Medical negligence definition is derived from the Law of Delict, which comprises the evaluation of medical practitioner’s conduct according to acceptable societal standards. It is also defined as when the conduct of the medical professional does not meet the standard of a reasonable person. Such conduct is blame-worthy in South African law, therefore any medical practitioner who violates this will be at fault. Given such a context, medical malpractice is a negligent act or omission by the medical professional that results in damage to property or personal injury of the patient. The definition of negligence requires inter alia the following;
- wrongful conduct,
- causation; and
- damage or personal injury.
The skill and care of a reasonable medical practitioner under the same circumstances will be used as a yardstick to measure the reasonableness of the medical practitioner’s conduct.
The Common Claims In South Africa Are As Follows:
- Botched operation.
- Faulty Blood Transfusions.
- Treatment delays.
- Anaesthesia accidents.
- Prescription Errors.
- Misread X – Rays.
- Dental Malpractice.
- Emergency room negligence.
A Contractual Obligation Between The Doctor/Hospital And Patient
The medical profession is considered a noble profession because it helps in preserving life. We believe life is God given. A patient generally approaches a doctor/hospital based on his/its reputation. Expectations of a patient are two-fold: doctors and hospitals are expected to provide medical treatment with all the knowledge and skill at their command and secondly they will not do anything to harm the patient in any manner either because of their negligence, carelessness, or reckless attitude of their staff. Though a doctor may not be in a position to save his patient’s life at all times. He is expected to use his special knowledge and skill in the most appropriate manner keeping in mind the interest of the patient who has entrusted his life to him. Therefore, it is expected that a doctor carry out necessary investigations or seeks a report from the patient.
Furthermore, unless it is an emergency, he ought to obtain an informed consent of the patient before proceeding with any major treatment, surgical operation, or even invasive investigation. Failure of a doctor and hospital to discharge this obligation is essentially a tortious liability. A tort is a civil wrong (right in rem) as against a contractual obligation (right in personam) and breach that attracts judicial intervention by way of awarding damages. Thus, a patient’s right to receive medical attention from doctors and hospitals is essentially a civil right.
The relationship takes the shape of a contract to some extent because of informed consent, payment of fee, and performance of surgery/provision of treatment, etc. while retaining essential elements of tort.
Factors That Contribute To Increased Medical Negligence Claims
Countries face different challenges in respect of medical negligence claims. Of which reporting at times can be affected by socio-economic status and dynamics that affect the provision of health services. In South Africa, public hospitals by and large tend to be the epitome of the medical negligence cases. Thus in comparison to private hospitals. The same trend can be observed in other developing countries. Potential reasons for this are explored below.
i) Shortage of Staff and unfavourable working conditions: The shortage of staff in public hospitals contributes to the increase of medical negligence in South Africa. The shortage of medical practitioners including doctors, nurses or paramedics has a knock on effect in escalating the rate and percentage of medical negligence. A case in point is that there is a high ratio of nurse to patient (more patients than nurses); therefore the nurses are not able to provide qualitative medical service expected from reasonable medical practitioners.
ii) Shortage of qualified Medical Practitioners: The assignment of medical practitioners that are still in training, when given tasks outside of their scope, knowledge and skills also has a knock on effect on increased medical negligence cases, especially in rural areas. To avoid such cases, more trained and skilled medical practitioners should be recruited by the Department of Health. To ensure that medical interns have sufficient guidance during their training. In addition, only trained and rightly qualified medical professionals should be assigned to task regardless of the task’s magnitude or unless sufficiently guided.
iii) Working Hours and Workload: It is common cause that medical practitioners are human beings, who can equally be exposed to mental exhaustion. ‘Mental overload’ (ie fatigue and diminished concentration) can interfere with one’s ability to process other stimuli.
iv) The public awareness of their rights: The Constitution of South Africa, provides the Bill of Rights that have been cemented through Consumer Protection and National Health Insurance. The general populace has been empowered with the knowledge regarding their rights. Hence, can now easily trigger litigation and/or claims against public hospitals. This is exacerbated by lawyers who are now keen to work on the contingency fee basis which is No Win No Fee basis. The lawyers carry the costs for medical negligence cases and only claim their legal costs should they win the claim in courts or through negotiation.
In conclusion the medical practitioners are entrusted with a duty of care towards the patients. The patients are always required to sign for informed consent as a result creating a contractual relationship between the doctor and patient. Although there are various factors contributing to the increase. The increase in medical negligence is noted in public hospitals vis-à-vis private hospitals. Thus according to reported medical negligence in South Africa. The public awareness regarding constitutional rights should equally prompt the shift of public policy in addressing such a perennial problem.
We acknowledge Dr Maribanyana Lebeko who is part of the advisory for Simanye Clinic for his assistance with respect to compilation, editing and proofreading of this article.
Image credit: Getty Images.
Written By Advocate Dennis Chamisa and Dr Kim Lamont-Mbawuli (Legal Practitioner). In collaboration with Dech Legal & Associates and Simanye Mobile Clinic.
mPharma acquires majority stake in HealthPlus
mPharma, Africa’s leading patient-centered technology-driven healthcare company, has acquired the majority stake in HealthPlus, the leading pharmacy chain in Nigeria. mPharma and the former investor, Alta Semper, have signed an agreement leading to the acquisition of a majority stake in the HealthPlus Group.
According to the Chief Executive Officer and Co-founder of mPharma, Gregory Rockson, the acquisition is in line with the company’s mission to build an Africa that is in good health by delivering life-changing healthcare services and drugs to improve health outcomes for patients. He stated that the acquisition of the HealthPlus Pharmacy chain by mPharma complements mPharma’s deep commitment to increasing patient access to affordable and quality healthcare in Nigeria.
“mPharma is deepening its long-standing commitment to Africa by reimagining primary healthcare in some of the most vulnerable communities on the continent. We continue to transform community pharmacies into primary care centers to provide affordable and accessible healthcare to all patients so they can live not just longer but healthier lives. We are optimistic about the future of healthcare for Nigerians through the acquisition of HealthPlus.”, said Rockson.
In her remarks on the acquisition, Afsane Jetha, Co-founder and CEO at Alta Semper Capital, said: “We are delighted about HealthPlus’ partnership with mPharma. We have a strong conviction in mPharma’s strategy of revolutionizing primary care across Africa and believe mPharma is the ideal steward for HealthPlus’s next chapter of growth. We believe mPharma’s vision is consistent with that of HealthPlus’s shareholders and employees, and we are enthusiastic to support the business through a relationship with mPharma going forward”.
While mPharma plans to continue to keep and strengthen HealthPlus as Nigeria’s leading pharmacy brand in Nigeria, the acquisition will also provide expansion opportunities for mPharma within Nigeria and a platform to expand mPharma’s mutti pharmacy retail footprint across the continent through its fast-growing QualityRx program. Powered by mPharma’s proprietary Bloom software, HealthPlus will provide patients access to affordable primary care services within its pharmacies, in addition to affordable and quality medications it currently retails across 12 states in Nigeria. The HealthPlus pharmacy chain will also launch mutti®, mPharma’s health membership program, which will provide both existing and new customers with discounts, interest-free “heal-now-pay-later” plans, free health screenings, and other primary care services.
By combining HealthPlus pharmacies with mPharma’s growing portfolio of partner mutti pharmacies and GoodHealth shops (PPMVs),mPharma’s network will grow from 224 to over 320 health facilities in Nigeria and will provide care to more than 100,000 Nigerians each month.
Chantel Cooper: The Epitome of Empathy and Care
Chantel Cooper, CEO of The Children’s Hospital Trust (Image: Supplied)
Chantel joined the Children’s Hospital Trust in 2013 as the Head of Fundraising and Communication and was appointed as CEO in 2019. For her, 2020 was a year that reinforced the importance of the core purpose of the Trust and the difference the organisation wants to make in the lives of children. “Our cause is driven by the need to make a difference in the lives of sick and injured children. We are people who work together to save the lives of the children who matter. We all have a purpose!” she says.
Sharing excerpts from her journey, Chantel says:
“My purpose in life is to serve those who are most vulnerable: women and children. My career was driven by my passion to make a real difference in the lives of women and children. When I was 18 years old, I volunteered for an organisation that provided support for women who had been raped. While volunteering, I started working with women in rural areas in the Eastern Cape where we found opportunities to grow their businesses.
“My passion for women led me to Cape Town where I became Director of Rape Crisis Cape Town when I was 27 years old. After the birth of my two children, I moved to an organisation called St Joseph’s Home for chronically Ill Children. St Joseph’s is a step-down facility for tertiary hospitals like the Red Cross War Memorial Children’s Hospital. It was a profound move for me as I was able to work with children who inspired me.
“One of the most valuable lessons I learnt is the power of love. You can offer a child the best healthcare in the world, but what a child wants most is their parents to love them and be by their side. This is the value I most appreciate about the Red Cross War Memorial Children’s Hospital and my past experiences. This hospital believes in child-centered care and knows that a child heals when their parent or caregiver is by their side – even during the COVID-19 pandemic. All other hospitals had restricted access to patients, but the presence of a parent is imperative to their sick or injured child’s healing.”
“The COVID-19 pandemic taught our team that life can change in a blink of an eye and that we need to be prepared for all possibilities. The pandemic hit the world with such speed and velocity that we had no choice but to find a way to not only sail through the storm but also find ways to get out of the situation stronger than before.”
Chantel also states that 2020 provided the Children’s Hospital Trust with the opportunity to learn extraordinary lessons that they would not have normally had the opportunity to learn and some of these include:
- The value of deep listening and the importance of demonstrating kindness.
- Working in collaboration created the opportunity for meaningful impact for our beneficiaries.
- Opportunities do exist during challenging times; positivity exposed the opportunities.
- Adapting to change during uncertain times helped to build a resilient team.
“Our Trust team demonstrated ingenuity, compassion, resilience, commitment, and fortitude during a very difficult time. As a result, we surpassed our goals, and this enabled our organisation to reach more children and families. We are grateful for the contribution from every individual,” adds Chantel.
“Walking through the corridors of a children’s hospital during a crisis gave perspective on the real value of care, kindness, and collaboration. While children were not the face of the COVID-19 pandemic, the Social Work Department experienced first-hand the profound impact the pandemic had on children’s health and well-being.
“Unemployment, food insecurity, child safety and schooling were common concerns for many patients and their parents who entered the doors of the Hospital. The Red Cross War Memorial Children’s Hospital values patient and family-centred care which includes care for the whole family from a holistic perspective.
“In response to the needs of the families, the Trust secured funding to enable the social workers to provide additional counselling services and material support such as the provision of food, hygiene, and home-schooling supplies to vulnerable families when children were discharged from the Hospital.” Read more on the Family Care Project here.
The core to achieving our vision is upholding our values of Integrity, Accountability, Kindness, Dynamism, and Collaboration in every aspect of our work. The Trust has a sound financial record in administration and good governance. For the past 28 years, we have raised funds to address many pressing needs, but much has yet to be done. With the help of many donors, we continue to give hope and healing to our little ones who need it most.
The Trust raises funds for the upgrade and expansion of the Hospital’s buildings, the purchase of state-of-the-art medical equipment, and new medical treatment projects and funds the training of medical professionals across Africa – ensuring that the Hospital not only retains its world-class stature but is able to continue providing life-changing and life-saving care for children.
The Trust relies on donations to fund these needs. When you donate to the Trust, 100% of your donation goes towards funding projects that change children’s lives (and the lives of the people who love them). The operational costs of the Trust are funded from an endowment, so your generous contributions are never used to cover administration costs.
Donate to the Children’s Hospital Trust today! www.childrenshospitaltrust.org.za
SpecSMART Opens Optometry Clinic, Promises World Class Eye Care
SpecSMART, a world-class optometry clinic has opened its store in Lagos, the commercial hub of the country, promising to deliver high-quality optometry services comprising primary eye care, premium quality frames, lens variants, contact lens fitting, and optical/ophthalmic services to Nigerians, for patients seeking effective healthcare.
The clinic with the United Kingdom standard which debuted on Wednesday, 17th August, 2022 was unveiled at the Ikoyi Plaza Mall, Awolowo Road, in Ikoyi, Lagos, to cater to the over 50 million people requiring eye care that has become almost exclusive for the few in the country.
Speaking at the opening ceremony, Dr. Clarence Nwokocha, Practice Head and Medical Director, SpecSMART, said quality eye care is one of the key areas of healthcare and that the gap in the services has prompted the launch of the first-class clinic which was launched to meet the demand while ensuring the overall well-being of the patient and expectations that are fully guaranteed.
Dr. Nwokocha pointed out that with the unveiling of SpecSMART, patients would be able to have access to over 1,000 premium frames, contact lens fitting with sales and after-sales service, as well as international and designer sunglasses of a high standard at affordable prices.
He said SpecSMART will ensure on-the-spot glazing of spectacle prescriptions for standard lens prescriptions, fully automated quality eye examinations, full glaucoma care services, free registration for patients, world-class medical suite using automated digital equipment, and delivering a wide and comprehensive range of tests every day of the week, for flexibility of appointments.
The Medical Director stated that lots of Nigerians complain that they don’t get the type of customer service they need, the prescription of frames, type of eye care required, and we are here as a UK standard clinic to offer them the best treatment in line with global best practices.
“We are working towards opening another branch at the Lekki and Ikeja districts of Lagos State, to effectively provide our high standard services to Nigerians that desire quality eye care services.
According to him, there will be 24 hours automated appointment scheduler via the clinic’s website platform, 12-hour online customer care service, and eye care plans according to customers’ budgets and preferences, from skilled, licensed optometrists that would guarantee top-notched optometric and optical services to achieve accurate diagnoses.
With the unveiling of SpecSMART, patients seeking eye care treatment outside the country and within would now have access to excellent services in line with global best practices, as the clinic would also be extended to other parts of the country to meet the dire needs of patients.
Against this backdrop, the World Health Organisation (WHO) at the 74th World Health Assembly in 2021 pointed out that more than 800 million people in the globe have eye defects that could be addressed with the appropriate pair of spectacles, while an estimated 100 million people have moderate-to-severe distance vision impairment or blindness that could be corrected through access to cataract surgery.
It posits that to ameliorate the situation, there is a need for the provision of quality eye care services for underserved populations.