiums. The insurers wash off their hands on claims in the public sector, and demand that the state should take care of the estimated total claim of about R25 billion. The claims have been sharply increasing in numbers and value; the biggest claim settled in 2006 was R6 million, R14 million in 2008, and R33m in 2013. The highest claim was made in 2014 for R80m. There is no budget for these claims. Medicine, just like driving motor vehicles will always have accidents and adverse events, some beyond health professionals or the health system. The high burden of diseases and trauma in South Africa combined with limited human and infrastructure resources make the situation even direr.

It is an axiom none dare contest that victims of health shortcomings deserve recourse and compensation. But the current system is unsustainable, unaffordable, and threatens the future of healthcare in South Africa. The time to seek new and better ways is now, we should consider establishing a fund similar to The Road Accident Fund in health. This fund should be managed by competent, honest and qualified people life former chief justices or judges, civil society, labour, government and health professions. A person in the mould of outgoing Public Protector Adv Thuli Madonsela will ensure justice to victims, and sustainability of the healthcare system. We should find ways to capitalize this fund through contributions from health professionals, the state through taxes or levies of health products/services, private and public health services providers. The same way we fund Road Accident Fund through petrol levies.

Failure to address this critical problem has a potential to cause serious instability or catastrophe; resources meant for health services will be diverted to settle court orders, and our already strained health services will simply collapse. There will be no obstetricians to deliver babies or neurosurgeons to save critically injured patients. The time for action is now, health professions around the country need to lead this process, in full consultation and collaboration with government, civil society and the general population.

Issued by COSATU