The locality rule in the South African public health care system observations and applications

Abstract

Provision of health care to the almost 60 million people residing in South Africa (SA) relies on two separate Health Care Systems operating in intermingled geographical proximity, yet in truth representing vastly different working environments or Localities. This study is necessary against the stark reality that - generally speaking - the quality of health care in one Locality (SAPubHC System) is inferior to that in the other Locality (SAPrivHC System) and this to a seemingly increasing magnitude. The study will set out firstly, to identify clinically-relevant factors both from International and SA court rulings where the LR was applied ? mostly in the traditional geographical context. Clinically-relevant factors from every-day clinical practice in the SAPubHC System will then, secondly, be identified and examined. Based on these locality-specific clinically-relevant factors, the projected output of the study will extend towards identifying specific areas where SAPubHC Practitioners may be at risk of litigation by virtue of subjective and/or objective factors present in their specific Locality. Additionally, and of equal importance, is the identification of areas where timeous intervention could prevent adverse clinical outcomes, enhance service delivery, and improve patient care. The projected impact of this study - so it is yearned for - will be firstly towards the possibility of the recognition of the SAPubHC System as a compromised environment. The second impact - flowing from the first - would be toward the possibility of the on-going application of the LR by the Judiciary in cases of medical negligence litigation involving SAPubHC Practitioners.