In just two years, doctors in the country's public hospitals have cost taxpayers more than R1 billion in lawsuits because of botched operations.
An investigation by The Sunday Independent has found that provincial health departments - which are responsible for paying for the damages - have had to fork out millions to compensate patients left shattered because of negligence by public sector doctors.
Health Minister Dr Aaron Motsoaledi said the amount paid out in lawsuits was unacceptable and has called for an investigation of reasons for the increase in litigation.
"We have heard about cases in which operations have been done on patients and they had surgical gloves or, in some cases, scissors, left inside them, both in public and private hospitals," his spokesman, Fidel Hadebe, said yesterday.
Motsoaledi plans to launch an investigation of the apparent "disconnect" between patients and medical staff because the crisis at provincial hospitals has resulted in a groundswell of complaints to the national Health Department.
Another problem is that ambulance services are taking a long time to reach patients, partially because of poor management and the use of unsuitable vehicles. This, too, often results in lawsuits.
As authorities worry about what they perceive to be an increase in negligent conduct, health professionals say it is almost impossible not to err given their working conditions.
Doctors and nurses carry a heavy workload because of vacancies, an increase in the number of patients coming for treatment and lack of resources.
Abdul Barday, the Health Professions Council of SA ombudsman, said doctors at provincial hospitals worked under trying conditions, but the government's R4bn renovation plan could offer a reprieve, especially with filling staff vacancies.
SA Medical Association chairman Norman Mabasa attributed the errors to the skills shortage in the public health system. "There are not enough doctors. Even if you take all doctors in the country and put them in the public sector, we will still fall short of World Health Organisation (WHO) guidelines," he said.
South Africa has one doctor for every 4 000 patients, while the WHO says most countries have a ratio of 1:1 000 or, at the worst, 1:1500.
"South Africa falls short," Mabasa said. "As a result, doctors are overworked. Any exhausted doctor will make mistakes. When you are treating patients, you must rest if you are tired. It is human nature to make mistakes when you have not had a break."
Doctors from the KwaZulu-Natal Health Department, which has an overdraft of R3.5bn, are the worst. Their misdeeds have resulted in the department spending R547 million on lawsuits in 2009/10 and R376m in 2008/09.
Just three weeks into the new financial year, the provincial department has already paid out R87m in medical legal bills and has 294 cases pending.
Mpumalanga said it spent R19m last year on medically related legal bills - up from R666 643 in 2008/09.
Last year Gauteng spent R10m on medical legal fees, up from R2.8m the previous year.
The Western Cape spent R6m and R4m in the two years while North West spent R1.7m and R11.5m.
The Free State Health Department appears to be the only province that managed to keep claims against it under R1m. It paid out R577 000 in medical legal fees last year and R916 000 the year before. The Eastern Cape paid more than R8m in legal fees last year.
Since 2007, the Northern Cape has spent R23m in legal fees.
The Limpopo Department of Health and Social Development refused to disclose what it has paid out in lawsuits. Spokesman Selby Makgotho argued that the figures were "confidential".
Motsoaledi has said regulations and policies on patient care were being ignored by doctors and nurses.
Motsoaledi recently told Parliament's portfolio committee on health that he planned to commission an investigation of the reasons behind the negligence and state of care in public hospitals. Here's a list of recent shocking cases of patient neglect and lawsuits:
- In Mpumalanga, the department paid out R14m after being sued for R27m in a case in which a child born at the Mmametlhake Hospital in Nkangala experienced medical problems and the findings of an investigation showed negligence by staff. The child will need permanent care; hence the amount claimed. The nature of the negligence is still unclear.
- The father of a 15-year-old boy instituted a R12m claim against Alberton neurosurgeon Jaap W Earle two weeks ago - his son went blind after a minor operation in 1999.
- In November two-year-old Thembisa Kometsi was admitted to Far East Rand Hospital and later transferred to Charlotte Maxeke Johannesburg Academic Hospital for burns on her hands. Her legs were amputated. A legal and disciplinary process is under way.
- Jayanthie Devi Sonny, who gave birth to a baby with Down's syndrome in 2002, is suing the KZN Health Department for R6.6m, saying she would have terminated the pregnancy if she had been informed that there was a risk of her child suffering any abnormality.
- In March a Wynberg woman launched a damages action against Western Cape Premier Helen Zille, alleging that Tygerberg Hospital staff failed to remove part of her placenta after she gave birth, resulting in her suffering septicaemia and cardiogenic shock. She is suing Zille for R495 000 in her capacity as premier, saying Zille is responsible for the administration of the state hospital.