Rising insurance premiums, the result of huge negligence claims, could soon mean thousands of mothers will be unable to afford obstetric treatment in childbirth.
According to Siva Moodley, the provincial representative of the SA Society of Obstetricians and Gynaecologists (Sasog), there needs to be a change in the law to cut the rate at which patients claim against gynaecologists and obstetricians.
At present, specialists’ payouts from medical aid for deliveries cover only their insurance premiums, which are set to total R85 000 a month.
“At least 10 to 12 specialists in the greater Durban area have given up offering obstetrics,” said Moodley. “Lots more are considering giving it up in the New Year – it’s a concern.”
KwaZulu-Natal Department of Health spokesman Sam Mkhwanazi, said: “It is true that certain specialist obstetricians and gynaecologists working in private practice are now only practising gynaecology. This is due to, among others, fear of litigation.”
A Durban gynaecologist, who did not wish to be named, said he feared the crisis also discouraged younger doctors from specialising in obstetrics, the branch of medicine and surgery concerned with childbirth and midwifery.
Two weeks ago gynaes and the government met to discuss ways of averting a catastrophe Sasog national president Johannes van Waart sees happening within two years if things carry on as they are.
Sasog has asked Health Minister Aaron Motsoaledi to intervene with new legislation, which places a cap on the limit of liability. Van Waart said the society had presented ideas for other interventions, including setting protocols such as improved note-keeping in place and improved midwife training.
“But patients also need to be educated that they do not live in a perfect world,” he said.
Motsoaledi’s spokesman Joe Maila, said: “They have met. A number of issues have arisen, including that of insurance.
“We found that we need to work together to deal with this issue and avoid adverse events.
“We cannot afford a situation where our specialists are litigated out of practice.”
Van Waart said in the past four years insurance had risen to R450 000 and this year was R650 000. “We’ll hear from the Medical Protection Society in two weeks but we expect it to be between R800 000 and R1 million for next year.
“This is because the Medical Protection Society has had a drastic increase in the number and quantum of legal claims since 2009. With the exception of a few, other insurers have declined to quote on providing cover to specialists entirely.”
The society listed factors that contribute to “a high pressure pot bubbling over at an alarming rate”, including: a combination of the high-risk nature of obstetric and gynaecological disciplines; an increased and heightened awareness of potential litigants of their rights; and lawyers offering services on a contingency, or no-win no-fee basis.
Van Waart added that medical rates covered only insurance, not overheads – rooms, receptionists and ultrasound.
Other provinces are also affected. “There are no private specialists offering obstetrics in Worcester or Paarl and the East Rand has one or two.”
He said if the situation continued to deteriorate and specialists had to increase costs to cover rising insurance premiums, mothers of the 140 000 babies delivered each year by private specialists would end up in state facilities, “which have no capacity”.
Source : Independent on Saturday