On-line version ISSN 2078-5135
SAMJ, S. Afr. med. j. vol.100 n.10 Cape Town Oct. 2010
Medical indemnity regulations: MPS maintains commitment to South Africa
To the Editor: I want to reassure members of the Medical Protection Society and readers of the SAMJ that the surprise new government regulations on indemnity will not diminish our longstanding and strong commitment to the South African medical and dental professions.
We had no warning of the new regulations and we know their publication has caused a great deal of uncertainty, but the regulations will not affect MPS members until the end of December and in the meantime we are committed to doing everything we can to find a long-term solution.
The MPS has operated in South Africa for over 50 years and we want to be here for another 50. We have 25 000 members in South Africa, and each of them is important to us. As a mutual, our ethos, when looking at whether to offer our services and support in a country, is to ask the question: does the profession want us? We have been overwhelmed by the support we have received from our members over the past week, and this has galvanised our search for a solution that will allow the MPS to continue to indemnify and support doctors and dentists in South Africa. We are also encouraged by the response of government agencies and regulators who have voiced a strong desire for us to remain.
We do not dispute the principle behind the regulations; we agree that medical professionals should have compulsory professional indemnity so that they and their patients are protected if something avoidable goes wrong. We also support the requirement that indemnifiers should be capable of regulation. Our objection - our strong objection - is the preclusion of the indemnity that the MPS provides, which is widely regarded as the best available. Although it is discretionary, it allows us the flexibility to provide help and support in circumstances where a claim may otherwise be rejected by an insurer. In our long history there has been no case of the MPS declining to meet a proven claim of negligence that has resulted in a patient being left uncompensated. The occurrence-based nature of MPS indemnity means that doctors only need to be a member of the MPS at the time something goes wrong; after that, assistance can be requested at any time even if the doctor has moved away, taken a career break or retired. This provides comfort and peace of mind for the doctor and his or her patients.
In contrast, insurance contracts are complex and are governed by the wording of the policy conditions. They also are invariably based on the 'claims made' principle, which means that cover ceases at the end of the policy unless the individual doctor purchases 'run-off ' cover to meet past incidents that have yet to be reported as claims. It is because we so firmly believe in providing our members with what is best for them and their patients that we remain so committed to our discretionary occurrence-based model of indemnity.
I want to emphasise that the MPS is far more than a provider of professional indemnity against claims of negligence. We also assist with any problem that arises from a doctor or dentist's professional practice. This might include advice on ethical issues or support with disciplinary proceedings, inquests or medical council inquiries.
One of the core benefits of membership is our confidential counselling service, which we fund because the pressures facing those working within health care are such that the consequences of even the smallest error can be personally devastating for the individual doctor.
The MPS has accumulated a vast wealth of experience and expertise in medico-legal issues over many years and from more than 30 countries - we are truly world experts in our field. The MPS is committed to help improve patient safety, and we share our expertise to help prevent future problems occurring. We do this through lectures, seminars, courses and workshops. For doctors our influential publications such as Casebook and Junior Doctor are core components of continuing education, and we regularly develop materials on important matters such as consent and risk management issues.
We have evolved over the many years we have been in South Africa and, with the support of members and the profession, we want to evolve further in the future. We hope you will support our campaign to persuade the Minister of Health to review the new regulations and to allow us to continue to provide a high-quality service to our members and their patients. As our attempts to secure a solution progress, we will update you on progress regularly via the MPS website. No one should be in any doubt of the intensity of our activity to find a solution that is acceptable to the profession and to government.
South Africa is and will remain of immense importance to the MPS.
A D Mason
Medical Protection Society