​The implementation of the medico-legal strategy by the Gauteng Department of Health has significantly reduced the costs associated with medico-legal claims. This comes after the Department has worked to improve financial management and accountability, which led to a notable decrease in contingent liabilities over the recent financial years. 
From an opening balance of R24.7 billion in the beginning of 2019/2020 fiscal year, which was slightly reduced to a closing balance of R23.7 billion by March 2020. Notable reductions continued in subsequent years, culminating in a closing balance of R13.2 billion for the 2023/2024 fiscal year.
The Department achieved a reduction of roughly R6 billion in the fiscal year 2022/2023 alone, and R4.8 billion in the fiscal year 2023/2024. This consistent downward trend can be attributed to the effectiveness of the medico-legal strategy and interventions implemented.
Additionally, the Department archived 802 dormant matters with a total claim value of R7.2 billion, in line with the Policy on Management of State Litigation Contingent Liability. 
As part of a proactive approach, mediation strategies to resolve claims have been implemented. For instance, in October and November 2024, a total of nine (09) matters with a combined claim value of R91.8 million were successfully mediated, resulting in settlements and savings. In October 2024, two (02) of four (04) mediated matters were settled at a total of R26.3 million. Moreover, in November 2024, one matter was settled, yielding savings of R7.9 million, further demonstrating the effectiveness of mediation in reducing claim values.
At the clinical level, several interventions are implemented to improve patient care and reduce adverse incidents. These include an improved referral system to manage patient flows effectively. Furthermore, the capacitation of Emergency Medical Services (EMS) has improved response times, while increased capacity to care for patients who have experienced adverse incidents has been established. 
The Department has also embraced a public health defence model by facilitating in-kind support rather than large monetary settlements. Furthermore, the "I Serve With A Smile" initiative continues to be rolled out across facilities to address staff attitudes and bolster morale, creating a culture of empathy and compassion throughout the healthcare system.
The Department will continue implementing the medico-legal strategy, leveraging on mediation and strengthening internal control measures to further reduce medico-legal claims by effectively managing contingent liabilities and promoting responsible fiscal policies.