Health faces R50bn in medical negligence claims

Public hospitals are facing R50 billion in medical negligence claims, the Department of Health has told Parliament.

Acting chief financial officer Hardley Nevhutalu said the figure had come down from R58 billion a year earlier. The state paid out R1.5 billion in 2025/26 and is fighting the rest.

"The medico-legal claims as well, from 2024/25 to 2025/26, have reduced from R58 billion to R50 billion. But we need to indicate that the number might be reflected as R50 billion; that is medico-legal claims, that is a contingent liability.

"We still have to go and defend it in the courts and so forth. So what we paid in the previous year was R1.5 billion, because others we are still engaging and disputing," Nevhutalu said.

He was speaking at the NCOP Select Committee on Social Services on Wednesday, 28 October.

ANC MP Makhi Feni said the claims are eating into money meant for patients.

"I know that provinces are always making justifications in terms of the funds that they have: that instead of the funds being utilised where they were allocated, they are utilised for these specific cases. And you discover that some of the things that led to these litigations could have been managed or dealt with in a different way.

"But that is not the case. Instead, it has consumed all the budget," Feni said.

Committee chairperson Desery Fienies asked why most provinces still do not budget for the claims.

"How is budgeting for medico-legal cases managed in the provinces as well as at national level? Why is there such a varied response to this issue, with most provinces not budgeting for medico-legal claims? Should there not be a consistent, agreed-upon policy on this matter?" she asked.

Nevhutalu said provinces were previously not allowed to budget for the claims.

Treasury has now agreed to a special sub-programme so provinces can set money aside.

"Because of these accruals and medical claims, we find ourselves at times not being able to achieve the set targets, because we are not able to budget correctly for medical claims. Before, we were not allowed. But now we've agreed with Treasury: we have created a special sub-programme where our provinces are now allowed to budget some funding to deal with medico-legal claims," he said.

He said provincial accruals, which are bills owed but not yet paid, fell by R3.9 billion, or 16.5%, between 2024/25 and 2025/26.

National Treasury warned on 28 October that provincial health departments' weak financial control is a significant fiscal risk.

It said provinces owed the National Health Laboratory Service R10.7 billion.

The South African Law Reform Commission has proposed scrapping lump-sum payouts for medical negligence in favour of structured settlements.