This is the government's strategy to tackle the healthcare crisis amidst doctor unemployment in SA

This is the government’s strategy to tackle the healthcare crisis amidst doctor unemployment in SA

After scores of unemployed doctors and medical students marched in Pietermaritzburg on Monday to hand in their CVs at the KwaZulu-Natal health department, we take a look at what the government plans to do about the healthcare crisis plaguing South Africa.

In a recent statement issued by the health department, the department said it plans to tackle the issue it has had several meeting with National Treasury.

“Given the fiscus challenges the country is facing as alluded by the minister of finance, the department has had several bilateral engagements with National Treasury to find creative ways to shield the healthcare service and the frontline workforce,” read the statement.

This crisis rears its head only days after President Cyril Ramaphosa vowed to improve the quality of healthcare and equality of access during his State of the Nation Address.

“While our health system has had a great impact on people’s lives, we are working to improve both the quality of healthcare and equality of access. The National Health Insurance will provide free health care at the point of care for all South Africans, whether in public or private health facilities,” said Ramaphosa.

“We plan to incrementally implement the NHI, dealing with issues like health system financing, the health workforce, medical products, vaccines and technologies, and health information systems.”

The department added that challenges emerged after the 7.5% salary adjustment agreement at the Public Service Bargaining Council.

According to the health department, this was not budgeted for.

“This means that as health, we must fund this general salary adjustment from within the available budgets. Minister of finance in the [Medium Term Budget Policy Statement] MTBPS provided a 65% relief from the salary adjustment.”

The department reiterated that it aims to employ as many health professionals as possible due the critical role they play in South Africa’s public health system.

“The issue of doctors who wish to stay in the public service employment is of major concern to us as the department, hence we are doing everything possible, working with the provincial health departments to mobilise resources to fund vacant posts, especially in health facilities in underserved communities.”

The department added that the provinces advertise posts in line with the employment guidelines as issued by the department of public service and administration.

“However, they place adverts at varying times depending on several factors, especially budget availability,” read the statement.

How does the training and deployment for medical doctors work?

– Medical school graduates undergo a two-year internship in Health Professions Council of South Africa (HPCSA) accredited health facilities.

– After internship, they must complete a one-year community service in designated facilities by the national department of health, prioritising rural, township, or marginalised areas.

– All eligible graduates for internship placement have been placed, as well as those finishing internship and starting community service.

– After completing community service, doctors are registered with HPCSA as Medical Officer Independent Practice, enabling them to work autonomously, including as private practitioners.

Statistics

According to reports, there are hundreds of unemployed doctors – 825 doctors to be exact.

SA Medical Association Trade Union submitted a list of 825 unemployed medical doctors in January, but 694 had just finished community service.

Despite the crisis, the department said there has been an annual increase in medical doctor employment despite the funding constraints.

Annual increase in medical doctor employment: 1,472 (2018), 1,879 (2019), 2,315 (2020), 2,271 (2021), 2,155 (2022), 2,365 (2023), 2,210 (2024).

Annual increase in community service placements: 1,340 (2020), 1,541 (2021), 2,063 (2022), 1,965 (2023), 2,101 (2024).

Since October 2023 to date, the department claims 564 medical officers’ posts were filled, 239 posts are currently advertised in public media outlets and 375 “will be” advertised in the next six months.

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