- Free State Department of Health must pay R2.8 million for a child’s urgent medical and rehabilitation needs.
- The child has severe cerebral palsy and multiple permanent disabilities after being admitted due to medical negligence
- The judge found the department did not prove that public healthcare could meet the child’s urgent needs.
A six-year-old girl living with severe cerebral palsy and multiple disabilities will receive R2.8 million for urgent medical treatment and care after the High Court in Bloemfontein ruled that her needs could not wait for the finalisation of a R31 million medical negligence claim.
The child suffered a hypoxic-ischaemic brain injury following a cardiac arrest during anaesthetic induction. The Free State Department of Health has already admitted liability for the negligence that resulted in her injuries, paving the way for the family to seek financial assistance while the main damages claim remains pending.
Judge M Opperman said the child’s condition was severe and required immediate intervention. The court found that delaying access to treatment and rehabilitation would place a vulnerable child at further risk while litigation continued.
Daily life shaped by profound disabilities
The judgment paints a devastating picture of the child’s daily reality. Medical evidence before the court showed that RD suffers from severe cognitive and neurological impairments, cortical blindness, epilepsy, impaired auditory processing and severe physical disabilities affecting all four limbs.
She is unable to sit, stand or walk independently and depends entirely on caregivers for every aspect of daily life. The child is also non-verbal and experiences significant feeding difficulties, bladder and bowel incontinence, scoliosis, hip dislocations and severe muscle spasticity.
“The consequences of the injury are severe,” Judge Opperman noted when considering the medical evidence presented to the court.
Family battling financial hardship
The court heard that the child lives in Leribe, Lesotho, where her grandmother has become her primary caregiver. Her mother works on temporary teaching contracts and earns about LSL2,500 a month, while her father works as a construction worker on short-term contracts, earning between LSL4,000 and LSL5,000 monthly.
Both parents contribute towards the child’s care, treatment and day-to-day expenses. Their financial resources are extremely limited and already under considerable strain because of the demands associated with caring for a child with profound disabilities.
The family has struggled to secure appropriate care and has relied on untrained caregivers to assist the grandmother. The demands of caring for RD have resulted in a high turnover of caregivers, creating further challenges for the family and affecting the consistency of care available to the child.
Department argued public healthcare could provide treatment
The Department of Health opposed the application, arguing that Universitas Academic Hospital in Bloemfontein was capable of providing the treatment and therapy required by the child. It also argued that the amount sought was excessive and suggested an interim payment of R1.5 million instead.
The department maintained that specialists, therapists and rehabilitation services were available within the public healthcare system and that the child’s future medical expenses claim could ultimately be reduced. It further argued that the child was already receiving treatment through public healthcare systems in both South Africa and Lesotho.
However, the court found that the department failed to place expert evidence before the court to support those assertions. “The submission that Universitas Hospital can provide the required care remains a bare assertion,” Judge Opperman said. “It does not engage with the specific and complex needs identified in the applicant’s expert reports, nor does it address issues of accessibility, timing, or adequacy of such care.”
Child’s interests take priority
Judge Opperman stressed that courts are required to place the interests of children above all other considerations. The judge found that the family had presented detailed medico-legal reports showing the urgent treatment, therapies and support services required by the child.
In contrast, the department had not produced sufficient evidence to demonstrate that equivalent care would be available through public healthcare facilities in a timely and effective manner. The court found that the legal requirements for an interim payment under Rule 34A had been met.
“In matters concerning children, the court must adopt an approach that best serves their interests,” the judge said. “To refuse interim payment in the absence of convincing opposing evidence would, in effect, prejudice a profoundly vulnerable child and undermine those interests.”
The judgment also highlighted concerns about delays in litigation involving children with serious disabilities. “Matters involving young children demand urgent and diligent attention from all concerned,” Judge Opperman said. “The interests and welfare of the child remain paramount.”
Larger claim still to be decided
The R2.8 million payment covers only urgent medical, hospital and related expenses for a limited period while the main case continues. The family’s broader claim exceeds R31 million and includes future medical expenses, loss of earning capacity, caregiving costs, trustee fees and general damages.
Judge Opperman ordered the department to pay R2,810,317 within 30 days. The money will be used to fund urgent treatment, therapy, equipment and related care while the main action proceeds.
The department was also ordered to pay the family’s legal costs. The court emphasised that matters involving children require urgent attention and warned against delays that could prejudice their welfare and long-term interests.
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