Private practice obstetrics crisis looms
There is great cause for concern as skyrocketing insurance premiums are putting many obstetricians out of work
THE future of obstetrics in the private sector hangs in the balance as South Africa waits on national Health Minister Aaron Motsoaledi to rescue the sector from what he has termed a ‘national crisis’.
Owing to exorbitantly high indemnity insurance premiums, obstetricians in the private sector are being forced into early retirement, leading to the closure of some private hospitals’ maternity wards.
The situation has arisen from a contingency law, which allows lawyers to get involved in malpractice suits, sometimes initiating such suits, earning 30% of the payout.
As a result, insurance premiums have skyrocketed and numerous private practice obstetricians have opted to stop delivering babies, working only in gynaecology.
The 24-week mark in a pregnancy is the point where gynaecology becomes obstetrics and it is at this point that doctors are referring patients to obstetricians who can do the delivery.
‘Not everybody has the same insurance, therefore some obstetricians can still afford to continue, for now,’ said Richards Bay obstetrician Dr Abraham Warnich.
Should the situation worsen, however, worst case scenario is that there will be no private practice obstetricians, forcing patients of private gynaecologists to deliver at a state hospital.
‘Empangeni and Richards Bay are safe – for now – as local obstetricians enjoy good working relationships and patients are guaranteed to deliver in private hospitals,’ said Warnich.
Those concerned about potential safety risks that this ‘referral’ system could pose need not be, as a patient seen by a specialist up to the point of referral will have a comprehensive referral report.
‘Quality care up to 24 weeks is crucial and includes all screening, ultrasound and blood tests. This can still be offered by a gynaecologist. He or she will refer the patient with all the relevant information to the obstetrician,’ confirmed Warnich.
This year, obstetricians’ indemnity premiums are R750 000 per annum, and this amount is expected to rise to R1-million in the near future.
According to Warnich, professionals in the sector warned the Department of Health some 10 years ago, to no avail.
Motsoaledi held a meeting with relevant stakeholders, including the SA Society of Obstetricians and Gynaecologists (SASOG), in December.
According to SASOG President Johannes van Waart, each obstetrician must deliver 17 babies monthly just to cover their insurance premiums.
‘This is a real, real crisis,’ he said.
Van Waart added that without private practice obstetricians, the state health system would not cope with the 140 000 deliveries in the country annually.
‘We are aware that [obstetricians] are being litigated out of practice and that indemnity cover is expensive,’ said Department of Health spokesperson Joe Maila after the meeting in December.
There has been no outcome as yet.
HAVE YOUR SAY
Like our Facebook page and follow us on Twitter.
For news straight to your phone invite us:
WhatsApp – 072 069 4169
Instagram – zululand_observer
