The South African health system faces numerous challenges. A
large majority of the population are dependent and have to
contend with a dysfunctional public sector. The quality of
care patients receive is severely compromised. Systemic
factors, that are particularly prevalent in state facilities,
exacerbate the problem. As a result, patient safety is
endangered and many avoidable adverse events occur. These
adverse events bring about grave consequences for the
practitioner involved, the healthcare system with regard to
the detrimental impact on resources and, most importantly, the
patient.
It must be acknowledged that many of the problems and
institutional weaknesses that prevail in the public sector
have been inherited. Recognising this, however, does not
absolve the current administration, as many of the challenges
are compounded by poor policy decisions and failures in
crucial areas. This necessitates the need for a critical
evaluation of proposed reforms. This dissertation conducts
such an evaluation to investigate whether the National Health
Insurance will adequately address the deficiencies of the
existing system and ensure that South Africans have access to
affordable, quality healthcare services. It is argued that
there are many unanswered questions in the proposal as set out
in the Green Paper. An insufficient case is made for the
complete reform of the healthcare system. The adequacy and
effectiveness of the NHI, as the preferred mechanism with
which to achieve positive health outcomes, have not been
established. There are also serious concerns about the
affordability thereof as well as the transparency of the
process. Medical malpractice is also investigated. The dissertation
provides an overview of the current regulatory and civil
liability framework, before evaluating the current malpractice
situation. The increasing costs and frequency of claims have
been identified as a threat to the existing healthcare system
and the successful implementation of the NHI. The dissertation
assesses the problem, by considering the extent, effects and
causes of increased malpractice litigation. It is argued that
the existing malpractice system may be inadequate at promoting
and ensuring quality care and patient safety. Reforms that
align the objectives of the health system with those of the
medical malpractice system should be implemented. Conventional
reforms that would merely alter the current system will be
insufficient. Fundamental reforms should thus be considered. A
patient-orientated approach will be crucial in this regard.
Patients are the most severely affected by malpractice and
will have to contend with the consequences of malpractice
litigation as well. Reforms, seeking to ensure that patients
receive compensation whilst making healthcare safer, should be
central to any discussion.
Concrete research is necessary. Information on South Africa’s
health system as it relates to the burden of iatrogenic injury
and the causes and avoidability thereof should be studied. The
malpractice system should also be scrutinised. Reliable data
is required on the number of malpractice claims filed, the
causes, costs involved and the difficulties experienced in
obtaining compensation. Policy decisions that would ensure
that quality care is provided and that patient safety is
emphasised must be informed by the necessary inquiries. / Dissertation (LLM)--University of Pretoria, 2014. / lk2014 / Public Law / LLM / Unrestricted
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:up/oai:repository.up.ac.za:2263/43213 |
| Date | January 2014 |
| Creators | Oosthuizen, William Thomas |
| Contributors | Carstens, Pieter Albert, 1960- |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Dissertation |
| Rights | © 2014 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
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