Government to clamp down on medical claims

Minister of Health Dr Zweli Mkhize says measures will need to be found to deal with the spiralling amounts being claimed from the various provincial health departments. Picture: Jairus Mmutle/GCIS

Minister of Health Dr Zweli Mkhize says measures will need to be found to deal with the spiralling amounts being claimed from the various provincial health departments. Picture: Jairus Mmutle/GCIS

Published Mar 2, 2020

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Cape Town - The government is tightening measures to deal with the massive medical claims against provincial departments of health, now sitting at almost R100 billion.

This is after Finance Minister Tito Mboweni had warned that the claims were unsustainable. Mboweni said they would not allow the medical bill to spiral out of control.

Five years ago the medical claims were sitting at R28.6bn, but now the bill has shot up to R99.2bn.

The National Treasury said several measures would be undertaken to clamp down on the rising medical claims.

The fiscus would not have the funds to deal with all the claims and there was a need to reduce it.

The budget review said there were a number of intervention measures to reduce the medical claims.

This would include the national Department of Health re-prioritising its funds to pilot the national quality health improvement plan.

“The department has contracted law firms with medico-legal expertise to support claim management and provide legal services in some provinces,” states the budget review.

“Several provinces are strengthening medico-legal teams including by contracting external legal capacity,” it said.

“Parliament is considering the State Liability Amendment Bill, which would introduce periodic payments and provide for compensation in kind, in the form of future medical care in public facilities,” the budget review stated.

“The Special Investigating Unit is probing potential fraud in this area, which has resulted in several arrests. The effect of these interventions on state-contingent liabilities still needs to be evaluated.

“Long-term solutions may require wider legal reform, which the South African Law Reform Commission is exploring,” reads the budget review.

The rise in medical claims has been raised by Mboweni in the past two years, saying this would have an impact on the budget of the department and provinces.

If the department was forced to pay large claims this would have dire consequences for its operations and delivery of services.

Health Minister Zweli Mkhize also spoke out against the medical claims in Parliament last year, saying they were not sustainable.

He said measures would have to be found to deal with the problem.

The provincial departments of health also complained to the standing committee on public accounts a year ago about this problem.

They said serious intervention was required to deal with the increase in medical claims.

Political Bureau

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