Lerato Mbhiza
THE government lacks enough doctors to meet the needs of patients who rely on public hospitals and clinics, but cannot afford to hire more, health minister Joe Phaahla conceded on Monday.
The minister said his department has also been affected by budget cuts as the state looks to curb spending.
About 1,000 doctors who completed community service in 2023 are unemployed, according to Akhtar Hussain, chair of the employed doctors’ forum of the SA Medical Association (Sama).
Some of the desperate doctors have taken to social media to highlight their plight where they are sitting at home unemployed while the public health sector is crumbling under the strain of not having enough doctors.
Dr Phaahla held a public briefing to address the ongoing public outcry around this, after a number of qualified doctors affiliated to unions staged a protest in Tshwane last month, where they marched from Heartfelt Arena in Thaba Tshwane, Pretoria, to hand over a memorandum of demands to the Minister of Health.
Phaahla said the department, and part of the government, wish for a situation where all graduates who have completed the statutory requirements of internship and community service, can get immediate employment in the public health sector.
“But there are a number of challenges in that regard. However, the opportunities are also there,” he said.
The minister mentioned budgetary restraints as the first obstacle, limiting the department from taking on new hires.
“Provinces face challenges due to budgetary constraints, with increasing pressure on healthcare budgets. The rising cost of employment, including salaries, poses a significant challenge, making it difficult for provinces to allocate funds for new positions,” he explained.
He also said that the healthcare sector had complex salary structures, including overtime benefits, which contribute to a high salary bill.
“The second point to emphasise is that healthcare service is delivered in health facilities by a team of health workers, and medical doctors are an integral part of these teams. The issue of doctors who wish to stay in 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,” added Phaahla.
He said the National Treasury allocates funding for internships and community service through a conditional grant for training.
“Due to the fact that, unlike internship and community service, which are a statutory requirement and are subject to placement by the Department of Health, independent practitioners have an individual choice of where to go. We are unable to know how many wish to stay in the public service until the numbers are collated by the medical associations and unions.
“It is important for me to indicate that whilst the phenomenon of rising numbers of unemployed graduates is being experienced across many sectors, in the public health sector, the employment of health professionals has been on a steady increase.”
However, the Minister clarified that once a doctor has finished community service, they are registered with the HPCSA in the category of medical officer independent practice. This means they can work on their own without supervision, including as a single private practitioner.
“We appreciate the fact that there are many medical officers who are now registered for independent practice, who prefer to stay in the public service.
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