South Africa’s healthcare system is facing a dire shortage of doctors, particularly in the state-run public healthcare system, which has run out of money to employ new doctors who are increasingly turning to the private sector for employment.
This is feedback from the chairperson of the South African Medical Association (SAMA), Dr Mvuyisi Mzukwa, who told Newzroom Afrika that some doctors even leave the country as there are no jobs here for them.
Mzukwa’s comments come on the back of a revelation that 800 qualified doctors are not being employed in public health posts because of a shortage of funds.
He said the problem is rooted in poor planning and not only in cuts to the Department of Health’s budget.
As the public sector provides the majority of healthcare services in the country, there should be a clear understanding of the resources the department needs and how this may change in the future. This planning has not happened.
Mzukwa added that the government is concealing the number of openings in the public sector as it is not replacing doctors who retire. It is rather erasing the posts held by former doctors.
“In the state system, there is a dire shortage of healthcare workers, especially doctors. In rural areas, the shortage is particularly dire,” he said.
The shortage of healthcare workers extended from nurses to highly trained specialists whom the public sector is also unable to employ for various reasons.
Mzukwa said many of these specialists end up working in the private sector, leaving the country, or remaining in their current posts rather than filling a specialised role.
“The problem is you are leaving the public healthcare sector in a dire state because there is a shortage of staff, and those that remain are overworked,” he explained.
This, in turn, has a chilling effect on future doctors who are wary of working in the state-run system because of the workload and deteriorating work conditions.
The implementation of National Health Insurance (NHI) will make the problem worse as it will require the government to rapidly expand the capacity of the existing healthcare system and employ more people.
The NHI, as currently outlined, will not increase the funds available to train and hire new doctors but will only pay for services on behalf of South Africans. The capacity of the system will not be improved.
Ultimately, the NHI is only a funding model and not a piece of legislation that will reform healthcare in South Africa.
Trade union Solidarity comments
Trade union Solidarity said the latest data is in stark contrast to Deputy Director General of Health Dr Nicholas Crisp’s statements.
Crisp said that there was no shortage of doctors because the Department of Health “at this stage is struggling to give work to all the doctors qualified in this country.”
He is also a prominent campaigner for the implementation of the National Health Insurance (NHI).
“Although he denies that there is a shortage of doctors in South Africa, there is some contradicting evidence,” Solidarity said.
“Up to a thousand frustrated junior doctors are asking for solutions on social media and elsewhere to their frustration with the problems regarding their placement for community service and jobs.”
Theuns du Buisson, economic researcher at the Solidarity Research Institute (SRI), said the Department of Health is concealing the real reason for the failure to place doctors.
“The core of the problem lies in a serious shortage of funds, and Dr Crisp chooses to ignore it,” Du Buisson said.
“The Department of Health is experiencing serious challenges financially and with management, leading to an inability to place healthcare graduates.”
He said the problem extends beyond just the immediate issue of unemployment and career frustration among doctors.
“This has an impact on access to healthcare for millions of South Africans, especially in communities where doctors in their community service years are the only doctors available,” he said.
Du Buisson added that many doctors have already indicated that they will emigrate under the new proposed NHI system.
Solidarity appealed to the government to urgently put structures in place to get doctors placed.
“We hope that this state of affairs will be a wake-up call to the government to abandon its plans with the NHI and its much larger structures,” it said.