R10m saved in medico-legal cases – Gauteng Health

Dept says it has put measures in place to minimize future lawsuits

Health Dept saves R10 million in medico-legal cases

13 February 2020

In a space of two months October to November 2019 the Gauteng Department of Health (GDoH) has managed to save an estimated 10 million on Capital through mediation this is excluding the possible legal costs and costs of acquiring medical experts that could have been incurred through litigation if these cases were not mediated.

The Mediation Process has proven to be one of the most successful factors in reducing cases of medical negligence and by large reducing the Contingent Liability thus far. It has cost-effective tools and can be implemented at any stage, during and/or before the litigation process. It is less acrimonious and helps to improve the patient experience in the health system.

The Mediation Policy and the Mediation Strategy has been approved by Exco, and the Department started implementing it in October 2019.

On the 18 December 2019 the GDoH won yet another case which has created common law and has marked the greatest success for the GDoH. This Judgment briefly created common law in that the Department can now offer Future Medical Expenses in kind as opposed to monetary compensation.

In implementing corrective measures, the GDoH is focusing mainly on the 3 key areas which are; Internal Issues within Institutions identified as the root causes of the issues around litigation, re-visit the Consortium and Standard Operating Procedure with the State Attorney and addressing the challenges within the Head Office Legal Services.

This was adopted as a further strategy to not only mitigate litigation but to also analyse and eradicate the actual root cause of Medico-Legal court cases.

The GDoH has put the following measures in place to minimize future lawsuits that have been a biggest challenge in the Province:

Mediation process

Public Health Institutions can render Future Medical Care instead of paying cash towards compensation for these services

Intensive Investigation of Cerebral Palsy cases

Patient Safety and Medico-Legal Advisory Committee

Increasing Human Resources and Equipment

Partnerships with service providers like Cognitive Analytical Litigation and Investigations Joint Venture (CALIJV), SIU and Integrated Forensic Investigators, the Office of the Premier as well as National Department of Health.

Revival of the State Liability Amendment Bill

The dates for Mediations is guided by the availability of the Mediators from the South African Medico Legal Association (SAMLA). Mediation resumed in February for the year 2020 and the Department has since Mediated 7 more matters in February, the status of each case will be outlined once all the administration process is concluded. The Department has Mediated a total of 13 matters since October 2019 to date.

The mediation of these 6 matters was very successful, not only did the GDoH save on the capital amount, it is also important to note that the greatest savings was on litigation costs which would have accumulated through the years even before the matter had gone to court.

The Department’s reputation is being restored as the complainant’s (even though some were still grieving) felt valued by the Mediation team and process.

The complainants further expressed that they trusted the Mediation process and the Mediator's Independence in attending to both sides and that they found closure. The Gauteng Department of Health is indeed making strides through the smart and strategic partnership with the stakeholders which yielded positive result using mediation process.


The GDoH has absorbed 8 600 of the 10 000 CHWs in the Persal system and capturing of the remaining is still in process.

The Regional Training Center (RTC) has trained CHWs on quarterly basis on various topics such as:



Mother and Child Health focusing on community IMCI

HIV Prevention strategies e.g. VMMC, condom usage

New updates on HAST programmes e.g. introduction of TLD

In the 2019/2020 financial year there were 1083 CHWs who were trained against the target of 645.

The Gauteng Department of Health wishes to assure the Community Health Workers (CHWs) that it remains committed to their integration into the Department staff establishment as from 01 April 2020 and the process is currently being finalised with Gauteng Treasury.

In addition, CHWs need not worry about the memo which was circulated recently regarding new contracts. It should be noted that the memo was a contingency measure put in place to ensure that payments of CHWs will not be stopped on the 31 March 2020, when the current CHWs appointment on PERSAL ends or owing to any delays in the integration process. Furthermore, Gauteng Health MEC, Dr Bandile Masuku has appointed 12 CHWs from all the 5 District to serve on the MEC’s Advisory Committee on matters relating to Community Health Workers.

Issued by Kwara Kekana, Spokesperson: MEC for Health, 13 February 2020