Payouts by provincial health departments for damages as a result of negligence have come down sharply in the last few years. But billions of rands are still paid out each year in legal claims.

The claims largely stem from cases involving obstetric injuries, including cerebral palsy, from orthopaedic surgery and from trauma-related incidents.

Payouts of negligence claims decreased from R1.8-billion in 2019/20 to R1.5-billion in 2023/24, according to the National Treasury. In 2024/5, the government paid out R1.1-billion in negligence claims.

But while actual payouts are falling as the state successfully contests more claims, the value of claims against the state is still very high. Only a fraction of claims are paid out; many claims are reduced upon settlement, and many have no realistic chance of success. (Claims take years to be finalised in the court system, and claimants and the state incur huge legal costs.) But the state still has to take into account that claims may succeed, and to account accordingly. As of 31 March 2024, this “contingent liability” amounted to R62-billion, over 20% of the public health budget.

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