Health Minister Aaron Motsoaledi has issued an ultimatum to lawyers to withdraw fraudulent medico-legal claims over the next 2 weeks or face prosecution.

Motsoaledi and the Special Investigating Unit revealed over the weekend that there is widespread corruption, fraud and maladministration related to medico-legal claims in the public health care sector, worth billions of rand.

“We wish to take this opportunity to make an offer to lawyers, who might have knowingly submitted claims that are fraudulent, to withdraw them within two weeks and there will be no consequences. Failure to withdraw within two weeks would mean that the offer will have lapsed and the SIU will strike.”

He says the investigation into fraud has already saved the department more than R3 billion. Motsoaledi says the investigation is ongoing and more corrupt claims will be exposed.

The Minister says medico-legal claims have become a ”feeding trough for unscrupulous legal practitioners.”

The damning and ongoing investigation by the SIU has revealed that some legal practitioners have been targeting provincial Departments of Health – at times with the help of health practitioners working for the State.

“[The] Department of Health noticed several claims which were completely out of sync and made no sense at all. There were claims that were evidently fraudulent.

“Just as an example, a claim was submitted in which the claimant demanded R70 million for a supposedly botched circumcision by a doctor in a hospital in Limpopo province. On investigation of this claim, it was found out that no such circumcision was ever performed,” Motsoaledi said.

The Minister explained that during the investigation, it was revealed that during 2015, the number of medico-legal claims grew exponentially.

“This explosion happens to have coincided with the Road Accident Fund (RAF) strengthening its systems. It is common cause that RAF had been hollowed out by a multiplicity of claims that brought it to its knees.

“In the aftermath, legal practitioners who used to litigate against RAF seem to have migrated en masse to the health care sector. In response, the Department of Health convened a medico-legal claim summit in 2015,” Motsoaledi said.

The provincial breakdown of medico-legal claims investigations finalised by the SIU is as follows:

• Eastern Cape: 89 matters to the value of R1.2 billion (unfinalised matters: 108 matters to the value of R2.6 billion)
• Free State: 30 matters to the value of R280 million (unfinalised: 22 matters to the value of R120 million)
• Gauteng: 58 matters valued at R66 015 234 (unfinalised: 2 392 matters valued at R23 783 535 552)
• KwaZulu Natal: 107 matters valued at R2 416 284 800 (unfinalised: 1 420 matters valued at R18 020 272 612.60)
• Mpumalanga: 902 medico-legal claims unfinalised investigations valued at R10 115 964 997.77
• Limpopo: 63 medico-legal claims valued at R139 753 944.09 (unfinalised: 698 medico-legal claims valued at R2 732 710 053)
• Northern Cape: one medico-legal claim finalised valued at R23 250 000 (unfinalised: 19 medico-legal claims valued at R535 305 250)
• North West: 12 medico-legal claims to the value of R32 million (unfinalised: 20 medico-legal claims to the value of R190 million)
• Western Cape: Preliminary assessment of raw data/databases of claims provided by the Office of the State Attorney is still underway.

Between 2015/16 and 2020, Provincial Health Departments paid out a total of more than R7 billion in medical claims.