Donald Dinnie

Even if there
are funds to implement National Health Insurance (NHI) as envisaged, Donald
Dinnie, well-known medico-legal practitioner, has predicted that the scheme
will be “stillborn” due to the large list of historical and current
medico-legal claims faced by the Department of Health.

“The scheme
will be stillborn if the huge historical medico-legal exposure of public
healthcare institutions is not resolved urgently together with the quality of
healthcare provided,” Dinnie has warned in his 2018 Medico-Legal Year in Review
paper.

“Starting
with a clean slate – or at least a substantially clean slate – is necessary to
avoid the situation where billions of rands are taken from the health budget
annually to resolve a large historical list and current list of medico legal
claims,” he stressed. Such an eventuality, he noted, would mean that money
would not be spent on delivering and improving healthcare quality and
facilities thereby creating a spiral of ongoing claims “which the public sector
will have difficulty in escaping”.

Dinnie, CEO of Natmed Medical Defence who
also spoke at the Gynaecology Management Group/SASOG Private Practice Weekend
seminar, said that the action required would be the large number of claims being
dealt with innovatively, aggressively and urgently: “Every month delay makes it
more and more difficult to resolve existing and new claims cost effectively
because, with the passing of time, records are lost, witnesses disappear or
memories fade, expectation of the claimants harden and the cost of medical
interventions which may be needed to assist deserving claimants increase
significantly.”

Discussing
the current state of the healthcare sector in general, Dinnie reiterated that
the Health Market Inquiry (HMI) report, coupled with the NHI and Medical Scheme
drafts have done little to reassure “an already skittish private healthcare industry”
whose relationship with government has not been comfortable for years.

“Although
having recently shown signs of improvement, this relationship is likely to
remain challenging due to ideological differences and different views on
funding. Everyone,” Dinnie acknowledged in his review, “is agreed on the desirability
of quality universal healthcare and accessibility of affordable healthcare for
all.

“It is in how
that is to be achieved, as we now well know, where the differences arise.”