Bhisho’s R14bn baby ‘bill’
The Eastern Cape Department of Health is facing a potential R14-billion in claims for 1 820 babies born with brain injuries linked to errors and high-risk pregnancies – a scenario it also believes is being exploited for profit. While the department admits there are errors and says it is doing what it can to improve the level of newborn care to reduce cerebral palsy, its medico-legal headache stretches back 10 years and is exacerbated by teen pregnancies, HIV/Aids, malnutrition and even superstition. Unscrupulous lawyers and health staff are also suspected of colluding to make fraudulent claims. In releasing the massive claims figures, health department superintendent-general Thobile Mbengashe said the national Treasury and Eastern Cape premier Phumulo Masualle and his executive were monitoring the situation. Mbengashe said the department had paid out R259-million in damages in the 2015-16 financial year alone for 62 claims. It had also paid R59-million to the state attorney for legal costs. Dora Nginza Hospital paediatric department head Dr Lungile Pepeta said they were trying to cut down on the number of cerebral palsy cases by improving obstetric and newborn care.
Mbengashe said preventing cerebral palsy was not straightforward. “We accept that the moms were treated by the department and something went wrong,” he said. “This is not a unique problem to the Eastern Cape, or even to South Africa. “Even in developed countries about 2% of children are born with cerebral palsy.” Issues the department had identified as contributing to a high number of high-risk pregnancies included HIV/Aids (about one-third of all pregnant women are HIV-positive), chronic malnutrition, diabetes, hypertension and infections. “We try to get moms to get prenatal care so that we can monitor the high-risk pregnancies,” Mbengashe said. “There is so much superstition and folklore around, however, that most moms don’t come to see us before 20 weeks. “We are also seeing many moms who come to hospital already in the advanced stages of labour.” Mbengashe said the number of unwanted pregnancies among youngsters under 18 was also presenting a unique high risk. “This province also has a lot of premature babies,” he said. “A baby’s brain must not get enough oxygen for only five minutes for cerebral palsy to set in. “Our biggest problem is that we make notes to talk about treatment. “Our notes do not meet legal requirements – so the courts can’t see we have done our best.
“Notes also get lost and stolen.” Mbengashe said the department was now paying out claims on cases that were 10 years old or older. “This makes it difficult for us to pursue those involved at their respective professional bodies,” he said. Where possible, negligence was reported to professional bodies. Meanwhile, the department has implemented a new protocol to minimise the incidence of cerebral palsy. This includes compulsory monitoring of women in labour and the presence of an obstetric ambulance at every clinic that has a delivery room. “We accept cerebral palsy as a disease,” Mbengashe said. “We are using the services of a legal ombudsman to assist us in setting up ways to assist these children. “We hope to present this to the courts as a mitigation strategy [reducing the amount of damages that must be paid]. “In the end, however, we know attorneys are not making the money they used to from the Road Accident Fund – so now they have turned to cerebral palsy cases.
“There is major collusion between staff and attorneys, and there is a lot of fraud going on – all because people are making big money out of these claims.” Mbengashe said he feared that the worst was still to come. “We have 1 820 claims for cerebral palsy babies against us,” he said. “If you work it out, each claim is worth between R7.2-million and R7.6-million on average – that gives us a potential liability of R14-billion in claims for these babies alone.” DA health spokeswoman Celeste Barker said: “Our worries are twofold. “In the first instance, this alarming statistic indicates that the Eastern Cape Department of Health is at least partially dysfunctional or very badly managed. “[The] statistic indicates that hundreds of families have had their lives turned upside down by poor service. “Such a massive drain on our budget is likely to compromise service delivery further,” Barker said.
