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Tuesday, March 29, 2016 - 10:29
Road Fund consequence

Private doctors are likely to see an increase in malpractice suit possibilities because of pending changes to the Road Accident Fund. The situation, in turn, is ultimately likely to impact on fees passed on to private patients. This is according to Graham Anderson, CEO and Principal Officer of Profmed, who was commenting on a view first expressed by Health Minister Dr Aaron Motsoaledi.
Anderson is in agreement with the Minister, and both believe that pending changes to the Road Accident Fund (RAF) are likely to bring the possibility of increasing malpractice suits brought against doctors. This expectation comes from the stricter conditions that will apply when claiming from the Road Accident Fund, which will be renamed the Road Accident Benefit Scheme (RABS)

Anderson says, “Malpractice lawyers are now starting to focus on medical doctors who work in private practice in hospitals. I find the situation extremely disturbing and believe we have seen a trend, over about the past five years, of certain firms of attorneys looking for people whom they can encourage to become clients in order to sue their doctors. I think that the proposed changes we will see in the Road Accident Benefit Scheme will help to bring about these changes.”

In terms of the RABS, payments will be made directly to claimants as well as medical and healthcare service providers. In addition, there will be a removal of the requirement to prove fault, as we see currently with the Road Accident Fund. The focus will essentially be on how the claimant is assisted. The RABS will be funded by the fuel levy and will provide structured, defined benefits for medical expenses, income support, family support and funeral benefits rather than cash lump sums, as occurs with the Road Accident Fund.

Anderson clarifies, “We expect the role of attorneys in the new scheme to be limited, considering the removal of the requirement to prove fault and also because benefits will be defined. It is for this reason that we expect to see some attorneys who specialise in medical litigation turning their attention towards doctors in private practice.”

Anderson warns that the effects of the anticipated increased litigation could ripple wider still within medical circles. “I believe that an increase in litigation could ultimately discourage certain doctors from specialising, or discourage certain specialists from carrying out particular procedures due to fears of litigation. In addition, I anticipate a potential rise in doctors’ fees, due to their increasing need for insurance cover to protect against possible malpractice suits. These costs would then, logically, be borne by their patients.”

Anderson says that some doctors in certain specialist fields have already alerted Profmed to their increasing insurance costs, with a request to increase tariffs paid by the medical scheme. “Medicine is not an exact science and matters do, therefore, go wrong sometimes. In those instances it is obviously human nature to want to receive some form of reimbursement via litigation, and therefore it is critical for doctors to have this type of insurance cover.

“However, it is costly, as it is largely underwritten by the Medical Protection Society (MPS), which is based in the UK. The fees are therefore paid by local doctors in pounds, and with the currency at extremely weak levels, this of course has an impact on a doctor’s fees, over and above their normal overheads.”

Anderson concludes, “The pending changes to the Road Accident Fund have admirable considerations at their heart but have certainly brought possibly unintended consequences. I do foresee a difficult situation potentially unfolding further before it ultimately peaks at reasonable levels.

“My advice to doctors is to ensure they brief their patients properly in advance regarding the potential risks of procedures, and that they ensure they are sufficiently covered by the requisite insurance policies. I would really not want to see a situation unfolding in which medical specialisation in different spheres declines, as a consequence of unscrupulous litigation attempts related to the pending changes built into the new Road Accident Benefit Scheme.”  

Copyright © Insurance Times and Investments® Vol:29.3 1st March, 2016
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