{"id":60686,"date":"2024-02-07T12:55:13","date_gmt":"2024-02-07T12:55:13","guid":{"rendered":"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors"},"modified":"2024-02-07T13:03:16","modified_gmt":"2024-02-07T13:03:16","slug":"why-the-health-department-cant-employ-these-doctors","status":"publish","type":"post","link":"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors","title":{"rendered":"Why the health department can\u2019t employ these doctors"},"content":{"rendered":"

Africa-Press – South-Africa. <\/strong><\/span>South Africa has close to 700 medical doctors who haven\u2019t been able to find a job in the public sector since qualifying. The shrinking health budget, rising salaries and high medical negligence claims, have meant the department can\u2019t afford to employ these professionals.<\/p>\n

The medical negligence claims of close to R900m paid out in only one South African province in a recent financial year would have been enough to employ the country\u2019s documented 694 unemployed doctors, health minister Joe Phaahla said on Monday.Though Phaahla didn\u2019t name the province, a 2023 report from the auditor-general shows in 2021 the Eastern Cape paid out almost R867m in claims, while the salary bill for 694 newly qualified doctors (in 2023) would have been around R838m.<\/p>\n

Phaahla admitted: \u201cIt is a paradox. On the one hand, we’re dealing with amounts of money being paid out for claims, while at the same time we’re unable to employ people who help to reduce this.\u201d<\/p>\n

This year the South African Medical Association Trade Union, the watchdog for health practitioners\u2019 rights, informed Phaahla they had at least 800 unemployed medical doctors on their records. According to Phaahla this number dropped to 694 after the list was double-checked against the state\u2019s employee database, which showed the doctors had completed their community service on December 31.<\/p>\n

One example was Sunhera Sukdeo, who graduated cum laude from the University of KwaZulu-Natal in 2023. In early January, she wrote in Daily Maverick: \u201cIt is now January 2024. I am a cum laude medical doctor. I am sitting at home unemployed. But I am not alone. Most of my peers are in the same boat.\u201d<\/p>\n

The deputy director for human resources in the national health department, Percy Mahlathi, responded: \u201cThe problem that primary employers, the provincial departments of health, face is the struggle to receive adequate budgets. The financial squeeze felt by every government sector and the country impacts on the resourcing of health services.\u201d<\/p>\n

Phaahla said 239 medical officer positions have been advertised and 400 more will follow in the next few months. A medical officer is an entry-level GP who works in the public health sector. Most of the positions are in Gauteng, Mpumalanga, Free State and the Eastern Cape.<\/p>\n

Ironically, universities have, in less than a decade, increased the number of medical interns they\u2019ve trained by about 60% \u2014 from 1,470 to 2,365, Phaahla said \u2014 to address the doctor shortage in government hospitals and clinics, but National Treasury has not increased provincial health departments\u2019 budgets at the same pace. As a result, they don\u2019t have budgets to employ the increasing number of graduates, despite many vacant positions.<\/p>\n

Medical interns are medical students who have completed their degrees but have to complete two practical years in a government health facility under the supervision of staff who work at a state hospital.<\/p>\n

Provincial health departments, according to Phaahla, spend 70% of their budgets on health worker salaries, but it\u2019s not nearly enough.<\/p>\n

In 2021, about one in seven doctor\u2019s positions in hospitals were unfilled, while one in five positions for doctors were vacant at clinics. This shortage of professionals in the public sector, given that more than 70% of South Africans use government facilities, means there are about three doctors for every 10,000 patients in the public system.Because of the increase in the number of medical students universities trained between 2018 and 2023, the state had to find money to pay 895 more interns within five years, which, according to Phaahla, amounted to just over R800m at a salary of R900,000 per intern per year. This includes overtime.<\/p>\n

The number of community service doctors, who earn around R1m per year (R1.3m if they work in a rural area), according to Phaahla, grew by almost 60% too between 2020 and 2024 (from 1,340 to 2,101), which meant government had to fork out an extra R913m for their salaries.<\/p>\n

Phaahla warned the pressure on the health department\u2019s purse is made worse by a 7.5% increase in public health worker salaries, negotiated between government and trade unions in 2023, which means fewer new workers can be appointed.<\/p>\n

\u201cWe received around 65% of the additional costs [caused by the salary hike]. It was a bit of a cushion, but we still needed to find within our budget the remaining 35%.\u201d<\/p>\n

Phaahla warned there\u2019s no \u201cautomatic placement\u201d for qualified doctors in the public sector.<\/p>\n

\u201c[While] we wish [employing newly qualified doctors] would be seamless, we must take into consideration that, once [a doctor is] out of the regulated training and community service, [they] are almost like any other profession. When [you\u2019ve] completed all your training, you are going to [apply] where opportunities are.\u201d<\/p>\n

Health system in crisis?<\/p>\n

Pressed about whether the department\u2019s funding woes are plunging the public health system into crisis, Phaahla responded that \u201cit\u2019s really a choice of description\u201d about what you call a crisis.<\/p>\n

However, in December, a committee of deans representing health sciences faculties from universities across South Africa warned that failing to fill community service posts \u2014 whether for doctors or any other health professions where graduates need to complete the mandatory year or two of work, such as dietitians, dentists, physiotherapists and radiographers \u2014 could lead to exactly that in future.Why? Because not having enough money available for community service posts will affect the quality of care for patients, especially in rural areas \u2014 the communities the in-service training programme was supposed to help \u2014 they wrote in a statement.<\/p>\n

\u201cWe already have poor provision of [these types of] services across our system and community service appointments are often the only care our people get,\u201d Lionel Green-Thompson, dean of health sciences at the University of Cape Town and chair of the South African Committee of Medical Deans, told Bhekisisa.<\/p>\n

The money crunch affects staff across all health professions, not only doctors. Since 1998, newly graduated health workers such as dentists, physiotherapists, radiographers, dietitians and environmental health practitioners have all been required to work at public hospitals or clinics for a year of community service before they\u2019re deemed fully qualified.<\/p>\n

The policy was introduced to make sure people who use state health facilities, especially those in rural areas, also have access to specialist and rehabilitation care.<\/p>\n

But more so, Green-Thompson explained, medical schools were concerned about posts not getting filled being a regular occurrence.<\/p>\n

Phaahla conceded at Monday\u2019s briefing that \u201cthe pressure on the fiscus did not happen overnight\u201d.<\/p>\n

Treasury vs training<\/p>\n

In their December statement, the committee of deans said they\u2019re concerned budget cuts will affect the quality of training for health sciences students which will have a knock-on effect on service delivery in state facilities. Already, community service placements are determined more by the needs of the facility, with less of a focus on training and improving the skills of newly graduated healthcare workers.<\/p>\n

Rural facilities in particular don\u2019t have many permanent healthcare workers as it\u2019s difficult to keep staff there because of poor conditions, such as equipment at hospitals or clinics not working, too few personnel and bad roads making it difficult to get supplies. Many of the facilities therefore rely on the work provided by new graduates doing their community service.<\/p>\n

Though universities have answered the government\u2019s calls to increase the number of graduates in health sciences, provinces are struggling to match the supply with available posts, said Green-Thompson.<\/p>\n

\u201cWe have called [in the past] for a clearer management of the required financial resources and the emerging numbers of graduates,\u201d he said.<\/p>\n

Green-Thompson said having graduates sitting at home while they could have been deployed to areas in need will leave many patients without access to professionals such as speech pathologists and occupational therapists in the public sector.<\/p>\n

Phaahla said: \u201cWe are not in the best of situations. We would have preferred to be in a position to employ everybody who wants to serve [in the public sector].\u201d<\/p>\n

For More News And Analysis About South-Africa<\/a> Follow Africa-Press<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Africa-Press – South-Africa. South Africa has close to 700 medical doctors who haven\u2019t been able to find a job in the public sector since qualifying. The shrinking health budget, rising salaries and high medical negligence claims, have meant the department can\u2019t afford to employ these professionals. The medical negligence claims of close to R900m paid […]<\/p>\n","protected":false},"author":84,"featured_media":60685,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,3],"tags":[274,315,275],"class_list":["post-60686","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all-news","category-community","tag-africa-press","tag-africa-press-south-africa","tag-south-africa-2"],"yoast_head":"\nWhy the health department can\u2019t employ these doctors - South Africa<\/title>\n<meta name=\"description\" content=\"South Africa has close to 700 medical doctors who haven\u2019t been able to find a job in the public sector since qualifying. ...\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Why the health department can\u2019t employ these doctors\" \/>\n<meta property=\"og:description\" content=\"South Africa has close to 700 medical doctors who haven\u2019t been able to find a job in the public sector since qualifying. ...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors\" \/>\n<meta property=\"og:site_name\" content=\"South Africa\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/AfricaPressTunisiaa\" \/>\n<meta property=\"article:published_time\" content=\"2024-02-07T12:55:13+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-02-07T13:03:16+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/static.africa-press.net\/south-africa\/sites\/31\/2024\/02\/sm_1707298288.383251.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"750\" \/>\n\t<meta property=\"og:image:height\" content=\"500\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"cfeditoren\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"cfeditoren\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors\"},\"author\":{\"name\":\"cfeditoren\",\"@id\":\"https:\/\/www.africa-press.net\/south-africa\/#\/schema\/person\/068c7ab4e9634ae78ec5d54ec46598bb\"},\"headline\":\"Why the health department can\u2019t employ these doctors\",\"datePublished\":\"2024-02-07T12:55:13+00:00\",\"dateModified\":\"2024-02-07T13:03:16+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors\"},\"wordCount\":1325,\"commentCount\":0,\"image\":{\"@id\":\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors#primaryimage\"},\"thumbnailUrl\":\"https:\/\/static.africa-press.net\/south-africa\/sites\/31\/2024\/02\/sm_1707298288.383251.jpg\",\"keywords\":[\"Africa Press\",\"Africa Press-South-Africa\",\"South-Africa\"],\"articleSection\":[\"all news\",\"community\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors\",\"url\":\"https:\/\/www.africa-press.net\/south-africa\/all-news\/why-the-health-department-cant-employ-these-doctors\",\"name\":\"Why the health department can\u2019t employ these doctors - 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