Abstract:
Patient safety is a serious global public health issue. Approximately 1 in 10 hospitalised patients are harmed by medical mistakes. Most of these adverse events are preventable. Medical error causes substantial morbidity and mortality. Unsafe care is not only responsible for immeasurable suffering, but also substantial added (and unnecessary) financial expenditure. Developing countries that can ill-afford these additional costs, likely face an even greater burden of harm. As South Africa transitions toward Universal Health Coverage, access to safe care will become all the more important. Lamentably, the poor performance of the public health system has compromised the care many patients receive. Increased instances of substandard care have probably also contributed to the recent proliferation of malpractice claims. The malpractice system has traditionally been the point at which the law and medical errors converge. This confluence and the recent regulatory and policy developments are examined to assess whether it is possible to reconcile patient safety and liability. By adopting a systems approach to error (as employed in other high-risk industries), inclusive of a safety/just culture, the healthcare and malpractice systems can be better aligned to foster prospective collective accountability. This approach, in turn, would not only create an environment conducive to safer care but could also allow for the application of processes rooted in restorative justice theory, that might assist in the healing of harm.
